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The New Agenda: Patient-Centered Strategies for the Exam Room

At the heart of the patient experience is good provider communication. From patient satisfaction to physician happiness—as well as actual health outcomes—how clinicians communicate with patients in the exam room can impact every critical aspect of our healthcare system.

In 2016 CCI, in partnership with Blue Shield of California Foundation, organized a patient engagement initiative focused on giving providers training and strategies — from agenda setting to a unique take on empathy — to make exam room interactions more effective and productive. Using a model developed by Dr. Richard Frankel, an internationally recognized expert on clinician-patient communication, this program builds on our communication training programs by going deeper into the relationships patients have with their clinical care providers.

Click here to read the New Agenda Results Report

The program curriculum was based on Kaiser Permanente’s Four Habits model, co-authored by Dr. Frankel, which emphasizes “actions in encounters” such as making a strong personal connection at the beginning of a patient visit, eliciting the patient’s top concerns through agenda setting, demonstrating empathy during a brief encounter, patient education and motivation, and summarizing the visit. The curriculum is supplemented with techniques that allow clinicians to experience “Shared Presence,” when physicians and patients enter into a deep sense of trust and respect that facilitates healing.

The New Agenda was a multi-pronged effort that combined onsite learning sessions, coaching and webinars. These tools allowed clinic organizations to engage with the curriculum through a cohort of 2-3 clinicians, and subsequently build a plan to spread these skills and sustain gains beyond the duration of the grant. Grantees received a $25,000 grant to support the implementation of this program.

Grantee Organizations

Organization Location
Chinese Community Health Services San Francisco
Community Medical Centers Inc. Stockton
Kokua Kalihi Valley Comprehensive Family Services Honolulu
LifeLong Medical Care Berkeley
MayView Community Health Center Palo Alto
Sacramento Native American Health Center, Inc. Sacramento
Tiburcio Vasquez Health Center, Inc. Hayward
Universal Community Health Center Los Angeles
Watts Healthcare Corporation Los Angeles

Key Resources

Access The New Agenda Program Resource Site

Four Habits Monograph

For more, click “See All Related Resources” to the left.


March 28, 2016 — Kickoff Webinar

The program kicked off with this webinar, which detailed the different offerings of the program. To view the webinar, click here.

May 5, 2016 — Training #1 (In-person)

Clinicians were trained on the Four Habits model. To download the slides, click here.

June 2, 2016 — Rapid Patient Feedback Webinar

This webinar covered rapid ways of getting patient feedback, such as direct observation, real-time intercepts, cognitive walkthroughs, and shadowing patients. To view the webinar, click here.

June 15, 2016 — Training #2 (In-person)

Clinicians attended a second training of the Four Habits. To download the slides, click here.

July 12, 2016 — Case Conference Call

This call was coaching for clinicians from Rich Frankel on specific skills that they are testing from the Four Habits.

September 8, 2016 — Share & Learn Webinar

During this webinar clinicians and project teams from The New Agenda program shared stories about what’s working well in testing the Four Habits and associated skills. Dr. Edgar Chavez from Universal Community Health Center presented about using Habit 2: Eliciting the Patient’s Perspective and Skill #8: Asking what the patient hopes to get out of the visit. Zenelia Roman from Tiburcio Vasquez Health Center shared her experience practicing and using Habit 4: Invest in the End and Skill #21: Explore barriers to implementation of the treatment plan. Other project teams shared successes around measuring patient experience. To view the webinar, click here.

September 27, 2016 — Spread & Sustainability Webinar

During this webinar, Hunter Gatewood, Improvement Advisor and coach for the New Agenda program, walks participants through what it takes to spread and sustain something. In this context, the organizations that are part of the New Agenda program are thinking about what skills from the Four Habits model they may want to spread and sustain in their organization and with new providers. Hunter highlights examples of a spread plan and key elements that make spread successful. To view the webinar, click here.

October 13, 2016 — Share & Learn “Office Hours”

This is a call for clinicians and project team members to ask questions of Rich Frankel and the program coaches.

December 8, 2016 — Outcomes Celebration Webinar

This webinar is a space for teams to reflect and celebrate everything they accomplished in the New Agenda program.