WUSM Pediatrics Leadership Development Series Difficult Conversations January

WUSM Pediatrics Leadership Development Series Difficult Conversations January 25, 2017 Dawn M. Newman, Ph. D. dawn. m. newman@wustl. edu Human Resources – Applied Leadership & OD

Introductions • Anyone in the class who was not here last week? If so, please introduce yourself, tell us your role, and what you’d like to accomplish in today’s session. 2

Effective Communication Quick Recap • What did you apply since last week? • Did you connect with an accountability partner? • What did you learn? 3

Objectives 1. Learn techniques/methods for holding difficult conversations. 2. Identify difficult/sensitive situations and steps to take to manage. 3. Know how to obtain receptivity from the other person. 4

Difficult Conversations • Think of a conversation you had recently (or plan to have soon) that was (is) “difficult” • Write down 3 -4 attributes that make the conversation “difficult” • Indicate your preference on the continuum Avoiding Addressing • Discuss your answers in your small group then share with the larger group 5

Attributes of a Difficult Conversation (from prior classes) • • • Lack of trust Fear of retaliation Emotional impact High stakes outcome Timing bad Anxiety Closed body language Avoidance Defensive Preformed opinions 6

Video • http: //smartbyt. es/7 R 6 OM • Why We Avoid Difficult Conversations • by Dr. Marcia Reynolds 7

AID Model (Reynolds, 2014) • Action – Describe the action that had the negative result • Impact – Share how the action had an impact • Desired Outcome – Clearly state the outcome you desire Reynolds, M. (2014). The discomfort zone: How leaders turn difficult conversations into breakthroughs. 8

Tips & Resources • We Have to Talk (Ringer, 2017) • http: //www. judyringer. com/resources/article s/we-have-to-talk-a-stepbystep-checklist-fordifficult-conversations. php • Handout: Six Step Checklist (Ringer, 2017) • http: //www. judyringer. com/perch/resources/ six-step-checklist-for-diff-conv-2. pdf 9

Let’s try…. Practice Round 1 • Choose a situation for a conversation • Prepare by using the AID model and/or Six Step Checklist (3 -5 minutes) • Pair up and practice (5 minutes) • We’d like two volunteers to demonstrate the approach in our safe environment • Others observe to capture what works 10

Giving & Receiving Feedback What works? Giving Receiving 11

Video • http: //smartbyt. es/GE 10 F IMS video • Three C's of a Difficult Conversation • by Dr. Marcia Reynolds • 3 C’s: Calm, Curious, Care (Reynolds, 2014) 12

Practice Round 2 • Choose a conversation you plan to have in the next week • Prepare using the tips & resources • Practice the conversation • Discuss what went well and what you will do in the “real” conversation • Please share a learning point 13

Additional Resources Rosenstein, A. H. (2012). Physician Communication and Care Management: The Good, the Bad and the Ugly. Physician Executive, 38(4), 34 -37. http: //libproxy. wustl. edu/login? url=http: //search. ebscohost. com/login. aspx? direct=tr ue&db=bth&AN=78855042&site=ehost-live&scope=site Shannon, D. (2012). Effective Physician-to-Physician Communication: An Essential Ingredient for Care Coordination. Physician Executive, 38(1), 16 -21. http: //libproxy. wustl. edu/login? url=http: //search. ebscohost. com/login. aspx? direct=tr ue&db=bth&AN=70548724&site=ehost-live&scope=site 14

“Difficult” Patients • A study of internists and family practitioners noted several characteristics* – Patients with mental health problems or >5 somatic symptoms – Patients who brought a list of complaints to the visit/frequent users of the health care system • In the pediatric population, it is often the parent who is the contributor to a difficult patient encounter • http: //pediatrics. aappublications. org/content/pediatrics/127/ 1/163. full. pdf *2010 Cora Breuner and Megan Moreno to the Difficult Patient/Parent Encounter Approaches 15

Difficult Conversations • Today I learned. . . 16