Patient Engagement

Improv training helps Cleveland Clinic improve MD communications

Even though the idea of "medical improv" came from an instructor and performer at Chicago's legendary Second City comedy factory, laughs are not the goal. Relationship-building is.

Amy Windover of the Cleveland Clinic’s Center for Excellence in Health Care leads an improv exercise at the Beryl Institute’s 2016 Patient Experience Summit in Dallas.

No joke: The Cleveland Clinic employs improvisational techniques to teach clinicians how to improve patient engagement.

Even though the idea of “medical improv” came from an instructor and performer at Chicago’s legendary Second City comedy factory, laughs are not the goal. Relationship-building is.

“Comedy is just one genre” of improv, said Amy Windover, a psychologist who directs the Cleveland Clinic’s Center for Excellence in Health Care. At its heart, it’s about listening, understanding, quick thinking and communication, Windover said during the Beryl Institute’s Patient Experience Summit in Dallas. “In improv, you are listening for facts, feelings and intentions,” Windover explained.

She and two colleagues hosted a highly interactive session on Thursday. All the chairs were moved to the perimeter of the room so the Cleveland Clinic presenters could get audience members to face and talk to each other. They partnered up and shared stories with each other for a minute at a time, to simulate the often-rushed atmosphere of a healthcare setting.

“It feels artificial that you are stopping in one minute,” one participant said. “But that’s what happens to us every day.”

It may have been initially uncomfortable, but the consensus was generally positive.

“For me, this exercise taught me about vulnerability,” another attendee said to the group at the end of the session. “We expect that people are listening to us. Take that to heart.”

Improv has been part of the Center for Excellence in Health Care for about two years, but the effort to employ new methods of physician communication skills training dates to 2009.

The year before, according to Windover, the venerated Cleveland Clinic scored dismally low on physician communications in the CAHPS Hospital Survey — in the seventh percentile nationally. Clinic leadership stepped in and realized a possible root of the problem.

“[Being] patient-centered is lovely, but sometimes the provider feels left out,” Windover told MedCity News. “We need to attend to their needs as well.”

Soon, the Center for Excellence in Health Care created an 8-hour training course that became mandatory for all physicians. For the past two years, there has been optional improv training. The program now is being expanded to advance-practice nurses and other professionals.

In the most recent HCAHPS survey, Cleveland Clinic scored in the 82 percentile on physician communications. “These are learnable skills,” Windover said.

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