title: Enhancing clinician communication skills in a large healthcare organization: a longitudinal case study.
abstract: OBJECTIVE
  This article describes the approach taken over the past 16 years by one large healthcare organization, Kaiser Permanente (KP), to enhance the clinical communication and relationship skills of their clinicians.
  
  
  METHODS
  The centerpiece of KP's approach has been the creation and dissemination of a unifying clinician-patient communication (CPC) framework for teaching and research called the Four Habits Model.
  
  
  RESULTS
  The Model has served as the foundation for a diverse array of KP programs. Sustained improvement in patient satisfaction scores has been demonstrated. Clinician-patient communication training has become a well-established component of professional development in KP.
  
  
  CONCLUSIONS
  Enhancing clinicians' communication with patients is a complex task requiring planning and organizational commitment. Factors that have contributed to the success and lessons learned from incorporating clinician communication skills across the organization are described.
  
  
  CONCLUSIONS
  The KP experience attests to the feasibility of bringing the vital skills of effective communication to large numbers of busy clinicians.
  
  
  CONCLUSIONS
  Healthcare practices wishing to enhance clinician-patient communication skills should consider using a consistent teaching model, ensuring strong sponsorship from leaders, and emphasizing clinician satisfaction in the design of programs.
authors.affiliation: The Permanente Medical Group, Kaiser Permanente, Northern California, 1800 Harrison St, 21st floor, Oakland, CA 94612, USA. terry.stein@kp.org
authors.forename: Terry
authors.initials: T
authors.lastname: Stein
authors.forename: Richard M
authors.initials: RM
authors.lastname: Frankel
authors.forename: Edward
authors.initials: E
authors.lastname: Krupat
mesh_terms: D002140:California; D003142:Communication; D003162:Competency-Based Education; D019033:Delivery of Health Care, Integrated / Q000458:organization & administration*; D004502:Education, Medical, Continuing; D006279:Health Maintenance Organizations / Q000458:organization & administration*; D006801:Humans; D008503:Medical Staff / Q000193:education* / Q000523:psychology; D017146:Models, Organizational; D020380:Needs Assessment; D019982:Organizational Case Studies; D017060:Patient Satisfaction; D018802:Patient-Centered Care; D010817:Physician-Patient Relations; D013997:Time Factors