Conversations at the End of Life
End of life communication with patients, families and colleagues presents a significant challenge for many clinicians. Often the needs of patients and families facing death go unmet because for many health care providers, the conversations about death and dying are uncomfortable and are often avoided.

This workshop is designed to give the practitioner a comfort level by offering six modules, offered to clinicians or teams, structured to promote good communication skills around end of life issues.

Team STEPPS: Team Strategies and Tools to Enhance Performance and Patient Safety
This training consists of 4-6hr sessions focusing on the communication within the healthcare team, teaching specific tools proven to create a highly functional team that delivers patient centered care. This type of training is particularly useful for teams in OB, OR and ER settings.

Clinical-Patient Communication to Enhance Health Outcomes
Clinician-patient communication underlies successful medical care. Until recently, though, medical training paid little attention to the development of communication skills.

Improved diagnostic accuracy, greater involvement of the patient in decision making and increased likelihood of adherence to therapeutic regimens are all outcomes of using effective communication strategies. Additional benefits are an increase in patient and clinician satisfaction and a reduced likelihood of exposure to malpractice litigation.

This workshop, which has been presented to thousands of clinicians throughout the United States and Canada, will introduce communication techniques to clinicians and develop their skills in using the techniques in a brief period of time.

Communication: A Risk Management Tool
Recent research has demonstrated that poor clinician-patient communication is a dominant factor in the decision to initiate or explore malpractice litigation. Moreover, the specific communication behaviors that lead to malpractice litigation have been well documented in several of these studies.

This highly focused workshop is structured to provide clinicians with an educational experience that will enable them to reflect upon their own communication habits, modify those that are not effective, and integrate new approaches that are more effective.

Treating patients with C.A.R.E. - Specifically designed for all staff that interacts with patients.
This workshop provides a model and specific techniques that guide all staff members-receptionists, nurses, medical assistants, business office clerks, maintenance workers (literally anyone who comes in contact with patients)-to communicate in ways that will enhance satisfaction and encourage patient partnership.

Strangers in Crisis - Specifically designed for emergency room physicians, intensivists and hospitalists.
Patients enter the hospital and the emergency department in crisis and are met by strangers who in an instant become responsible for their care. Time pressures, high information processing needs and the seriousness and complexity of the patient's medical problems contribute to the intensity of the situation.

This workshop, developed in cooperation with Kaiser Permanente of Northern California, is based upon surveys and interviews that were done with hospitalists at Kaiser and emergency department physicians at Duke, will better equip clinicians to manage communication challenges in the emergency department and inpatient settings.

Disclosing Unanticipated Outcomes and Medical Errors
Clinicians and staff need the skill and understanding to communicate effectively when patients and families are disappointed with the outcome of care. JCAHO, the AMA, the National Patient Safety Foundation and the ethical literature in health care all encourage forthrightness when there has been a disappointing outcome. In order to address this constructively, clinicians must understand what caused the disappointing outcome, how the patient and family feel and think about it and respond in a timely and empathic manner. This process begins with shared decision making before the fact and empathy rather than defensiveness or avoidance when the disappointment occurs. When the outcome may be the result of medical error, it requires a particularly thoughtful response on the part of the clinical staff, organization and malpractice carrier.

This workshop will address each aspect of the communication process in order to identify and practice the most effective ways of responding.

Situation Management Training for Physician Support in Disclosure Situations.
The disclosure conversation is likely to be the most difficult of a physician's career. The Situation Management Team is a group comprised of representatives of administration, patient safety, risk management, legal, social work and/or pastoral care, trained to serve as an immediately available resource for caregivers faced with an unanticipated outcome. This group comes together, much like a Code Team, to support the physician in his or her disclosure efforts. Members of the group remain involved as needed with follow up interactions.