AHRQ Demonstration Update

Physicians Insurance partnered with the University of Washington and the Foundation for Healthcare Quality to create the HealthPact Forum, a group of diverse health care stakeholders from across the state of Washington hoping to transform communication in health care. The HealthPact Forum is one activity in a three-year demonstration project designed to improve communication to prevent and respond to unanticipated outcomes. The forum is funded by the federal Agency for Healthcare Research and Quality (AHRQ).

First HealthPact Forum event explores the potential for better communication in health care

The HealthPact Forum kicked off its inaugural meeting in January, with the goal of transforming health care communication and transparency in Washington State. 

The guest list was a who’s who of health care leaders in Washington. Attendees included medical leaders from Washington’s largest hospitals and health systems: directors from state boards of nursing, medicine, pharmacy, and osteopathic medicine; powerful voices in patient safety and legal advocacy; and champions from academia and the insurance industry.

The University of Toronto’s Wendy Levinson, MD, keynoted the day. “It is rare to have this diverse group of people come together who can really impact progress and make a difference,” said Dr. Levinson, an expert on physician-patient communication and chair of the School of Medicine. 

Dr. Levinson described the benefits of strong physician-patient communication:

  • Better engagement of patients in decisions and self-care
  • Higher patient satisfaction
  • Better biological outcomes, especially for patients with chronic illness
  • Greater coordination between team members
  • Less litigation due to communication breakdowns

“Sophisticated, excellent patient care requires equally sophisticated communication skills,” Dr. Levinson said. 

Stories from the field

The day featured brief presentations showcasing facets of communication in health care in our community. Medical leaders Myron Berdischewsky, MD, of Providence Health & Services, Robert Caplan, MD, of Virginia Mason Medical Center, and John Vassall, MD, of Swedish Health Services described how they promote and formalize cultures of safety in their organizations. 

Patient advocates Dylan Malone and Brandelyn Bergstedt next spoke about the need for clinicians to listen more and speak more openly with patients and families about their care. Following the presentation, medical malpractice attorney Carol Johnston discussed the legal pursuit of truth when unexpected events occur. 

In the afternoon, Dr. Michael Soman of Group Health Cooperative described his medical group’s journey using shared decision-making tools that inform patients more fully about their treatment options. Dr. Richard Goss of Harborview Medical Center introduced the concept of a “just culture.” Organizations fostering a just culture use a fair, clear, and transparent process to evaluate errors and separate blameworthy from blameless acts. 

Next, Dr. Thomas Gallagher of the University of Washington School of Medicine presented research on the real and imagined barriers that keep clinicians and organizations from making things right when health care goes wrong. Dr. Sarah Shannon of the University of Washington School of Nursing discussed the myths that impair communication with patients and families as we provide end-of-life care.

What will it take?

Participants discussed what it will take to make Washington State a place where our health care community models best-practice communication and transparency. 

They emphasized the importance of having such a broad group of stakeholders engaged in the initiative, their eagerness to identify and disseminate best practices in communication, and their desire to strengthen interprofessional collaboration as a means to promote communication and transparency. Dr. Gallagher, who leads the overall HealthPact project, noted, “The HealthPact Forum represents an important first step that has enormous potential to enable Washington State to be the national leader in communication and transparency in health care.”

The HealthPact Forum will hold its next meeting on May 14, 2012. Participation is invitation-only. However, videos will eventually be available on the HealthPact Web site. To see the videos and learn more about HealthPact’s programs, please visit www.healthpact.org.