6. To
soluFons
we
seek:
1 Safe,
quality
care
2 Healthy
staff
&
organizations
3 Patient
satisfaction
#medimprov08
7. How
does
Medical
Improv
do
all
this?
#medimprov08
8. By
building
the
so0
skills
we
need…
1 Communicate
2 Collaborate
3 Lead
#medimprov08
9. Overview
Introductions:
Meet
our
Expert
Panel
Compelling
evidence
for
building
soft
skills.
Medical
Improv
Classroom:
teaching
strategies,
principles,
and
games.
How
can
you
begin
to
pilot
Medical
Improv
in
your
healthcare
setting?
Q
&
A
#medimprov08
10. Our
Expert
Panel
Who
are
you?
What
inspired
you
to
join
us
today?
How
are
you
or
will
you
be
using
Medical
Improv
in
healthcare?
(About
2
minutes
each!
)
#medimprov08
11. Lauren
Dowden,
MSW
Candidate
Stephanie
Draus,
ND
Edward
J.
Dunn,
MD
Dan
Sipp,
SP
Nancy
Smithner,
PhD
Richard
Snyder,
MD
Tobias
Squier-‐Roper,
BFA
#mediprov08
12. What
are
so0
skills?
#medimprov08
• Communication
• Emotional
intelligence
• Interpersonal/relationships
13. How
are
problems
with
so0
skills
contribu7ng
to
problems
with
safety
and
quality?
#medimprov08
14. Progress
with
paFent
safety
has
been
slow!
In
1999.
Institute
of
Medicine
(IOM)
Report
-‐To
Err
is
Human:
Building
a
Safer
Health
System
Estimated
44,000-‐98,000
deaths
every
year
due
to
medical
errors
#medimprov08
15. Health
Affairs
April
2011
• 187,000
deaths
in
hospitals
per
year
• Preventable
medical
errors
are
ten
times
more
frequent
than
hospitals
and
regulators
are
reporting.
• Estimated
cost
of
17.1
Billion
in
2008
#medimprov08
17. The
Joint
Commission
tracks
root
causes
of
senFnel
events.
What
do
you
think
the
top
3
causes
of
these
preventable
and
catastrophic
errors
were
in
2010,
2011,
2012?
#medimprov08
18. Leadership
Human
Factors
Communication
http://www.jointcommission.org/assets/1/18/
Root_Causes_Event_Type_04_4Q2012.pdf
#medimprov08
19. Each
cause
or
category
has
subcategories
that
are
filled
with
implicaFons
involving
so0
skills
20. Category:
Leadership
Subcategories:
Organizational
planning,
organizational
culture,
community
relations,
service
availability,
priority
setting,
resource
allocation,
complaint
resolution,
leadership
collaboration,
standardization
(e.g.,
clinical
practice
guidelines),
directing
department/
services,
integration
of
services,
inadequate
policies
and
procedures,
noncompliance
with
policies
and
procedures,
performance
improvement,
medical
staff
organization,
nursing
leadership
21. Priority
se*ng
requires…
• Self
awareness
• Awareness
of
others
• Being
assertive
• Being
a
respectful
listener
22. How
are
problems
with
so0
skills
contribu7ng
to
concerns
with
our
workforce
and
work
cultures?
#medimprov08
23. Workforce
&
Culture
Through
the
Eyes
of
the
Workforce:
Creating
Joy,
Meaning,
and
Safer
Healthcare-‐
Lucian
Leape
Institute-‐NPSF
Roundtable
Report
(2013)-‐
http://bit.ly/104KSE4
#medimprov08
24. Physical
Harm
Health
care
workforce
injuries
are
30
times
higher
than
other
industries.
“I
need
help
giving
this
patient
a
boost
in
bed”
#medimprov08
25. Psychological
Harm
Lack
of
respect
A
root
cause,
if
not
THE
root
cause,
of
dysfunctional
Cultures
95%
of
nurses
report
it;
100%
of
medical
students;
huge
issue
for
patients
#medimprov08
A
nurse
waits
a
little
too
long
to
report
a
patient’s
increasing
blood
pressure
to
a
physician.
The
last
time
she
tried
to
talk
with
him
about
a
concern,
he
was
abusive.
27. Alan
Rosenstein,
MD,
MBA
Medical
Director
of
Clinical
Efficiency
&
Care
Management
at
ValleyCare
Hospital
www.physiciandisrupFvebehavior.com
No
one
starts
out
the
day
planning
to
be
disruptive.
We
must
recognize
the
emotional
impact
and
downstream
effect
of
inappropriate
behaviors
and
explore
experiential
learning
methods,
like
“medical
improv”
that
build
the
necessary
skill
sets
for
positive
change.
#medimprov08
36. What
does
a
Medical
Improv
class
look
like?
#medimprov08
37. Teaching
Strategies
Frame
with
objectives
&
brainstorming
Principles
of
Medical
Improv
Games
&
activities
Debrief,
reflection,
action
plan
Notes:
Variables:
time,
audience,
skill
focus,
complexity…
Expertise
in
healthcare
AND
improv
#medimprov08
38. Principles
of
Medical
Improv
“Yes
and…”
Affirm
and
add
(don’t
negate)
Surrender
your
plan
&
co-‐create
See
‘failure’
as
opportunity
(to
learn,
be
human,
forgive,
help)
Listen-‐be
present
Avoid
questions
You
have
everything
you
need!
Support
each
other
#medimprov08
39. Games
&
AcFviFes
(100s
more)
Yes
and…,
Yes
but…,
No…
Teaching/learning:
Assertiveness,
listening,
collaboration,
validation/invalidation
&
reinforces
medical
improv
principle:
“Yes
and...”
Status
Slide,
One-‐Up-‐Man-‐Ship
Teaching/learning:
Status-‐related
verbal
&
nonverbal
communication,
body
language,
comfort
level,
self
and
other
awareness,
leadership
skills,
and
therapeutic
relationships.
#medimprov08
40. Like
practicing
a
team
sport,
Medical
Improv
elevates
each
player’s
ability
to
communicate,
collaborate,
and
lead.
So
when
the
game
starts,
individuals
and
teams
are
performing
at
their
best.
#medimprov08
41. Unpredictable
and
fluid,
the
human
interactive
aspects
of
healthcare
interventions
can
emerge
in
the
moment
with
a
positive
dynamic
that
has
already
been
established.
#medimprov08
42. How
can
you
begin
to
pilot
Medical
Improv
programs?
Beth
Boynton
Stephanie
Frederick
#medimprov08
43. Collaboration
across
all
disciplines
of
healthcare
(conventional,
traditional,
complementary)
Medical
Improv
training
coordination
to
facilitate
communication,
quality
and
safety
of
care
in
the
U.S.
Consultant/Advocate
for
engaging
and
empowering
the
Patient
Experience
Program
and
Curriculum
Development
for
healthcare
organizations
and
higher
education
in
the
U.S.
Contact:
stephaniefrederick@outlook.com
Website:
stephaniefrederick.com
#medimprov08
44. Beth
Boynton,
RN,
MS
ConsulFng
Medical
Improv
workshops
Integrating
with
‘Whole
Systems’
consulting
work
Hospital-‐based
Programs
(pilot
projects)
Undergraduate
curriculum
development
for
of
ALL
healthcare
&
related
studies
Promote/develop
train-‐the-‐trainer
programs
(Professor
Katie
Watson,
Dr.
Belinda
Fu
are
planning
next
one-‐
fall
2014)
#medimprov08
45. Q
&
A
Working
Definition:
Medical
Improv
is
the
study
and
practice
of
improv
theater
philosophy
and
techniques
as
applied
to
the
unique
challenges
and
environment
of
healthcare
for
the
benefit
of
improved
health
and
well
being
of
providers
and
patients.
-‐-‐Professor
Katie
Watson,
JD
Northwestern
University
&
Belinda
Fu,
MD,
University
of
Washington
#medimprov08
46. Lauren
Dowden
laurendowden@
gmail.com
Stephanie
Draus
sdraus@nuhs.edu
Edward
J.
Dunn
edwdun@gmail.com
Dan
Sipp
dsipp@nc.rr.com
Nancy
Smithner
ns23@nyu.edu
Richard
Snyder
richardsnyder@me.com
Tobias
Squier-‐Roper
tobysr@gmail.com
#medimprov08
47. THANK
YOU!
Beth
Boynton
confidentvoices.com
Beth@bethboynton.com
Stephanie
Frederick
stephaniefrederick.com
Stephaniefrederick@outlook.com
Judy
White
theinfusiongroupllc.com
Judy@theinfusiongroup.com
#medimprov08