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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

1.

Patient Engagement

A semi-structured approach
Photo by mynameisharsha
2.

Key Concepts

  • Describe elements of a semi-structured patient interview that invites patient narrative and participation in decision-making
Photo by lautsu
3.

Elements

  • Introduce yourself
  • Elicit the Patient Narrative
  • Demonstrate/Express Empathy
  • Preface Your Summary & Clarification
  • Summarize & Clarify
  • Describe Next Steps
  • Invite Questions
  • Exit
Photo by mrlins
4.

1. Introduce Yourself

Photo by hang_in_there
5.

Click to Edit

Write your name on the board
6.

2. Elicit the Patient Narrative

Photo by HowardLake
7.

Patient confidence & trust

is important to learning pertinent facts
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8.

Smile

It never hurts to offer a
Photo by Walt Stoneburner
9.

Sit down

It communicates attentiveness
Photo by Tulane Publications
10.

Speak at Eye-level

It communicates attentiveness
Photo by zubrow
11.

Avoid doing this

as much as possible
Photo by NEC Corporation of America
12.

If you have to do this...

Photo by NEC Corporation of America
13.

Remember to reconnect face to face

Photo by Lisa Brewster
14.

3. Demonstrate Empathy

Photo by For Inspiration Only
15.

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.
16.

Empathy & Assurance

  • I know things can move slowly here, but we'll do our best to complete your workup as soon as possible.
17.

4. Confirm Understanding

Photo by Alex E. Proimos
18.

I’m going to summarize what you’ve told me. Please correct me if I’ve misunderstood anything.

Photo by Alex E. Proimos
19.

5. Summarize & Clarify

Photo by Alex E. Proimos
20.

Summarize 1 pertinent fact

at a time and confirm
Photo by Alex E. Proimos
21.

Ask Questions that build on what the patient has told you

Photo by Seattle Municipal Archives
22.

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.
23.

Try different ways of asking or saying things. Simply repeating or talking louder does not help.

Photo by Orange_Beard
24.

6. Describe Next Steps

Photo by Erik Schepers
25.

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
26.

7. Encourage patient involvement

Photo by JasonUnbound
27.

Invite questions & Shared decision-making

Photo by Stefan Baudy
28.

8. Leave an open door

Photo by Luz Adriana Villa A.
29.

Physicality is Important

Don't have one hand on the door as you announce your exit
Photo by Graham Ó Síodhacháin
30.

When it's time to leave, be sure to

Face the patient
Photo by Geek2Nurse
31.

Let the patient know you're happy to meet and work with them

Photo by Walt Stoneburner
32.

Remember

Photo by my little red suitcase
33.

How you interact with patients becomes a model for medical students

Photo by phalinn
34.

They're watching your every move

Photo by Walt Stoneburner
35.

References

  • Cole, Steven A., and Julian Bird. The medical interview: the three function approach. Elsevier Health Sciences, 2013.
36.

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
37.

Karen Spear Ellinwood, PhD, JD, EdS

Director, Faculty Instructional Development, Residents as Educators Program
Photo by contemplicity
38.

FID.medicine.arizona.edu

Visit
Photo by cobalt123

Karen Spear Ellinwood, PhD, JD, EdS, BSW

Haiku Deck Pro User
http://twinpalmscp.com