AACH: Communication and Relationships

I attended the American Academy of Communication in Healthcare Conference in New Haven. The AACH is the professional home for all committed to improving communication and relationships in healthcare. About 200 people attended from US, Canada, Israel, Brazil, Belgium, Australia. Although most attendees were physicians, I met nurses, therapists, coaches, office managers, patients, sociologists, medical students, and researchers. A couple of very low-key sponsors but no vendors present. A pleasant relief. The conference was designed to maximize interaction, learn from each other, and build skills within work groups and special interest groups. Met several venerable experts. Very open and quite humble: We have a lot to learn. Especially about patient centeredness. Most exciting for me was a presentation by Sharon Schindler Rising, a nurse midwife, talking about Centering Groups – facilitated groups of 6-10 young moms/couples preparing for the impending birth of a child. A wonderful example of people-centered design with participants directing much of the flow of the monthly small groups. Professionals and services came to them. Groups often kept meeting on their own after the children reach one year old, sometimes for 8-10 years. New groups have been starting for decades. Evidence over that time showed significant increase in proportion of pregnancies going to full term and decrease in the proportion of low birth weight babies. One sad piece of the presentation was the description of the barrier caused by the advent of the electronic health record. One participant-generated practice had been for moms and dads to enter their own health data into the paper record: instant empowerment!  Not so with electronic record. People could no longer enter their own data into the health record. Shadow records had to be created. Lord, I was crushed when I heard this. I participated in several subsequent discussions about the infrastructure and skill set that would be needed to spread the Centering Group model to other settings. Instant learning!!

I learned a new word, intersectionality (the interconnected nature of social categorizations such as race, class, and gender as they apply to a given individual or group). I took this to mean that we do not fit into one category. We are multidimensional.  Hence Health Hats: patient, caregiver, nurse, informaticist, leader, Opa, musician.

I attended a session about end-of-life conversations. I’m curious to learn more about AACH’s studies about that. I found some discussion of the ecosystem (the context) of communication. Much about workforce, learning, work flow and life flow, less about technology, and almost nothing about governance. When attendees spoke of communication it was mostly about clinician to patient in hospitals and doctors’ offices and little about transitions in the community or home, and none about communication between professionals. Yet when I brought these up, there was much interest. While I met no one working or conducting research in mental health or substance use, I did meet several people supporting individuals with cognitive disabilities of all ages. I loved the eagerness of everyone I met to discover the expertise and passion of their neighbor, to begin brainstorming how expertise could be cross fertilized, and considerable support for the hard work of effective communication. Openness, curiosity, appreciation, growth. The Society of Participatory Medicine and AACH have much in common. Quite exciting.