In 2009, Putting the Charter into Practice grants were awarded to several organizations that developed initiatives to advance professional values and behaviors among practicing physicians.
We worked with the Council of Medical Specialty Societies and a consumer representative to select the following projects for funding:
Cleveland Clinic Lerner College of Medicine of Case Western Reserve University - Increasing Empathic Behaviors of Staff Physicians through Reflective Writing
The Cleveland Clinic Lerner College of Medicine engaged faculty in the principles outlined in the Physician Charter through the use of reflective writing as a vehicle to increase self-awareness, with a focus on improving empathy among practicing physicians. Topic areas covered included:
- Introduction to reflective writing/narrative medicine as a vehicle to increase empathy;
- The patient experience of suffering;
- Empathy across cultural barriers;
- Empathic communication of treatment plans;
- Health literacy; and
- Empathy to improve quality health care.
Johns Hopkins Bayview Medical Center - Timeouts Facilitated by a Coach: Bringing the Charter to Life in Real-Time for Hospitalists
Johns Hopkins Bayview put the Charter into practice for hospitalist physicians using the "timeout" and the "personal coach" methods. The hospital proposed to train two hospitalists to become Physician Charter/Professionalism Coaches (PCPCs). Through one-on-one and group timeout sessions, the PCPCs interacted with hospitalists to discuss the applicability of the Charter’s principles to their daily work, and reviewed orders and charges of newer hospitalists to encourage commitment to the just distribution of finite resources. In addition, Bayview created a Physician Charter blog for the coaches to share insights that tie together their clinical work and the Charter.
National Physicians Alliance - Promoting Good Stewardship in Clinical Practice
The National Physicians Alliance (NPA) addressed how physicians in internal medicine, pediatrics and family medicine can adhere to the Physician Charter’s commitments to putting the patient’s interests above all else and using limited resources prudently. Through developing a list of “5 Things You Can Do in Your Practice,” the NPA helped physicians, via comparative effectiveness practices, act as good financial stewards and promote the just distribution of finite resources in internal medicine, pediatrics and family medicine. Additionally, the NPA hosted a virtual community, where physicians shared how they put the actions on this list into practice. The NPA proposed to share this list with specialty societies and boards for distribution to their members.
The Ohio State University Medical Center, Mt. Carmel Health Systems, and OhioHealth -
Putting the Charter into Practice for Central Ohio Physicians
This project represents a collaboration of Mt. Carmel Health System, OhioHealth and The Ohio State University Medical Center, which encompass 16 hospitals and outpatient facilities. The investigators:
- Collected stories that describe challenging situations in which physicians successfully demonstrated professional values;
- Analyzed those stories to identify themes and sources of success; and
- Shared the stories through educational programming.
Clips of interviews and summaries were disseminated in online modules and CD/DVDs for the medical staff and at professional society meetings, where they served as triggers for discussion by the physician community.
Society of General Internal Medicine -
Communicating about Professionalism: SGIM Regional Workshop
The Society of General Internal Medicine created a replicable workshop entitled "Communicating about Professionalism." It addressed the principles of patient welfare, patient autonomy and the professional values of:
- Maintaining appropriate relations with patients
- Trust, including managing conflicts of interest
The workshop featured case-based discussion and skills practice and used scenarios that portray challenges to these principles. SGIM posted the workshop materials on its website and in its newsletters.
University of Chicago Medical Center - Improving On-Call Etiquette among Internal Medicine Residents in Chicago: A Multi-Center Collaborative
The study team, consisting of researchers from the University of Chicago Medical Center, Northwestern Memorial Hospital, and NorthShore University Health System, created video vignettes depicting three types of "unprofessional" interactions related to on-call etiquette, such as:
- Blocking an admission
- Disparaging the ER for missing findings
- Misrepresenting a test as urgent to expedite care
These video vignettes are used in workshops to improve professionalism among practicing internal medicine residents and hospitalist physicians. The workshop materials have been disseminated internally and through professional meetings.