Corine Jansen was the Chief Listening Officer for the Radboud University Medical Center in the Netherlands and has been at the forefront of transforming the patient-doctor relationship by looking at listening as the key to better diagnosis, treatment, and recovery. She co-chaired the first European Listening And Healthcare Conference (ELAHC) in October 2014. She invited Narativ to open the conference and run a workshop there. We compiled our notes about her reflection on the Conference and how listening is becoming part of healthcare in the Netherlands.
Could you tell us about the European Listening and Healthcare Conference that took place in October in Nijmegen, Netherlands?
We had people from all over the world; India, England, Germany, Japan, Sweden, Belgium, a lot of people from the USA. It was a real international audience, half men half women. We had about 100 attendees, more patients than physicians. We based the time for speakers on the TED method, which is 8 to 18 minutes.
I was one of the organizers and moderators for the event along with Jennie Grau.
We didn’t interfere between the stories because there was such energy between them. We created different cultures through music as well, we had a pianist from the US who has performed throughout North America and Germany, a trumpeter soloist in the Rotterdam Philharmonic Orchestra and a member of the Netherlands Wind Ensemble, and Tom Beek, a Saxophonist who has played with Prince, and talked about music therapy. We covered the room with posters about listening or storytelling and plants so that the atmosphere was comfortable and intimate. There were no phones out during the whole conference which gave it a very sacred feeling.
We had what we called the “World Cafe”, composed of round tables where people from all over the world could sit and chat about the importance of listening and storytelling. We created postcards with all kinds of questions like: What does storytelling in medicine mean to you? Or what does listening mean to you? Then we asked everyone in the groups to nominate a moderator to present. We took an hour and a half so people could have a conversation with the audience and present in an interactive way.
We had a very successful doctor from the Netherlands, Prof. dr. Bas Bloem, stand before the room and ask people: What are you here for? What do you want to learn? He created parkinsonnet. Through redefining of care, ParkinsonNet increases expertise of healthcare professionals, quality of care and patient health, as well as it reduces societal costs. In 2010 national coverage within the Netherlands was achieved by 66 unique, multidisciplinary networks. ParkinsonNet has been awarded several prizes for healthcare innovation. Today, every person with Parkinson’s in the Netherlands is part of ParkinsonNet.
From the physicians side, he created a trustful feeling about being at the conference. Most of the audience said it felt very safe; there was crying and laughing and everyone was hugging by the end of the day.
Was there anything that stood out for you during the conference?
Paul Browde and Murray Nossel (founders of Narativ) were having their workshop on listening and storytelling in a conference room that used to be an intensive care unit. One of the participants in the workshop had lost her mother in that very room. Paul and Murray had two very ill people in wheelchairs in their workshops. They were very tired and one had a lot of pain from an accident, but one of them said he was at the right place at the right time.
Was there anything that was new to you from the conference as a Chief Listening Officer?
What really touched me is the importance of trust. People need to trust someone to share their story. Even if you’re trying to be interested in the patient; if they don’t trust you, they won’t share. Leana Wen researched when physicians listen, 80% of the diagnoses can be made- that’s without medical research. We already know from the beginning of this century the average time a physician listens to a patient is 12 seconds. It used to be 18 seconds and 23 seconds before that. Also, patients confirmed with me that they wanted to learn how they could better share their stories. The patients need a better and more thorough way to prepare before meeting with their physician. Physicians said that if a patient has a good story, they can listen and answer questions better. If you only get two minutes with a physician, you should be as prepared as possible.
I introduced the question to patients: What do you think you need from your physician? And a lot of them didn’t gave me a concrete answer. Often when the physician asks the patient what they think they need, they see a lot of fear. Sometimes people don’t need pills, they just need attention…a listening ear.
Our Parliament spoke about the budget for healthcare last week. A lot of them want us to be able to order a ‘good conversation’ like they do an MRI or an ECG. So a patient can go in and get their physician paid for ordering a good conversation about the quality of life. If that’s what it takes to get good listening, then that’s what we have to do.
To think that there are politicians in the Netherlands’ Parliament debating the healthcare budget to include listening is huge. What else is going on? What are you working on?
I’m working with some people on The Golden Ear Award Health. This was the first year we did it. We gave an award to healthcare organizations of care and cure. We think it’s needed that the Golden Ear can be adopted into healthcare culture.
What was it like five years ago when you started? Were people even aware of the kind of work you were trying to do? What made people think that they should have a chief listening officer in a medical center?
Five years ago there was a change in the healthcare system in the Netherlands. We were starting to talk about patients in the scope of proper healthcare. We were talking about centering our healthcare around patients, what they want and what they are suffering from. Before we were only looking at how to cure someone and not how to care for someone. Lucien Engelen talked about my role as a Chief Listening Officer at the conference:
“About five years ago, I started to work on a program we now call the REshape, it didn’t have a name back then. Coming from a business family with automotive, ambulance services and funeral services, witnessing how little time in healthcare was used to REALLY listen, I needed to DO something.
Looking around I heard about ‘this woman’, sitting on people’s couches at people’s homes for a public broadcast network, ‘fighting’ with her bosses about the gap in their thinking and what the targeted group actually wanted to see.
I sent a tweet and we had coffee and tea within a day or so.
“So… what should I do then?” she asked. “I Don’t know” I answered, “help me, help us to make a difference- to have an impact”.
“So… what is the job called then?” she asked (she asks a lot of questions, still does.) “I Don’t know, I said : let’s call it Chief Listening Officer”. Within 24 hours she quit her job and the next day she was working for me.
Together we tried to build something, something out of nothing, slowly but surely closing the gap. Gently, we’re showing our experts to the medical experts. We’re showing that their insights really do matter.”
My job was to listen to patients, caretakers, and family members and find out what worries them, how illness disrupts their lives, what they want to know about, and the things they don’t share with doctors. Not having a formal relationship in terms of treatment, not being a care professional but thoroughly experienced in informal care I try to deliver insights that really add patients-view. I don’t try and solve their problems or tell them what to do; I just listen.
Listening is a therapeutic intervention in its own right, but regrettably, a lot of the health
professionals are not good at it.
I became a part of the International Listening Association to meet new people in this field and to learn about listening. My mentor Dr. Richard Halley taught me so much about the insights and power of listening. He helped me to become a better listener.
For five years I did a lot, a lot, a lot of listening and bragged about the importance of it on social media. Being Chief Listening Officer at the Radboud University Medical Center put me in a position to make a small, but impactful change in the healthcare system.
The conference created a lot of buzz, do you have any specific next steps as you go forward with your mission?
I consult for several other health organizations in the Netherlands in the same job I started in. I try and reach as wide an audience as possible. Last week I spoke in front of 1000 people on listening to the elderly because that’s a different challenge.
We are looking to find a way to teach patients to learn to tell their story in two minutes. Together with Narativ, and Radboud REshape we will have a pilot next spring to empower them in creating their story.
I’m hoping to visit Israel and the US next year to study patient engagement. There’s been a lot written about it, but researchers don’t often ask patients and informal caregivers about patient engagement and what they need to be engaged.
This conference was my goodbye to the University Hospital and it couldn’t have been a better end.