Shared Decision-Making and Open, Honest Communication Change Outcomes

Rick Boothman sharing insights on open and honest communication related to adverse events.

What an amazing and invigorating second day of discovery and consensus building at our Telluride Roundtable on “Open and Honest Communication Skills in Healthcare”. The high altitude and beautiful mountain valley scenery have ways of opening up creative thought processes that lead to amazing new ideas. Some reflections from day two:

  1. Our second day focused on what patients and family expect related to open and honest communications in the domains of (a) informed consent and (b) when harm occurs from our care. Rosemary Gibson and Helen Haskell led the morning session which quickly evolved from the concept of informed consent to one of shared decision-making. David Longnecker talked about the “partnership” between patients and their caregivers when decisions on care need to be made and stressed that open and honest communication must go both ways in those critical discussions.  Cliff Hughes from Australia and Rick Boothman from Michigan both highlighted that open and honest conversations between patients and caregiver is not only the first component in transparent care, it is one of the best risk management strategies an organization can put in place because open and honest conversation reduces the “surprise factor” that can occur later if care does not go as expected. The morning ended with the consensus conclusion that “open and honest conversations can change outcomes” when it comes to true informed consent and shared decision-making related to patient care.
  2. The afternoon session was devoted to building curricular models around open and honest communication when harm occurs. Rick Boothman and Tim McDonald led small group break-outs that put together a curricular model on the current medical-legal environment and how a “principled approach” to unanticipated harm reduces medical liability, improves patient safety and helps restore trust. The students were totally engaged and worked alongside patients and healthcare leaders to put together an outstanding curricular model that will help educate inter-professional caregivers and attorneys on the importance of open and honest communication in healthcare.
David Pierce sharing his small group work from one of the break-out sessions.

Day two was a remarkable day – everyone broke from our traditional mental models that held us back on Monday and focused all creative and disruptive energies on the topic at hand. The student’s active participation in both our small group breakouts and large group consensus building sessions added great insights. Their ability to see issues related to open and honest communication in healthcare without pre-existing biases brought emphasis to right from wrong.

A solid foundation for a curricular model on open and honest communication skills is now in place. I am confident participants will build on this foundation in the next three days and produce a solid product by the end of the week.