Patients’ Perceptions of Health Care Providers’ Dismissive Communication

Some patients experience negative interactions with health care providers, such as when they perceive that their concerns are ignored by providers. The present study, guided by patient-centered communication, examined health care provider communication behaviors that resulted in patients feeling dismissed, and whether there were differences in providers who dismissed being perceived as (dis)similar to the patients in gender, race/ethnicity, or age. U.S. adults claiming they felt dismissed by a provider were asked to recall demographic information they perceived about the provider and what the provider said that was dismissive. Responses were coded for emergent themes. Results revealed that younger, female, and non-White participants most frequently reported being dismissed by a dissimilar provider. Patients felt dismissed when they perceived that providers were rude or did not take action, provided poor information, did not believe patients, rushed the visit, or were uninformed. Providers may want to avoid these behaviors and could consider obtaining training in supportive communication behaviors such as providing validation to patients and listening to patients in order to enhance patient satisfaction. Patients can also receive communication training to take a more active role in their medical encounters by learning to effectively ask questions, express preferences, and speak up for themselves.

Electronic Task Management System: A Pediatric Institution's Experience

Background Electronic medical task management systems (ETMs) have been adopted in health care institutions to improve health care provider communication. ETMs allow for the requesting and resolution of nonurgent tasks between clinicians of all craft groups. Visibility, ability to provide close-loop feedback, and a digital trail of all decisions and responsible clinicians are key features of ETMs. An embedded ETM within an integrated electronic health record (EHR) was introduced to the Royal Children's Hospital Melbourne on April 30, 2016. The ETM is used hospital-wide for nonurgent tasks 24 hours a day. It facilitates communication of nonurgent tasks between clinical staff, with an associated designated timeframe in which the task needs to be completed (2, 4, and 8 hours). Objective This study aims to examine the usage of the ETM at our institution since its inception. Methods ETM usage data from the first 3 years of use (April 2016 to April 2019) were extracted from the EHR. Data collected included age of patient, date and time of task request, ward, unit, type of task, urgency of task, requestor role, and time to completion. Results A total of 136,481 tasks were placed via the ETM in the study period. There were approximately 125 tasks placed each day (24-hour period). The most common time of task placement was around 6:00 p.m. Task placement peaked at approximately 8 a.m., 2 p.m., and 9 p.m.—consistent with nursing shift change times. In total, 63.16% of tasks were placed outside business hours, indicating predominant usage for after-hours task communication. The ETM was most highly utilized by surgical units. The majority of tasks were ordered by nurses for medical staff to complete (97.01%). A significant proportion (98.79%) of tasks was marked as complete on the ETM, indicating closed-loop feedback after tasks were requested. Conclusion An ETM function embedded in our EHR has been highly utilized in our institution since its introduction. It has multiple benefits for the clinician in the form of efficiencies in workflow and improvement in communication and also workflow management. By allowing collection, tracking, audit, and prioritization of tasks, it also provides a stream of actionable data for quality-improvement activities.

PATIENT - HEALTH CARE PROVIDER COMMUNICATION IN THE DIGITAL ERA

The paper gives an overview of digital health components and their role in individual and collective health including telemedicine, artificial intelligence for health, wearable devices, mobile phones and mobile health. A particular focus is given to mobile health that significantly improve health care provider - patient communication, ensure maximum coverage with minimum resources, influence behavior change communication and stimulate healthy lifestyle. Mobile health application may vary from prevention risky behavior among patients, ensuring proper treatment and rehabilitation of the patients with various form of addictions, providing information on health to various target groups. The article gives examples of such programs and their effectiveness.