High Stakes

Lean in to the Hard Truth: Creating a Culture of Transparency

Lean In To The Hard Truth: Creating A Culture Of Transparency

Traditionally, hospitals brace against the difficult truth.

But when a physician at Henry Ford Hospital in Detroit started using her personal experience as a patient to educate doctors about communication problems at her employer, leadership didn’t silence her. In fact, then Chief Experience Officer Rose Glenn and others built her a bigger platform.

“I hired her to head up the Center for Physician Communication and Peer Support,” said Glenn, who is now the senior vice president and chief marketing officer for Hackensack Meridian Health in New Jersey. “This is what needs to happen for change to take place.”

The Henry Ford physician, Dr. Rana Awdish, is the director of the hospital’s pulmonary hypertension program. While seven months pregnant, Dr. Awdish suffered an acute emergency that resulted in multiple organ failures and the loss of her unborn baby. Throughout the trauma, she received care at Henry Ford that, she maintains, was excellent. But she noticed a jarring – and painful – lack of empathy from members of her care team.

For example, caregivers talked about her as “trying to die” on them, she wrote in an article for the New England Journal of Medicine. Others questioned her assessment of her physical pain.

After the incident, she began sharing her story with Henry Ford doctors, hoping to help prevent patients from the suffering that comes from a break in communication. In 2017, she published a book called “In Shock,” that has since received critical acclaim. Now, as the head of Henry Ford’s Center for Physician Communication and Peer Support, her work has transformed from a grassroots effort to a scalable program that has delivered real results.

Through Awdish’s program, all Henry Ford physicians receive four hours of training in communication, compassion and connectedness with patients.

Providers can also choose to be shadowed by a communications consultant who offers feedback about doctors’ patient interaction skills. Clinicians who have worked with consultants, Awdish said, have seen a 10 percentile point improvement in their patient satisfaction scores.

Patient care has also improved. “Compassionate communication drives real change, in measurable areas. It improves medication adherence and decreases return visits to the ER,” Awdish said. “There’s so much more depth to it than I think we had anticipated.”

Through her program, physicians who want advanced training can work with improvisational actors to roleplay difficult conversations. “We didn’t talk about that medical school, but in a quaternary care center like ours, we all see so much,” she said. “We have to have just as robust a skillset in communication as we do in healing disease.”

Now, Awdish’s book is being used in medical schools across the country, said Glenn. “I’m really proud of Rana and of Henry Ford Health System for training the next generation of physicians – and not just trying to be better here, but to really change the practice of medicine.”

Awdish said she never doubted that Henry Ford would embrace transparent communication about an internal problem.

“It’s been one of the most fulfilling aspects of my life to work at an institution that lives by the motto that we are a learning organization and when we learn things, even if it’s about ourselves and even if it’s hard, we’re going to look at it and come up with solutions that benefit everyone – patients, physicians and the whole organization.”


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