Better Together! Collaborative conversations with colleagues and patients

"Healthcare is innately relational including the interactions with patients, family, other health and social professionals as well as the broader community."

~ Langlois et al, 2020

Optimize relationships with patients

Enable positive communication

  1. Build the foundation
    • Have clear policies and procedures for your practice that address code of conduct, and commonly occurring requests and situations
    • Ensure patients are aware of these policies and procedures
    • Apply these policies consistently and transparently
  2. Select your tools
    • FIFE: Feelings – Ideas – Function – Expectations
    • HEART: Hear the patient – Empathize – Apologize – Respond – Thank the patient
    • APE: Acknowledge, Agree, Apologize – Pause, Paraphrase – Empathy, Explore
  3. React when necessary – know when your and your staff’s safety is threatened and call for help. Ensure you have a safety plan in place.
  4. Have you objectively and factually documented:
    • That you have reviewed your practice’s code of conduct, policies, and procedures with patients?
    • Conversations you have had about specific patient behaviours and consequences?
    • Your and your staff’s efforts to defuse conflicts and de-escalate situations?

Impacts of effective communication on physician-patient relationship

  • Provision of safer care
  • Enhanced focus and engagement with patients
  • Appropriate use of testing, treatment, and consultation
  • Enhanced desire to advocate for patients
  • Positive impact on patient mood
  • Increased likelihood of patients adhering to healthcare plans

Optimize relationships with team members

Psychological safety: A psychologically safe environment is one where people listen to one another, and feel safe to speak up, without being afraid of being embarrassed or punished.2

In the healthcare system, high psychological safety has been linked to:

  • The generation of novel ideas and solutions
  • Knowledge sharing
  • Increased technical team performance
  • Improved quality of care
  • Care that is more patient centred

4 Stages of psychological safety, with strategies corresponding to each level

Stage 1

Inclusion safety

Learning people’s names, facing people when speaking, asking more than we talk, frequent touchpoints to build connections


Stage 2

Learner safety

Sharing what we learn with our team, celebrating failures


Stage 3

Contributor safety

Recognizing accomplishments and small wins, giving “stretch” assignments


Stage 4

Challenger safety

Assigning dissent, rewarding shots on goal and creativity


Learn more about other strategies to foster a psychologically safe environment at The 4 Stages Behavioral Guide (

CMPA resources

Optimizing relationships with patients

Optimizing collaborative care in challenging times


  • 1Isbell LM, Tager J, Beals K, Liu G. BMJ Qual Saf. 2020;29(10):803-814
    Scheepers RA, Boerebach BCM, Arah OA, et al. Int J Behav Med. 2015;22(6):683-698
  • 2Grailey KE, Murray E, Reader T, Brett SJ. BMC Health Serv Res. 2021;21(1):773