Making a Human Connection

“I’ve never wanted to make nurses feel like they have to convince me to come to a bedside. I’ve always said, ‘If you want me to come look at the baby just say so and I’ll come.’ Ninety percent of the time it is clinically worth the trip. The 10% of the time that everything’s OK is still well-worth the visit just to build a two-way trusting relationship.” -Dr. Chris DeRienzo

This month I was fortunate to chat with Dr. Bridget Duffy, Liz Boehm, Evan LaBranche, and Ben Fleury from the Experience Innovation Network for a report called Clinical Communication Deconstructed.  I’m a huge believer in the power of communication to transform outcomes in healthcare (and elsewhere in life for that matter), and the EIN team has done yeoman’s work bringing together these seven elements of effective clinical communication.

The full report is available here and its a fantastic read.  Below I’ve reproduced with permission the case study we created together:

Case Study: Caring Conversations for Difficult Diagnoses

Like many of his peers across specialties, Chris DeRienzo, M.D., MPP, System Chief Quality Officer, and a neonatologist at Mission Health, has had to deliver his share of bad news to his patients’ families.

It’s never easy.

Early in his medical training, Dr. DeRienzo received guidance and opportunities to practice so that he could deliver hard news with as much compassion and empathy as possible, despite his discomfort.

“We first learned the basics of structuring a difficult compassionate conversation, then we actually practiced while being recorded. It was awful watching yourself but invaluable to improving as a communicator because seeing and hearing yourself dramatically increased the velocity of change.”

The basics Dr. DeRienzo learned included beginning with a “warning shot,” pausing long enough so families could absorb the emotional impact of the difficult news, and offering the first steps in a path forward. “By the fifth time we went through the practice sessions, pausing for seven seconds of silence didn’t seem so awkward.”

Dr. DeRienzo recounted the first time he had to put those skills into practice, telling young parents in the emergency department that their child had cancer.

“I will forever remember that day, the room we were in, even what they were wearing. When I close my eyes I can still see their eyes at the moment my words turned their whole world on end, and how hard it was guiding them back into orbit. I was so glad I had practiced.”

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About the Author

Dr. Chris DeRienzo is a dedicated husband, a proud father, a storyteller, and a mediocre triathlete. He’s also a doctor dedicated to improving the quality, safety, experience and sustainability of healthcare for all Americans. You can read more about him at or follow him on Twitter

1 Comment

  1. Chris,
    I find this post very valuable!
    For years, I have focused on communication for my teams, noting that almost always, when bad things happen, communication is a major contributing factor, if not the main root cause, for the failure.
    I enjoy operationalizing the specifics of communicating in difficult situations, always remembering how it can reduce costs, minimize bad events, and improve clinical outcomes.
    Great post!

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