The Empathy Effect: Countering Bias to Improve Health Outcomes

Program Description

Compassionate and trusting relationships between patients/clients and their caregiver team members are the foundation for high quality care in every specialty and every setting. Where relationships are weak, we see poor clinical decisions, poor adherence, higher malpractice risk, inadequate sharing of vital information and provider burnout. Blue Shield of California Foundation initiated creation of The Empathy Effect communication skills curriculum by the Connecticut-based nonprofit Institute for Healthcare Communication (IHC). The Foundation supports the development of communication strategies for reducing bias, stigma and re-traumatization. The Empathy Effect is a unique skill-building curriculum designed for an inclusive array of professionals, para-professionals and support staff members. It builds common vocabulary for countering bias in caregiving settings that serve patients/clients at high risk of receiving disparate healthcare. It offers evidence-based, practical and immediately applicable techniques and strategies for providing equitable and respectful care for all. Based on IHC’s decades-long experience developing evidence-based and context-specific healthcare communication curricula, the Empathy Effect is disseminated through train-the-trainer faculty courses that support and enhance the in-house communication skills training capacity of caregiving organizations.

Creativity

The Empathy Effect (EE) is an evidence-based, practical response to subtle and pervasive barriers to care for vulnerable populations that flow from judgment and bias. EE’s graduated experiential exercises help learners first recognize and acknowledge cues that trigger habitual judgment of others, then apply techniques to mitigate judgment and build empathy conveyance for all caregiving interactions. The workshop experiential activities help learners build self-awareness to unlearn patterns of disconnection, and acquire and practice techniques to build and enhance patient connections. IHC’s train-the-trainer model for dissemination is a proven approach to bring essential communication skills enhancements to a wide range of organizations. In-house faculty are trained and certified to lead IHC workshops such as EE. Local workshop leaders can adapt IHC curricula to reflect local language and culturally-specific concerns, thereby enhancing contextual relevance and acceptability. IHC’s cadre of workshop leaders are responsible for more than 600 programs annually throughout North America.

Leadership

The externalities supporting access to care for vulnerable populations (e.g., affordability, physical access, concordant language), are necessary but insufficient to engage patients/clients in enduring and meaningful ways. High communication standards that ensure consistently welcoming and patient-focused interactions are best achieved through structured, experiential learning and reinforcement for caregiving teams. One of the most valuable, evidence-based strategies for enhancing and sustaining provider-client communication is balanced feedback. All IHC curricula nurture workshop leaders’ feedback skills. The essential skills and feedback techniques that are part of all IHC curricula are widely applicable. Organizations that successfully adopt IHC skill-building programs find that applying effective communication skills to interactions with co-workers brings unexpectedly positive effects. Caregiving teams function more smoothly, to the benefit of patients/clients and enhanced satisfaction of team members. Program leaders disseminate information about EE through the IHC website, specialized communications and myriad training interactions with existing and prospective client organizations.

Sustainability

IHC training is expressly designed for sustainability. Organizations provide a modest investment to engage IHC to train and certify in-house workshop leaders, and ensure access to copyrighted training materials. IHC-trained faculty receive significant guidance and support in several areas: strengthening their own communication and feedback skills, enhancing and practicing workshop leadership skills, nurturing organizational support for training, and navigating the nuts-and-bolts of workshop delivery. Blue Shield of California Foundation initiated creation of The Empathy Effect (EE) based on its knowledge of and confidence in the successes of other IHC curricula. As of December 2017, EE program development is approaching completion and the first cohort of EE faculty from seven California safety net organizations has been trained (Alameda Health Consortium, Community Medical Centers, Health Improvement Partnership of Santa Cruz County/Parajo Valley Community Health Trust, Transitions Mental Health Association, San Francisco Health Network and Salud Para La Gente).

Replicability

The Empathy Effect (EE), in common with all IHC curricula, is readily available to interested organizations. They engage IHC to conduct a train-the-trainer (TTT) faculty course, coordinate a faculty certification visit for workshop leadership support and vetting, make arrangements to secure workshop learner material (through workbook purchase or a print license), and conduct workshops according to their own schedule and rollout plan. IHC provides essential assistance at every step: guiding faculty selection, TTT faculty course scheduling, marketing and planning; facilitating ongoing learner assessments and accreditation; and promoting leadership support. In addition, IHC works closely with client organizations interested in customizing curricular materials. IHC has a straightforward process for reviewing and approving suggested adaptations, and encourages client organizations to make IHC programs optimally relevant to local audiences.

Results/Outcomes

In these early days of the Empathy Effect (EE), we have learner evaluations from four workshops (88 learners, 81 completed evaluations) and one train-the-trainer (TTT) faculty course (14 learners, 13 completed evaluations). Blue Shield of California Foundation has funded a two-year grant that includes evaluation of organizational-level outcome measures. Data for pre-, mid- and post-project outcomes of patient-related and employee-related measures will be available after the end of the grant period (9/30/2019). Workshop learner self-evaluations and comments were extremely positive, with 98% of respondents feeling that the workshop will help them improve their clinical interactions, and 96% recommending the workshop to colleagues. TTT learner evaluations were even more positive, with 100% finding the TTT effective and recommending it to colleagues. Summary learner evaluations and comments from the completed workshops are attached.