Better Together! Collaborative conversations with colleagues and patients

Optimize relationships with patients

Enable positive communication

1. Build the foundation
• Have clear policies and procedures for your practice that address code of conduct, and commonly occurring requests and situations
• Ensure patients are aware of these policies and procedures
• Apply these policies consistently and transparently
2. Select your tools
• FIFE: Feelings – Ideas – Function – Expectations
• HEART: Hear the patient – Empathize – Apologize – Respond – Thank the patient
• APE: Acknowledge, Agree, Apologize – Pause, Paraphrase – Empathy, Explore
3. React when necessary – know when your and your staff’s safety is threatened and call for help. Ensure you have a safety plan in place.
4. Have you objectively and factually documented:
• That you have reviewed your practice’s code of conduct, policies, and procedures with patients?
• Conversations you have had about specific patient behaviours and consequences?
• Your and your staff’s efforts to defuse conflicts and de-escalate situations?

Impacts of effective communication on physician-patient relationship

• Provision of safer care
• Enhanced focus and engagement with patients
• Appropriate use of testing, treatment, and consultation
• Enhanced desire to advocate for patients
• Positive impact on patient mood
• Increased likelihood of patients adhering to healthcare plans

Optimize relationships with team members

Psychological safety: A psychologically safe environment is one where people listen to one another, and feel safe to speak up, without being afraid of being embarrassed or punished.²

In the healthcare system, high psychological safety has been linked to:

• The generation of novel ideas and solutions
• Knowledge sharing
• Increased technical team performance
• Improved quality of care
• Care that is more patient centred

4 Stages of psychological safety, with strategies corresponding to each level

Learn more about other strategies to foster a psychologically safe environment at The 4 Stages Behavioral Guide (leaderfactor.com).

CMPA resources

Optimizing relationships with patients

• Challenging patient encounters: How to safely manage and de-escalate
• Ending the doctor-patient relationship
• How to manage conflict and aggressive behaviour in medical practice
• The office safety plan
• Patient-centred communication, CMPA Good practices

Optimizing collaborative care in challenging times

• Physician health: Putting yourself first
• Resolving conflict between healthcare providers
• Tired? You’re not alone...
• Just Culture, CMPA Good practices
• Dealing with Conflict, CMPA Good practices

References

• 1. Isbell LM, Tager J, Beals K, Liu G. BMJ Qual Saf. 2020;29(10):803-814
  Scheepers RA, Boerebach BCM, Arah OA, et al. Int J Behav Med. 2015;22(6):683-698
• 2. Grailey KE, Murray E, Reader T, Brett SJ. BMC Health Serv Res. 2021;21(1):773