What do you think patients living with serious and life-limiting illness in your hospital, long-term care facility, or outpatient clinic would say if they were asked:
Over the past two days, how much have you felt heard and understood by the doctors, nurses, and hospital staff? Completely, quite a bit, moderately, slightly, or not at all?
In the February 2016 issue of Journal of Pain and Symptom Management, Robert Gramling and colleagues at the University of Rochester and University of San Francisco Medical Centers, published an article “Feeling Heard and Understood: A Patient–Reported Quality Measure for the Inpatient Palliative Care Setting.” This project is part of the Measuring What Matters initiative, a national palliative care quality improvement effort working to identify, promote, and refine measurable indicators of high quality care for patients with serious illness. Gramling’s work found that a large cohort of advanced cancer patients were able to complete the simple measure pre- and post-palliative care consultation, suggesting that it is easily understood, quick to administer, and is not burdensome for patients to use even when very ill.
From my experience working in palliative care, many patients are in fact often not heard and experience a significant lack of understanding by health care providers working in our complex and harried health care environment. This is one of the reasons we are placing a great emphasis on communication training and skills acquisition as we develop the curriculum for the new Master of Science in Palliative Care and Interprofessional Palliative Care Certificate programs at the University of Colorado Anschutz Medical Campus.
Breaking down the core concepts
In our first course, Core Concepts, Principles, and Communication Skills, we are working with experienced nursing, physician, social work, and spiritual care providers as well as communication training experts to craft both online training and on-campus weekend-intensive lessons. The course includes experiences with simulated patients and families, enabling students to develop the high-level of skill and confidence needed to immediately apply to their own practice in their community setting. In addition, we have developed an innovative case-based approach highlighting 10 individuals with serious and life-threatening illness, their family caregivers, and providers. These cases will be used each week to introduce and illustrate the many issues patients encounter from pain and non-pain symptoms to the intricate psycho-social-spiritual issues that occur in every day clinical settings. Through these stories, we can weave, demonstrate, and reinforce exemplary communications skills to ensure patients and families can honestly say they felt heard and understood. We hope you will join us on our journey to improve palliative care in the community and beyond.