Laura Cooley, Ph.D., senior director of education and outreach, Academy of Communication in Healthcare, will kick off RISE’s 18th Risk Adjustment Forum on November 16. In this article Cooley shares time-effective steps health care leaders can take to manage complex change.

Although most people who work in the health care industry do so because they care about people and want to make a difference, the demands of the job sometimes get in the way of forming meaningful relationships with coworkers, staff, and patients.

Time and financial constraints, as well as the daily pressures of the job, often result in people forgetting about their communication skills and failing to make human connections. But building those relationships is a worthwhile investment for future effectiveness and efficiency, says Laura Cooley, Ph.D., pictured right, senior director of education and outreach, Academy of Communication in Healthcare, a nonprofit organization that focuses on research and teaching relationship-centered health care communication.

Cooley, who will present the opening keynote address at the upcoming Risk Adjustment Forum in Las Vegas, says effective communication can help leaders manage complex change. It’s an upfront investment that will pay off for years to come.

The Risk Adjustment Forum

“When we invest in communication and relationships, it has outcomes across the spectrum. It's not just that it feels good or it's the right thing to do, it's also the smart and strategic thing to do, because it does lead to better outcomes across many domains, and I think if we can say that it's smart and it has heart, then people are willing to buy into it,” she says.

One of the biggest misconceptions leaders make is assuming that somebody understood what they said. “Unless we have a dialogue and check those assumptions and check that understanding, we haven't truly communicated and we haven't built a relationship, and I think that's where we often go wrong,” she says. “Time is one of the biggest threats to that because when we feel time pressure, we're less likely to engage and we can use that as an excuse to not do so.”

Cooley’s goal is to challenge health care leaders to think about helping equip themselves and others with simple communication skills as well as creating a space where people can relate and communicate more effectively. These skills, she says, will lead to better outcomes for patients and the entire organization.

Three steps for effective communication

Cooley’s work has been grounded in patient-provider communication, but she says the same skills are important in all our relationships. She suggests health care leaders develop these skills to help build stronger relationships and trust, reduce staff turnover and provider burnout, and ultimately achieve better patient outcomes. The steps are so simple and can become a natural part of everyday communication, she says, but they are incredibly effective.

Do the small talk before the big talk. This simply means to take a moment at the beginning of an encounter to create a connection with the person. “If we have a little bit of rapport, it can lay a foundation of safety for the bigger conversation,” Cooley explains. It just takes a minute or two at the beginning of the encounter and paves the way for the more serious conversation, such as telling people they have a serious diagnosis or need a procedure that is going to cost a lot of money and their insurance isn’t going to cover it.

Invite people to share their concerns. When you begin a conversation, acknowledge that the person you are talking to probably has a lot on his or her mind. For example, you can say, “We only have about 15 minutes, and I’d love to hear a quick list of what we should address today.” And then you listen.

“That simple skill of inviting somebody to share what they’re concerned about and leaving the space for them to tell you. Again, it only takes a few minutes and people worry that when they invite someone to speak, they are going to just talk forever. But in most patient encounters, the average time is about 90 seconds for an uninterrupted download from a patient,” she says.

The conversation forces the leader to respond to the person’s concerns. “You can’t just listen and then walk away. And the response can simply be repeating back the concerns they are worried about, like ‘What I heard you say is that you’re really worried about how you are going to pay these bills or I hear you saying it’s been difficult to keep up with the workload here in the office because you have a lot of things going on at home and that must be really challenging. So, we teach people skills for how to respond after they listen,” Cooley explains.

Practice the teach back method, which calls for people to repeat what was told to them so the leader can be sure they fully understand the information. This technique allows the leader to correct any misunderstanding and then provide more information, and once again ask for them to repeat it.

These skills allow the other person to feel heard. “There’s a clear communication dynamic and that goes a long way when we think about leadership skills,” she says. “Leaders who listen have much stronger collegial relationships and trust and respect. And by building some quick rapport and inviting the person to share their concerns, it sets up an ability for a leader to provider direction and to give feedback when it’s needed.”

The skills also lead to having a dialogue with people instead of a monologue and deepens the relationship. Ultimately, Cooley said, all the steps help create a better culture of safety in the work environment, according to Cooley. “I think leaders who are trying to create complex change and navigate that change and health care need the simple skills and listening is a big one of them.”

Leaders who have gone through the communication skills training have been impressed when they put their new-found skills into action, Cooley says. “They feel that it's making a difference, and they have these aha moments like ‘I didn't realize how little my patients were understanding me’ or ‘I now see that pausing and building some rapport like opens up the conversation in a different way.’ The biggest thing we hear from leaders is that I now see how these skills are applicable across everything I do.”

The 18th Risk Adjustment Forum will take place at Caesars Palace, Las Vegas on Tuesday and Wednesday Nov. 16-17 with preconference workshops on Monday, Nov. 15. Cooley will present the opening keynote address, Relate & Communicate: Simple Skills for Leading Complex Change, Tuesday morning, Nov. 16. Proof of COVID-19 vaccination is required to attend the conference. Click here to view the full agenda, list of speakers, registration information, and safety protocols.