Patient-centered Engagement
Published on May 17, 2016
This HaikuDeck offers a guide to essential components in the patient engagement process, emphasizing communication skills and a patient-centered approach. This guide can help residents become more mindful of the skills they are modeling for the medical students they teach, and offer a semi-structured approach to assist medical students in understanding the process not only as a fact-gathering objective but as a human interaction.
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PRESENTATION OUTLINE
Key Concepts
- Describe elements of a semi-structured patient interview that invites patient narrative and participation in decision-making
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Elements
- Introduce yourself
- Elicit the Patient Narrative
- Demonstrate/Express Empathy
- Preface Your Summary & Clarification
- Summarize & Clarify
- Describe Next Steps
- Invite Questions
- Exit
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1. Introduce Yourself
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Write your name on the board
2. Elicit the Patient Narrative
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If you have to do this...
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Remember to reconnect face to face
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3. Demonstrate Empathy
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Empathy & Assurance
- I’m sorry you’re feeling this way, and we will do our best to find out what's happening and help you to feel better.
Empathy & Assurance
- I know things can move slowly here, but we'll do our best to complete your workup as soon as possible.
4. Confirm Understanding
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I’m going to summarize what you’ve told me. Please correct me if I’ve misunderstood anything.
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5. Summarize & Clarify
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Ask Questions that build on what the patient has told you
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Example
- Provider: So your headache has gotten worse since yesterday, and now it hurts to have the lights on.
- Patient: The light bothered me from the beginning.
- Provider: How has it gotten worse?
- Pt: The pain's more intense and constant now.
- Provider: Thank you for clarifying.
Try different ways of asking or saying things. Simply repeating or talking louder does not help.
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6. Describe Next Steps
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What can the patient expect to happen?
- Lab tests, diagnostic imaging
- Referrals to specialists
- Inpatient: discharge and plan of care or admission/longer hospital stay
- Outpatient: Follow-up plan
7. Encourage patient involvement
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Invite questions & Shared decision-making
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8. Leave an open door
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Physicality is Important
Don't have one hand on the door as you announce your exit
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Let the patient know you're happy to meet and work with them
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Remember
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They're watching your every move
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References
- Cole, Steven A., and Julian Bird. The medical interview: the three function approach. Elsevier Health Sciences, 2013.
References
- Mazzi, M. A., Rimondini, M., Deveugele, M., Zimmermann, C., Moretti, F., van Vliet, L., Deledda, G., Fletcher, I. and Bensing, J. (2015), What do people appreciate in physicians' communication? An international study with focus groups using videotaped medical consultations. Health Expectations, 18: 1215–1226. doi: 10.1111/hex.12097
Karen Spear Ellinwood, PhD, JD, EdS
Director, Faculty Instructional Development, Residents as Educators Program
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