Collaborative Communication

Dr. Cohn discussing collaborative communication with physician leaders

I smile that I am writing about collaborative communication because in residency, if someone had predicted that I would be teaching physicians about leadership development, especially relationships, team-building, and communication, I would have answered, “Sorry God, you have the wrong actor.”

Yet, I had a wonderful time last week with physicians and their COO, talking about ways to avoid amygdala hijack, where our midbrain stress center overcomes the frontal lobe, and how taking just a few seconds to breathe, sip some water, ask a question, or take a bio break can prevent an outburst that may be difficult to apologize from and seek forgiveness.

One of the things that I learned is that when the COO confesses his episode of amygdala hijack, it makes it easier for physicians to confess their errors. As he said:

Admitting vulnerability is a strength, not a weakness.

His words reminded me of Brene Brown’s Ted talk on the The Power of Vulnerability, in which she states that vulnerability is the birthplace of love, joy, and belonging. A sense of worthiness underlies these sensations and promotes healthcare professionals connecting with one another.

Collaborative Communication: The Relevance to Healthcare

In a video, I mentioned that effective communication is aligned with the reason we chose careers in healthcare: to make a difference in patients’ and families’ lives. In addition, ineffective communication is associated with approximately 95% of malpractice suits and 2/3 of sentinel events. Effective communication underlies the IHI triple aim of improved patient experience, decreased costs, and improved population health.

Afterward, a physician participant came up to me and told me that he put the measures I taught into place when a mentally ill patient disrupted his clinic and was proud that the nurses wrote up his behavior as part of the solution rather than part of the problem. Moreover, the dividends extended outside the hospital setting, with another physician telling me that she gets along better now with her teen-age son, by asking him to help her rather telling him he has to.

It amazes me that my education in communication during residency came only from being called into my supervisors’ offices to be told that I did not do it right, rather than receiving education on how to do it right the first time. It does not surprise me now that all ten surgical nurses at Dartmouth whom I asked, “What should be the central aim of a system of surgical residency education,” answered that it should be to teach residents communication skills (Cohn K, Batalden P, Nelson E, Farrell T, Walsh D, Dow R, Mohr J, Barthold J, Crichlow R. The odyssey of residency education in surgery: Experience with a total quality management approach. Current Surgery, 1997; 54:218-224).