Camilla Rathcke's Profile

It sounds like you’re on the right track – good initiative! In DK it’s often said, that doctors can’t communicate, mostly referred to the lack of time given to spend on communication for the individual doctor. But of course, some doctors are not that good at communicating or at least should have their communicative skills polished; others communicate well – and thereby also embrace the patient’s wishes to outcome etc – at a whole other and more profound level thereby enhancing the quality of patient experience.
In DK some projects have actually been made, where doctors learn about there communicative skills – forces and not-so-forces – by teaming up with another doctor throughout a whole day of consultations; a colleague that actually spends a whole day just by observing and “scoring” their colleague on certain pre-defined communicative skills e.g. how to address the patients issues, capability of listening and so forth. Afterwards the score is made up and the doctor become aware of his/hers forces and which issues that need to be addressed. Both doctors actually learn from this observing/observed study (which is flipped so both try both roles), because the doctor that observes actually reflects a lot on his/hers own way of addressing the patients while observing a colleague. The next step after this observing phase is then a more professional approach with a short training period for each doctor in the issues that need to be addressed (also including competences in shared decision making).
A lot of doctors were reluctant to the project – you have also probably heard most doctors say, that they “communicate very well, thank you”. But when they are actually showed, that this is not necessarily the case both by being observed and “scored” and by reflecting on there role as observers – they actually engage. Because no doctor is actually satisfied about not being good. So with your project you should address most doctors professional vanity of being the best they can.

Good comments – thanks to everyone; I agree a whole lot especially with the lack of strategy and roadmap to support the way we choose the different digital end electronic solutions and how to implement them so HCP acknowledge them and see them as advantages. And the importance of a reimbursement system that actually support new technologies and new ways of working.

I’m in line with a lot of the previous comments. In DK we are in the process of implementing the Epic model of EHR in all eastern DK, but we have had EHR – and a lot of other electronic systems – in the last decade although not integrated with each other. We struggled with the previous programs due to e.g. server capacity problems and the lack of integration, in the beginning we also struggled dut to “everything just being knew and different”. The previous programs helped with the standardization of care – everyone could see that, and it was easily transparent to all health care professional engaged in the individual patients. And that story should be told!
With Epic however, a lot of tasks have shifted hands and a lot of administrative tasks that were done by secretaries previously, is know done by doctors – that has actually changed the engagement of doctors, who tend to only apply only the highly needed in EHR (and not necessarily all the nice-to-know also in terms of quality improvement etc.). That compromises safety.
Therefore, my advice is, that all electronic and digital solutions should be used smart by all – and should be used by the right professions at the right time as the patients transition through e.g. treatments – so all engaged health care professionals feel motivated and have the capacity/time to register not only data need to know but also al the nice to know. And thereby support patient safety not only at the individual level but also in quality improvement in general. Education in and implementation of EHR solutions must be planned thoroughly and with a reality-check to make adjustments so work-arounds and individual solutions made by the health care professionals do not rule the usage of the systems.

Good question about a very important issue!
As a representative for all junior doctors we have actually tried as the Junior Doctors Association to engage all junior doctors in VBHC by talking to the idealist within themselves – talk to the nature of their profession of helping people in need on their (the patients) terms thereby creating not only high medical quality but also patient experienced value. We have made courses about shared decision making giving the doctors the competences needed to (perhaps) address the patients in new ways. And we have searched all the different pilot projects all over Denmark to make films about how it is not only valuable for patients (and hospitals), but also for joy in work, the quality of specialist training and the collaboration between professions. And afterwards distributed all know-how about the projects to the doctors nation-wide.
As I recall you don’t have the same kind of organisation of doctors, but all we have done can also be made by management levels – the most important things is to engage doctors in the design of the projects, maintain focus and leadership engagement – also when someone is moaning – and communicate about success as well as adjustments to improve.