The Center for Excellence in Healthcare Communication is driven by a dedicated team of professionals and colleagues with a passion and commitment to improving communication skills across the Cleveland Clinic system.
Katie Neuendorf, MD
Medical Director, The Center for Excellence in Healthcare Communication
Here more from Dr. Neuendorf about her experience
My interest in communication and palliative medicine are intertwined. I remember feeling helpless as a medical student in the intensive care unit when the entire healthcare team would update each other on a patient’s status (something to the effect of “Man, this poor guy, he’s not making it out of here), but that information rarely was communicated to the patient and family, especially when the news was not good. I took to heart the responsibility to be honest with my patients and their loved ones, even when the prognosis was poor.
To carry out that responsibility, I watched and listened to how my attendings would convey sensitive information – processing what worked well and what seemed to cause more distress.
I was challenged further in my fellowship when I received almost daily feedback on every aspect of the way I communicated to patients and families – the words I said, the words I didn’t say, my body language – everything. At first it was daunting, but I have since realized that it was the most helpful medical training I have ever received since it impacts every single patient encounter that I have. I came to a teaching institution so that I could teach fellows, residents and medical students a more effective way to communicate. When the chance arose to teach skills to staff as well as trainees surrounding sensitive conversations – such as delivering bad news, code status, Hospice, etc, I was more than happy to develop a curriculum! I am thrilled to be a part of the Center for Excellence in Healthcare Communication and am so excited to be part of an organization that sees the value in relationship centered communication skills.
Timothy Gilligan, MD
Director of Coaching
Director, Hematology-Oncology Fellowship
Medical Director, In-patient Solid Tumor Oncology
Hear more from Dr. Gilligan about his experience
During my residency and fellowship training I became interested in teaching communication skills after I watched different attendings interact with patients and what a huge impact communication skills could have on patients.
When I was put in charge of the hematology/oncology fellowship here at the Clinic, I felt a responsibility to help the fellows learn effective communication skills, so I underwent training in how to teach doctor-patient communication. This work led to my inclusion in the task force that developed the course that is currently being offered to Cleveland Clinic staff on relationship-based communication skills. I have now been teaching the course once or twice a month for over a year and it’s been an enriching experience. I’ve benefited from the opportunity to meet and spend a day with so many of my colleagues at the Clinic and to learn about the many different challenges that they face in their day-to-day work. They bring a wealth of experience and insight to the sessions and it is when we can harness the collective wisdom of the participants that we all learn the most.
The greatest lesson that I have learned is to appreciate the high-degree of difficulty of many of the communication challenges that we face. As medical professionals, we sometimes have to give people the worst news that they could ever imagine and we sometimes have to find a way to form a therapeutic relationship with people who are angry or who have challenging personalities. What works with one person may fail completely with someone else, so we need to be nimble on our toes as we read each patient and each encounter. I have also learned that as I improve my own skills, I enjoy the practice of medicine more because I feel increasingly competent to successfully navigate challenging encounters.
I have seen for myself that applying specific practical communication skills during patient visits not only increases patient satisfaction and my own professional satisfaction but also leads to better compliance with the treatment plan. Better communications leads to better care.
Vicente Jose Velez, MD, FACP, FHM
Director of Faculty Enrichment
Quality Improvement Officer, Department of Hospital Medicine
Experience Officer, Medicine Institute
Staff, Hospital Medicine
Hear more from Dr. Velez about his experience
Communication is the foundation of medical care. Patient safety, compliance, physician satisfaction, patient satisfaction, and true informed consent all depend on how well we foster a therapeutic relationship. With any patient, I have learned to never assume to know their perspective. We can only learn of the patient’s perspective by exploring their own ideas and expectations. Realizing this basic step paves the way for a meaningful and collaborative relationship. This experience has positively affected the quality of the work that I do and has made me more time-efficient. By understanding the key behaviors that are effective in nurturing relationship-centered care, I believe I’ve become a better physician and a better person.
Amy Windover, Ph.D.
Director of Curriculum & Faculty Development
Assistant Professor of Medicine and the Cleveland Clinic Lerner College of Medicine of Case Western Reserve University
Director of Communication Skills Training in the Lerner College of Medicine
Click to view Dr. Windover’s Physician Communication Testimonial
For more than 10 years, I’d been teaching relationship-centered communication and trying to apply the skills in my own patient interactions. But in Train the Trainer, I was able to practice the skills in a safe supportive group of peers and receive feedback on how to improve. When I started applying the skills more intentionally in clinic, the first thing I noticed was how good I felt at the end of the day. Patients seemed more satisfied with our partnership. Patients didn’t blur together…I could remember individuals and what was meaningful to them. I felt as if I was spending more time with patients but found myself actually being more productive and team-oriented. I began to connect deeper with my patients and colleagues. I was even more surprised when I started to feel joyful. This joy and sense of purpose to communicate in such a way as to foster relationship with others transcended productivity quotas, deadlines, and even my unrealistic expectations.
So it wasn’t just the introduction of relationship-centered communication skills, but more the opportunity to engage in deliberate practice and experience a genuine sense of relationship and belonging that has led to my passion in cultivating similar opportunities for others. I am grateful for the opportunity to play even a small role in transforming patient-provider experiences into transcendental relationships that have the power to heal in and of themselves.
Jessica Crow, MBA
As a program manager in Cleveland Clinic’s Office of Patient Experience, Mrs. Crow manages the daily operations, implementation and continued development of the Center for Excellence in Healthcare Communication as well as all physician communication improvement activities throughout the health system. Jessica manages all program and course logistics, Center budget, business development and sales, facilitator resources, vendor relationships and supply inventory. This also includes leading all development and management of Physician Communication improvement activities and initiatives, creating a business plan for the Center, managing all administrative support, resources and budget, delegating tasks and responsible for development and maintenance of internal and external websites and marketing material.
Her responsibilities also include enhancing partnerships with community hospital presidents and physician leaders, while educating them about physician scores and helping them to develop improvement plans. Mrs. Crow has a bachelor of arts in business and human resources management from Kent State University and her MBA from Indiana Wesleyan University. She has been at Cleveland Clinic for more than seven years, with a focus on managing enterprise-wide culture and improvement initiatives
Rachel Taliercio, DO
Director of Postgraduate Development
Associate Staff, Respiratory Institute
I used to take an all or nothing approach when viewing how physicians communicate with patients, the idea that as a doctor communication comes naturally or not at all. If a physician happened to be an effective communicator their patients were fortunate, as if this was an added bonus. I did not receive any communication training as a medical student and remember making it a priority to pay close attention to how doctors talked to patients. From these experiences, I would decide what worked well and try to emulate the physicians I viewed as effective. My first clinical rotation in medical school was family practice. The two physicians I worked with deliberately sat at eye level, were curious about the patients and their families, worked at finding a common ground, and modeled reflective listening. After having gone through communication training, I realized the qualities I recognized were skills we teach in our classes. These skills can, and should, be taught.
I now understand the role of deliberate practice in maintaining and improving communication skills. There is so much more to learn and this work is impactful and incredibly rewarding. When an interaction with a patient doesn’t go the way you planned it can be a terrible feeling. Equally as important as recognizing what went wrong is learning how to approach the next communication challenge. As a medical community we are learning how to bridge the gap between what we do well and what we need to work on. I am thrilled to be a part of this exciting and important work.
Mary Beth Modic, DNP,RN,CNS,C
Director of Interprofessional Enrichment
Clinical Nurse Specialist – Inpatient Diabetes
Assistant Adjunct Professor Frances Payne Bolton School of Nursing
Case Western Reserve University
I think of myself as a “Compassionate Stranger” entering a person’s life when he or she feels extremely vulnerable and may be suffering, fearful and feeling alone. I believe I am entering a very sacred space and must learn and honor the patient’s story.
My interest in communication is driven by my desire to sojourn with patients and to be completely and authentically present. It requires the skilled use of empathy and silence. It takes practice to convey empathy and to linger in the silence.
Each of us in healthcare has an obligation to be relationally proficient. Learning the skills provided in the Relationship Centered Communication Course offered me the opportunity to learn from masterful clinicians and communicators, to practice in a safe space and to receive helpful feedback about my skills. It has deepened my capacity to engage with patients, their families and other caregivers. It is important work and must be continually refined by self- reflection and solicited feedback from patients and their loved ones. I am honored to be a part of an incredible ensemble who are devoted to building relationships, fostering communication and supporting the practice of relationship-centered communication.
Adrienne Boissy, MD, MA
Chief Experience Officer, Cleveland Clinic Health System
Staff Neurologist, Mellen Center
Experience Officer, Neurological Institute
Associate Director, Clinical Neuroethics
Hear more from Dr. Boissy about her experience
My communication journey began as a medical student when I became aware that often times, after the medical team left the room, I’d see a blank look on the patients’ faces. Although we had done the job of dispensing our medical knowledge, I wasn’t convinced that any of it was absorbed or that we had created an environment conducive for a dialogue. In addition, I think we all have patient encounters that haunt us from a communication standpoint. We have the best of intentions, but somehow the signals get crossed. Lastly, I’m proud and honored to be a part of a collaborative effort that is meant to help all of us improve. Patient expectations are high, emotions are palpable, time is limited, and the illnesses we treat are exceptionally complex – despite all those challenges, creating a communication program has elevated all of us, myself included. We teach empathy here and much, much more…
My two greatest lessons from this work are to be quiet and to lay down my own agenda. Although patients don’t have the clinical expertise of their caregivers, they have an expertise about their experience with their illness and their perception of their care. I want them to have an opportunity to voice that and to feel that I am receptive to it. With respect to the agenda, I always thought it was more important to be right and direct, but I now recognize that sometimes what patients need more from me is to know that I am truly a partner on their healthcare journey and that I care about them as a human first. Tailoring my language around that concept is something I actively work on day in and day out.
Staff, Department of Cardiothoracic Anesthesiology
The Physician Communication program has been and continues to be a very rewarding experience. I have learned and gained much from my colleagues and from each professional staff group that comes through, and more importantly, I hope they have too. Just getting randomly assigned staff from different departments and institutes together for a day, who otherwise may never have the opportunity to exchange ideas like this, has been enlightening and great to see. I have found out that we all struggle at times with similar communication challenges across disciplines, and this program is fostering a spirit that will surely benefit patients and staff alike.
Chairman of the Department of Neurosurgery at Cleveland Clinic
The well-conceived and operationalized FHC initiative emphasizes the perpetual striving for excellence in communication. From my experiences with the FHC, I learned many tricks and pearls. I soon realized the beneficial effects of positive interpersonal interactions – with a de-emphasis on the negative. I have begun to appreciate the importance of immediately establishing rapport at the onset of an interaction and the probing into the depths of concerns and even fears of my patients and my colleagues. I began to increasingly appreciate the importance of empathic communication and the impact it has on patient and colleague engagement. Perhaps most importantly, and most certainly of greatest reward, I learned to help others to do the same.
When I was invited to participate in the communication program and to consider becoming a facilitator, I was intrigued because I was not aware that such initiative existed at the Cleveland Clinic. As I learned more about this initiative and started the course, I became very excited because I believe that in order to provide the best care to our patients, we need to understand their problems, be able to convey our recommendations, and establish a patient-physician relationship of trust and respect.Technology has become an integral part of patient care, it is a tool that allows us to better understand the nature of diseases, help confirm a diagnosis and implement treatments. However, technology is complementary to the practice of medicine and not a substitute to the patient-physician relation.Through this program, I’ve had the privilege of meeting and working with physicians that now I see as role models. I have seen how excellent surgeons and physicians with many years of experience have embraced the notion that communication is central to the practice of medicine and healing of patients. An important lesson that I learned and incorporated in my practice is to assure that patients understand my recommendations, and that they can implement them. I also learned to be more open minded, and importantly that it is never too late to incorporate new ideas and improve patient care.
Staff, Department of Preventative Medicine
I began teaching communication skills when the Lerner College of Medicine opened in 2004, teaching 1st and 2nd year medical students in small group sessions and with individual medical students in a longitudinal clinical setting. At that point, teaching communication skills reinforced how I apply those skills in a clinical setting. I took one of the early sessions of the Staff Physician communication skills course in early 2012, and was instantly excited to see these skills being shared with staff, so they could realize how much the field has developed in the years since their medical school training. In this relationship-based model, we emphasize that our interaction with patients should not lead to a 1 vs 1, with the 2 participants vying for what they want or protecting their own power, but rather to develop a relationship so they can be on the same side of solving a problem, opening up the possible causes, and looking at the options and approaches to the problem on a common ground, rather than a possible conflict of a paternalistic relationship. I have now consistently used this approach with each of my patients, creating a more efficient and much more satisfying interaction and result from the patient’s perspective and mine, and more importantly from our perspective together.
Staff, Obstetrics and Gynecology in the Women’s Health Institute
Over the past few years, the concept of doctor-patient relationship has evolved significantly. Enhancing patient experience had been an untouched subject in medical research for decades. Getting involved in the FHC project has been an eye opening experience for me. I learned basic skills that make my patients happier and more satisfied; it also improves patient compliance and clinical outcome. At the end of the day isn’t this the most rewarding experience for any caregiver?
Relationships, particularly the sanctity of those between doctors and patients, are among the most rewarding aspects of medicine. I had a glimpse of those relationships early in medical school, when I saw my father on the receiving end of health care. For a previously healthy and vibrant individual, this experience was traumatizing for him and the rest of our family. Consequently, any physician that cared for my father, by default cared for the rest of us as well. I appreciated how deftly and kindly many of his doctors were able to shoulder that responsibility.
Now, twenty years later, as I think about the journey of my career, I realize that when my eyes are open to seeing them, there have been special and surprising moments nearly daily that arise from my relationships with patients and their families. I am humbled and privileged to be a part of an initiative which has improved the manner in which I communicate not only with patients, but also with my colleagues, friends, and family; there is certainly an influence beyond our immediate work environment. With this program, I have learned to adapt, adopt, and polish effective communication strategies, many of which I learn from very talented and respected colleagues at this institution.
Section Head, General ThoracicProfessor of Surgery, Cleveland Clinic Lerner College of Medicine of Case Western Reserve University
It became apparent in the last few years that my focus had drifted from the principles of our founders. In the 26 years I have been on staff, I have worked very hard at perfecting my surgical skills. It was time to improve my personal skills and concentrate on building the best relationship I could with my patients. Communication is the key.My greatest lesson was the relationship extends beyond the patient to include the family. Establishing rapport is so important, first impressions are critical.This work is important because no matter how good a technician I am, I will fail my patient if I am not a good doctor. This program allowed me the opportunity to become a good doctor not just a good surgeon.The concentration on communications and relationship building has redirected me. My practice is much more manageable and I am more satisfied with my daily work. It has provided me tools to deal with those difficult situations, which were as upsetting for me as for the patient.I am fortunate to be a facilitator. It became very obvious early in my training and facilitation experience that there we are all in this together and we have common goals. We deal with similar situations and typical problems. Each session I learn as much as the participants.
Staff, Cardiovascular Medicine Section of Heart Failure
Professor of Medicine, CCLCM of CWRU
Director, Advanced HF & Transplant Cardiology Fellowship Program
After participating in more that a dozen FHC classes over the last year and applying lessons learned personally to my OPD, I am convinced more than ever that patient communication skills are ‘teachable’ and necessary. I was asked to participate as a member of the original task force that led to the development of the FHC course early in the process. At first, I was quite skeptical that it was necessary, would lead to a finished product, would be received favorably by medical staff, and that patient communication skills were even ‘teachable.’ I quickly became a convert as it became apparent that our team had developed a mature product that was teachable and necessary as we later began to ‘practice-what-we-preached’ in our own patient encounters.
Staff, Obstetrics and Gynecology at Hillcrest Hospital
Dr. Tower has served as the Chief of Staff twice at Hillcrest Hospital, the Director of the Department of Obstetrics and Gynecology, and the Director of the Division of Gynecology. Currently, he is a medical advisor for Care Management and The Doctor’s Company. He has spoken internationally in Sydney and Melbourne Australia.
Urologic Director, Center for Female Urology and Reconstructive Pelvic Surgery
I have always been interested in physician communication and relations as I think there is always an opportunity to communicate more effectively with patients. It is hard to come to a referral institution like ours with the high expectations that most patients have and then deliver on all fronts. This course has given me some skills to not only help patients through these important transitions in care, but also deal with some complex and challenging patient interaction scenarios. As one goes through their day to day affairs, one may not use every aspect taught in the class, but when it is necessary, the skills learned can be a valuable asset to effectively deal with these increasingly more common interaction challenges. Accordingly, I find my practice more satisfying and am more comfortable at dealing with tough patients.
Staff Surgeon in the Department of General Surgery and Digestive Disease Institute
I was on a committee related to the patient experience prior to the search for programs to enhance communication with patients. Adrienne was the chair of that committee. I was asked to train to be a facilitator, which I was happy to do. The greatest lesson that I have learned from the communication program is that we are never too old or experienced to not learn something new, particularly if we keep an open mind. This work is important.