Eliciting the Patient’s Agenda- Secondary Analysis of Recorded Clinical Encounters

Ospina, Naykky Singh; Phillips, Kari A.; Rodríguez-Gutiérrez, René; Castañeda-Guarderas, Ana; Gionfriddo, Michael R.; Branda, Megan E.; Montori, Víctor M.

doi:10.1007/s11606-018-4540-5

Cited by 225 publications

(104 citation statements)

References 32 publications

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“…Likewise, a screening tool may uncover multiple social risks, such as food, housing, and utilities instability, but the patient may tell her provider that her most pressing social need is to find a safe place to stay, away from a violent male partner. Failing to understand the patient's perspective—a common failure even within the scope of traditional biomedical care—could lead to the wrong immediate treatment.…”

Section: Terms and Distinctionsmentioning

confidence: 99%

Meanings and Misunderstandings: A Social Determinants of Health Lexicon for Health Care Systems

2019

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Health care systems and policymakers in the United States increasingly use language related to social determinants of health in their strategies to improve health and control costs, but the terms used are often misunderstood, conflated, and confused. Greater clarity on key terms and the concepts underlying them could advance policies and practices related to social determinants of health—including by defining appropriate roles and limits of the health care sector in this multisector field.

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Section: Terms and Distinctionsmentioning

confidence: 99%

Meanings and Misunderstandings: A Social Determinants of Health Lexicon for Health Care Systems

2019

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“…In the 1980s, research reported that the majority of physicians interrupted patients within 18 seconds of the conversation . The latest study on this topic shows an average of 11 seconds to interruption by a physician …”

Section: Discussionmentioning

confidence: 99%

“…17 The latest study on this topic shows an average of 11 seconds to interruption by a physician. 18 In contrast, chaplain listening appears to involve a substantial amount of time, with one large adult study reporting time spent between five minutes and over two hours. 19 Given that patient satis-faction is largely dependent on the quality of communication with the medical team, it is possible that deep listening is the means by which patient satisfaction is improved by visits from a chaplain.…”

Section: Discussionmentioning

confidence: 99%

Chaplain care in pediatric oncology: Insight for interprofessional collaboration

Lion

Skiles

Watson³

et al. 2019

Pediatric Blood & Cancer

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Background Although attending to spiritual and religious needs is part of high quality care of pediatric cancer patients, oncology clinicians may not understand the role of the chaplain, resulting in underutilization of resources and failure to fully integrate the chaplain into the clinical team. We provide a description of what the chaplain does in the care of pediatric oncology patients. Methods We conducted a qualitative content analysis of chaplain chart notes over a one‐year period on the pediatric oncology service at a freestanding children's hospital. Using criteria designed to capture multiple potential factors in chaplain referral, we selected 30 patients for thematic analysis. Results In 2016, 166 pediatric patients were diagnosed with cancer and received ongoing care at our institution. From the 30 patients selected, 230 chaplain encounters were documented in the medical chart. Three major themes emerged. (1) The chaplains provided a rich description of spiritual and psychosocial aspects of the patient and family's experience; (2) chaplains provided diverse interventions, both religious and secular in nature; and (3) chaplains provided care within a longitudinal relationship. All three themes depend on the empathic listening by a chaplain. Conclusions The chaplains’ observations about patient and family beliefs, experiences, and emotional/spiritual states have the potential to inform the interdisciplinary care of the patient. Chaplain documentation provides insight into how spiritual care interventions and close relationships may promote patient and family well‐being. In future work, we will explore how to give voice to their insights in caring for pediatric oncology patients.

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“…26 SIBR can address many of these barriers through simple modifiable measures such as making it easy to anticipate when the round will occur, prompting clinician use of appropriate language, assisting patients to formulate questions and prompting behaviours to facilitate participatory decision-making. 29 Conversely, with SIBR, behaviours such as explaining clinical issues to patients were more frequently observed. However, clinician behaviours to facilitate participation were inconsistent.…”

Section: Patient Engagement and Participationmentioning

confidence: 99%

Mixed methods quality evaluation of structured interprofessional medical ward rounds

Redley

Campbell

Stockman

et al. 2020

Internal Medicine Journal

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Background Standardised structure and content of interdisciplinary medical ward rounds can promote patient safety and patient‐centred teamwork. Aims To evaluate interdisciplinary ward rounds using a Structured Interdisciplinary Bedside Rounding (SIBR) intervention. Methods The study involved multi‐method, repeat measures with a non‐equivalent control group. Non‐participant observations were collected at: 1 and 6 months, on an intervention ward that introduced SIBR; and a control ward that continued traditional rounds. Focus group and survey data were also collected on the intervention ward. Participants were clinicians (medicine, nursing and allied health) working in two general medicine wards at a tertiary hospital in Melbourne, Australia. Results Seventy‐eight patient rounds were observed at Time 1, and 239 at Time 2. The SIBR ward rounds had all clinician disciplines represented, whereas allied health and nurses were present for less than 20% of non‐SIBR rounds. Interdisciplinary participation and frequency of desired clinician behaviours increased, and variability in duration of time per patient decreased, on the SIBR rounds. Longitudinal data reflected decreased performance of some SIBR behaviours in the intervention ward, while some desired behaviours increased in the control ward. Qualitative survey and focus group data indicated many positive views, but fit with broader ward routines impacted SIBR implementation. Conclusions The overall recommendation by staff was that SIBR should continue. The results provide insights into the adoption of SIBR behaviours and illustrated diffusion of behaviours across wards. Highlighting successes and identifying barriers can help meet challenges for ongoing improvement.

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Eliciting the Patient’s Agenda- Secondary Analysis of Recorded Clinical Encounters

Cited by 225 publications

References 32 publications

Meanings and Misunderstandings: A Social Determinants of Health Lexicon for Health Care Systems

Meanings and Misunderstandings: A Social Determinants of Health Lexicon for Health Care Systems

Chaplain care in pediatric oncology: Insight for interprofessional collaboration

Mixed methods quality evaluation of structured interprofessional medical ward rounds

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