Proposed Topic (Most preferred): :
Enhancing Partnership with Patients and Community (Projects initiated to engage patients / carers / community to improve efficiency / quality of care)
Authors (including presenting author) :
Lau LSL (1), To YF (1), Leung SK (1), Tang TF (1), Wong SL (1), Wong KP (1), Pang SM (1), Cheng KM (1), Poon KH (1), Chan HC (1), Yip YH (1), Wan D (2), Chan A (2), Rudolph J (3), Cheng KS (4), Nguyen DGH (4)
Affiliation :
(1) Work Group on Simulation Training for Enhanced Communication, Kwai Chung Hospital, Hospital Authority, Hong Kong (2) Training and Development Team, Division of Human Resources, Hospital Authority Head Office, Hong Kong (3) Centre for Medical Simulation, Harvard Medical School, Boston, United States of America (4) Kwai Chung Hospital, Hospital Authority, Hong Kong
Introduction :
The challenges: The Hong Kong Hospital Authority (HA) received 1700 complaints from patients dissatisfied with their care in average from 2017-2023 every year, being 18% related to staff attitude out of the overall figure. This is not surprising in the busy psychiatric context. The gap: While HA provides excellent clinical skills training to our doctors, there is room of improvement in training doctors to be ready for time-pressured difficult patient conversations.
Objectives :
The authors presented major challenges that affected organization of simulation program and solutions for them.
Methodology :
Content: (1) This workshop utilized a blend of practical conversational skill repetition with feedback, psychiatry specific role-play case scenarios, video clips, shorts & interactive game to support observational learning, and reflective debriefing to support the development of new insights into the learners' conversational habits. (2) Devising psychiatry-specific training workshop: this required seeking seniors’ endorsement and peers’ acknowledgement in different governance bodies, writing up manuscripts for training videos with high clinical authenticity, engaging peers in production of training videos conducive in spreading culture of effective communication, ironing out logistics in running the workshop, formulating strategies in enrollment of learners, and sourcing support for funding. (3) The instructors were primed with contributions to psychological safety, and ways of restoring any deviations from it. (4) Aligning the approach of coaching by instructors: approaches of the instructors in coaching the learners of a diverse range of years of service were different. We advocate the approach of the ‘with good Judgement approach’, by holding learners to high standards and high regard. (5) Optimizing participation of learners: there were many constraints in assembling learners. Advanced planning to tackle between training need of learners and operation of services was very important.(6) Outcome measurement: given a diverse input of resources to the program, it was important to evaluate any benefits to the various stakeholders such as patients, clinicians and hospitals. We evaluated the workshop to what extent that the five objectives were met: (a) fostering a positive attitude in patient communication using attentive-empathetic-proactive approach; (b) understanding the four service steps in patient interaction , namely building rapport, understanding concerns, offering help & seeking collaboration, and the application in challenging situation;(c) being aware of communication pitfalls and make enhancement in verbal and non-verbal communication; (d) grasping tips in defusing the challenging situations with four service steps and relevant communication toolsets; (e) gaining insight on guest speaker's sharing.
Result & Outcome :
Given the constructive quantitative and qualitative feedbacks (figures 1 & 2), the simulation program allowed our doctors to address patient’s concerns and complaints respectfully and efficiently. Results of the evaluation guided for optimization of the workshop which facilitated the workshop to be held recurrently.
