Taking Collective Action to Improve Patient-Provider Communication

2013 ◽  
Vol 22 (2) ◽  
pp. 69-78 ◽  
Author(s):  
Amy Wilson-Stronks ◽  
Sarah W. Blackstone
Keyword(s):  
Augmentative And Alternative Communication ◽  
Good Practice ◽  
Active Role ◽  
Provider Communication ◽  
Alternative Communication ◽  
Patient Centered ◽  
Raising Awareness ◽  
Centered Care ◽  
Patient Provider Communication ◽  
Improve Patient

Abstract There are many reasons for speech-language pathologists (SLPs), especially those who work in the area of augmentative and alternative communication (AAC), to take an active role in improving patient-provider communication. Effective patient-provider communication is fundamental to patient-centered care and correlates strongly with better patient outcomes, as well as increased patient safety and patient satisfaction. It is not only good practice, but good economics. In this article, we introduce existing laws, standards, regulations, and guidelines that address issues related to patient-provider communication in hospitals and other medical settings and discuss how, armed with this information and supportive data, SLPs (especially those with expertise in the area of AAC), can become active in preparing their clients for future medical encounters. We also highlight a need to work collaboratively with other professionals who support communication, such as language interpreters and nurses. Finally, we advocate for SLPs raising awareness about available services, tools, and strategies that support effective communication between patients and providers during medical encounters.

Improving Patient Safety and Patient–Provider Communication

2019 ◽  
Vol 4 (5) ◽  
pp. 1017-1027 ◽  
Author(s):  
Richard R. Hurtig ◽  
Rebecca M. Alper ◽  
Karen N. T. Bryant ◽  
Krista R. Davidson ◽  
Chelsea Bilskemper
Keyword(s):  
Acute Care ◽  
Augmentative And Alternative Communication ◽  
Health Care Team ◽  
Provider Communication ◽  
Alternative Communication ◽  
Patient Provider Communication ◽  
Acute Care Settings ◽  
Nurses Perceptions ◽  
Communication Needs ◽  
The Impact

Purpose Many hospitalized patients experience barriers to effective patient–provider communication that can negatively impact their care. These barriers include difficulty physically accessing the nurse call system, communicating about pain and other needs, or both. For many patients, these barriers are a result of their admitting condition and not of an underlying chronic disability. Speech-language pathologists have begun to address patients' short-term communication needs with an array of augmentative and alternative communication (AAC) strategies. Method This study used a between-groups experimental design to evaluate the impact of providing patients with AAC systems so that they could summon help and communicate with their nurses. The study examined patients' and nurses' perceptions of the patients' ability to summon help and effectively communicate with caregivers. Results Patients who could summon their nurses and effectively communicate—with or without AAC—had significantly more favorable perceptions than those who could not. Conclusions This study suggests that AAC can be successfully used in acute care settings to help patients overcome access and communication barriers. Working with other members of the health care team is essential to building a “culture of communication” in acute care settings. Supplemental Material https://doi.org/10.23641/asha.9990962

scholarly journals The Impact of Previsit Contextual Data Collection on Patient-Provider Communication and Patient Activation: Study Protocol for a Randomized Controlled Trial (Preprint)

2020 ◽  
Author(s):  
Jeana M Holt ◽  
Rachel Cusatis ◽  
Aaron Winn ◽  
Onur Asan ◽  
Charles Spanbauer ◽  
...  
Keyword(s):  
Controlled Trial ◽  
Patient Activation ◽  
Provider Communication ◽  
Patient Centered ◽  
Contextual Data ◽  
Randomized Controlled ◽  
Centered Care ◽  
Patient Provider Communication ◽  
Consumer Informatics ◽  
The Impact

BACKGROUND Patient-centered care is respectful of and responsive to individual patient preferences, needs, and values. To provide patient-centered care, clinicians need to know and incorporate patients’ context into their communication and care with patients. Patient contextual data (PCD) encompass social determinants of health and patients’ needs, values, goals, and preferences relevant to their care. PCD can be challenging to collect as a routine component of the time-limited primary care visit. OBJECTIVE This study aims to determine if patient-provider communication and patient activation are different for patient users and patient nonusers of an electronic health record (EHR)–integrated PCD tool and assess if the impact of using PCD on patient-provider communication and patient activation differs for Black and White patients. METHODS We describe a randomized controlled trial of a prospective cohort of non-Hispanic White and Black patients who receive primary care services at a midwestern academic health care system in the United States. We will evaluate whether providing PCD through a consumer informatics tool enhances patient-provider communication, as measured by the Communication Assessment Tool, and we will evaluate patient activation, as measured by the Patient Activation Measure for PCD tool users and nonusers. Furthermore, owing to racial disparities in care and communication, we seek to determine if the adoption and use of the tool might narrow the differences between patient groups. RESULTS The trial was funded in November 2017 and received local ethics review approval in February 2019. The study began recruitment in April 2019 and enrollment concluded in October 2019 with 301 participants. The analysis was completed in May 2020, and trial results are expected to be published in winter 2020. CONCLUSIONS Recently, there has been increased attention to the role of health information technology tools to enable patients to collaborate with providers through the sharing of PCD. The adoption of such tools may overcome the barriers of current EHRs by directly engaging patients to submit their contextual data. Effectively, these tools would support the EHR in providing a more holistic understanding of the patient. Research further supports that individuals who have robust digital engagement using consumer informatics tools have higher participation in treatment follow-up and self-care across populations. Therefore, it is critical to investigate interventions that elicit and share patients’ social risks and care preferences with the health care team as a mechanism to improve individualized care and reduce the gap in health outcomes. CLINICALTRIAL ClinicalTrials.gov NCT03766841; https://clinicaltrials.gov/ct2/show/NCT03766841 INTERNATIONAL REGISTERED REPORT RR1-10.2196/20309

scholarly journals Forum on Augmentative and Alternative Communication in Acute Care

2019 ◽  
Vol 4 (5) ◽  
pp. 989-990
Author(s):  
Richard R. Hurtig
Keyword(s):  
Clinical Trial ◽  
Acute Care ◽  
Augmentative And Alternative Communication ◽  
Large Scale ◽  
Care Setting ◽  
Provider Communication ◽  
Acute Care Setting ◽  
Alternative Communication ◽  
Patient Provider Communication ◽  
Large Scale Clinical Trial

This forum provides some insights into the process of initiating a clinical service to enhance patient–provider communication. It also provides a report of a large-scale clinical trial that introduced augmentative and alternative communication (AAC) tools in an acute-care setting.

scholarly journals The Impact of Previsit Contextual Data Collection on Patient-Provider Communication and Patient Activation: Study Protocol for a Randomized Controlled Trial

10.2196/20309 ◽  
2020 ◽  
Vol 9 (9) ◽  
pp. e20309
Author(s):  
Jeana M Holt ◽  
Rachel Cusatis ◽  
Aaron Winn ◽  
Onur Asan ◽  
Charles Spanbauer ◽  
...  
Keyword(s):  
Controlled Trial ◽  
Patient Activation ◽  
Provider Communication ◽  
Patient Centered ◽  
Contextual Data ◽  
Randomized Controlled ◽  
Centered Care ◽  
Patient Provider Communication ◽  
Consumer Informatics ◽  
The Impact

Background Patient-centered care is respectful of and responsive to individual patient preferences, needs, and values. To provide patient-centered care, clinicians need to know and incorporate patients’ context into their communication and care with patients. Patient contextual data (PCD) encompass social determinants of health and patients’ needs, values, goals, and preferences relevant to their care. PCD can be challenging to collect as a routine component of the time-limited primary care visit. Objective This study aims to determine if patient-provider communication and patient activation are different for patient users and patient nonusers of an electronic health record (EHR)–integrated PCD tool and assess if the impact of using PCD on patient-provider communication and patient activation differs for Black and White patients. Methods We describe a randomized controlled trial of a prospective cohort of non-Hispanic White and Black patients who receive primary care services at a midwestern academic health care system in the United States. We will evaluate whether providing PCD through a consumer informatics tool enhances patient-provider communication, as measured by the Communication Assessment Tool, and we will evaluate patient activation, as measured by the Patient Activation Measure for PCD tool users and nonusers. Furthermore, owing to racial disparities in care and communication, we seek to determine if the adoption and use of the tool might narrow the differences between patient groups. Results The trial was funded in November 2017 and received local ethics review approval in February 2019. The study began recruitment in April 2019 and enrollment concluded in October 2019 with 301 participants. The analysis was completed in May 2020, and trial results are expected to be published in winter 2020. Conclusions Recently, there has been increased attention to the role of health information technology tools to enable patients to collaborate with providers through the sharing of PCD. The adoption of such tools may overcome the barriers of current EHRs by directly engaging patients to submit their contextual data. Effectively, these tools would support the EHR in providing a more holistic understanding of the patient. Research further supports that individuals who have robust digital engagement using consumer informatics tools have higher participation in treatment follow-up and self-care across populations. Therefore, it is critical to investigate interventions that elicit and share patients’ social risks and care preferences with the health care team as a mechanism to improve individualized care and reduce the gap in health outcomes. Trial Registration ClinicalTrials.gov NCT03766841; https://clinicaltrials.gov/ct2/show/NCT03766841 International Registered Report Identifier (IRRID) RR1-10.2196/20309

scholarly journals Developing a Culture of Successful Communication in Acute Care Settings: Part II. Solving Institutional Issues

2019 ◽  
Vol 4 (5) ◽  
pp. 1037-1043
Author(s):  
Sarah Marshall ◽  
Richard R. Hurtig
Keyword(s):  
Acute Care ◽  
Augmentative And Alternative Communication ◽  
Alternative Communication ◽  
Shared Resources ◽  
Institutional Barriers ◽  
Successful Communication ◽  
Institutional Issues ◽  
Patient Provider Communication ◽  
Communication Needs ◽  
Institutional Challenges

Purpose Establishing services for hospitalized patients with complex communication needs (CCNs) requires identifying and addressing both patient-based and institutional barriers. Although the previous paper ( Marshall & Hurtig, 2019 ) focused on patient-based barriers, this paper addresses overcoming institutional barriers. Method We present a series of cases to illustrate the institutional challenges in meeting the CCNs of patients in an acute care setting. Results Each case illustrates how the deployment of augmentative and alternative communication tools required addressing institutional/systems barriers and how critical collaborations help patients with CCNs to more effectively communicate with caregivers and participate in their care. Conclusion Building a culture of improved patient–provider communication involves establishing a wider range of interprofessional collaborations and shared resources in order to effectively provide patients with CCNs the tools to summon assistance and communicate with their caregivers.

scholarly journals Patient-Centered Care: An Examination of Provider–Patient Communication Over Time

2019 ◽  
Vol 6 ◽  
pp. 233339281988287
Author(s):  
Leslie Riggle Miller ◽  
B. Mitchell Peck
Keyword(s):  
Positive Impact ◽  
Patient Centered Care ◽  
Patient Communication ◽  
Self Report ◽  
Primary Data ◽  
Provider Communication ◽  
Patient Centered ◽  
Centered Care ◽  
Over Time

Objective: To examine the quality of provider communication over time considering the increasing emphasis on patient-centered care (PCC). Patient-centered care has been shown to have a positive impact on health outcomes, care experiences, quality-of-life, as well as decreased costs. Given this emphasis, we expect that provider–patient communication has improved over time. Data Source: We collected primary data by self-report surveys between summer 2017 and fall 2018. Study Design: We use a quantitative retrospective cohort study of a national sample of 353 patients who had an ostomy surgery. Data Extraction Method: We measure provider communication from open-ended self-reports from patients of the number of stated inadequacies in their care. Principal Findings: Results show that the time since patients had their surgery is related to higher quality provider communication. That is, patients who had their surgery further back in time reported higher quality provider communication compared with patients who had their surgery performed more recently. Conclusion: Results suggest that the quality of provider communication has not improved even with an emphasis on PCC.

scholarly journals Improving patient-provider communication about chronic pain: development and feasibility testing of a shared decision-making tool

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Nananda Col ◽  
Stephen Hull ◽  
Vicky Springmann ◽  
Long Ngo ◽  
Ernie Merritt ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Nominal Group Technique ◽  
Nominal Group ◽  
Patient Treatment ◽  
Treatment Goals ◽  
Provider Communication ◽  
Card Sorting ◽  
Patient Provider Communication ◽  
Beta Testing ◽  
Improve Patient

Abstract Background Chronic pain has emerged as a disease in itself, affecting a growing number of people. Effective patient-provider communication is central to good pain management because pain can only be understood from the patient’s perspective. We aimed to develop a user-centered tool to improve patient-provider communication about chronic pain and assess its feasibility in real-world settings in preparation for further evaluation and distribution. Methods To identify and prioritize patient treatment goals for chronic pain, strategies to improve patient-provider communication about chronic pain, and facilitate implementation of the tool, we conducted nominal group technique meetings and card sorting with patients with chronic pain and experienced providers (n = 12). These findings informed the design of the PainAPP tool. Usability and beta-testing with patients (n = 38) and their providers refined the tool and assessed its feasibility, acceptability, and preliminary impact. Results Formative work revealed that patients felt neither respected nor trusted by their providers and focused on transforming providers’ negative attitudes towards them, whereas providers focused on gathering patient information. PainAPP incorporated areas prioritized by patients and providers: assessing patient treatment goals and preferences, functional abilities and pain, and providing patients tailored education and an overall summary that patients can share with providers. Beta-testing involved 38 patients and their providers. Half of PainAPP users shared their summaries with their providers. Patients rated PainAPP highly in all areas. All users would recommend it to others with chronic pain; nearly all trusted the information and said it helped them think about my treatment goals (94%), understand my chronic pain (82%), make the most of my next doctor’s visit (82%), and not want to use opioids (73%). Beta-testing revealed challenges delivering the tool and summary report to patients and providers in a timely manner and obtaining provider feedback. Conclusions PainAPP appears feasible for use, but further adaptation and testing is needed to assess its impact on patients and providers. Trial registration This study was approved by the University of New England Independent Review Board for the Protection of Human Subjects in Research (012616–019) and was registered with ClinicalTrials.gov (protocol ID: NCT03425266) prior to enrollment. The trial was prospectively registered and was approved on February 7, 2018.

How can we improve patient-centered care of motor neuron disease?

2020 ◽  
Vol 10 (2) ◽  
pp. 95-101
Author(s):  
Anne Hogden ◽  
Camille Paynter ◽  
Karen Hutchinson
Keyword(s):  
Service Delivery ◽  
Health System ◽  
Motor Neuron ◽  
Motor Neuron Disease ◽  
System Organization ◽  
Care Service ◽  
Patient Centered Care ◽  
Patient Centered ◽  
Centered Care ◽  
Improve Patient

This perspectives paper discusses patient-centered care for people living with motor neuron disease. We identify challenges and offer solutions from the patient-centered care literature for this population in frontline care, service delivery, research and health system organization. Examples from Australian and international motor neuron disease care are used to illustrate interrelated issues for practice and policy.

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