Tell Me More®

Tell Me More® (TMM) builds trust by anchoring compassion and human connection in ongoing health care interaction. Through facilitated learning and discussion, TMM encourages patients to share aspects about themselves, such as their interests and personal characteristics, so that it can inform ongoing collaborative discussion, and ultimately, the mutual development of the care plan. TMM also facilitates discussions between team, clinician, and with the patient. The program emphasizes the importance of human connection and shared experiences in the clinician-patient relationship. Why does this build trustworthiness?  This program addresses multiple dimensions of trust, including caring, compassion, and communication, and creates opportunities to deepen human connection

How It Works

The Gold Foundation’s Tell Me More® program (TMM) offers a strategy to anchor compassion and human connection in ongoing healthcare interaction. While the typical social history gathers specified information about a patient’s health and lifestyle, TMM expands our connection to the patient through prompts to facilitate learning about their interests and personal characteristics. TMM also facilitates discussions between team, provider, and with the patient.

TMM prompts elicit information about what’s important to the person — their family, loved ones, pets, hobbies, etc.–in other words, the things that make them unique. This information can be shared on a wall sticker hung in the patient’s room, by a note that is highlighted in the patient’s chart, or, in the case of a healthcare team member, as an addition to the employee name badge that highlights something personal about the individual delivering care. Personal characteristics impact care and may be incorporated into the mutual development of the care plan; however, they may also simply build a bridge to deeper communication.

The program is designed to create human connections and to help us see beyond the immediate professional relationship, whether it’s between a patient and a healthcare professional or between co-workers. A growing body of research shows that increased connection between patients and the healthcare team improves satisfaction and outcomes. Those receiving care appreciate the healthcare team getting to know them on a more personal level and team members like connecting with patients and each other. Through shared experiences, everyone is brought closer together.

Skills and Competencies

The program relies on compassionate, respectful, and engaged communication, elements that are essential to humanistic healthcare. Tell Me More® supports the development of two ACGME core competencies, including interpersonal and communication skills and professionalism. As reported in NEJM in 2017 (https://knowledgeplus.nejm.org/blog/acgme-core-competencies-professionalism/), “As the culmination of the ACGME Core Competencies, the Professionalism standard speaks directly to the attitude and behavior of the resident physician. The expectation for all medical professionals is that each and every one will treat all people with respect, compassion, and dignity.” Tell Me More® opens the door to communication that recognizes the experiences of the patient.

Origins

The Gold Foundation promotes humanism in healthcare, defined as compassionate, collaborative, and scientifically excellent care. It places human interests, values and dignity of all people at its core. Trust is integral in humanism.

The Gold Humanism Honor Society (GHHS) is a signature program of the Gold Foundation that recognizes exemplary medical students, residents, and faculty who practice patient-centered care by modeling the qualities of integrity, excellence, compassion, altruism, respect, and empathy.

First implemented in 2014, Tell Me More® was originally designed as a research project by students in GHHS at the Icahn School of Medicine in New York City. Concerned that patients in medical systems are often depersonalized, medical students set forth to learn about their patients and share some of that knowledge with other care providers. After obtaining consent, GHHS members spent time learning about patients’ personal lives in order to craft signs for display over their patients’ beds.

Patients lit up when asked about their personal lives. Students were awed by the depth and resiliency of the patients they interviewed. Everyone who entered the room – residents, attendings, nurses, other support staff, and visitors – were able to see those signs and remember that each patient is a unique individual.

Effectiveness

Northwell Health/Zucker SOM are rolling out Tell Me More® under the leadership of Dr. Alice Fornari, VP, Faculty Development and Associate Dean, Educational Skills Development and Dr. Taranjeet Kalra Ahuja, Asst. Prof. of Science Education & Pediatrics.

In an article about this rollout, Qing et al (2018) reported that patients felt more valued when clinicians asked about their personal qualities and experiences; that sharing the Tell Me More® information helped clinicians connect with patients on a more human level, and that Tell Me More® encouraged teamwork and coordinated efforts between hospital administrators, nursing leadership, providers, students, and educators.

After experiencing Tell Me More®, patients reported that “I felt like I was treated like a person, and not just as a patient” and “That poster hanging there gives me hope.”

Providers said,Gaining insight on a patient’s life outside the hospital makes it easier to form a connection with them,”and strongly agreed that the program helped them “… empathize with patients and their families” and “… communicate with patients and families more effectively.”

Providers also reported that the program helped me “…provide more personalized care to patients, and to “…achieve a higher level of connectedness with patients and families.”

Scalability

Yes. The program is being rolled out in medical education, hospital, and corporate healthcare environments. It can be implemented in a single department or at an institution.