Improving Improving Patient Patient

CommunicationCommunication in No Time in No Time

• It is possible to see more patients in less time and still be an effective communicator simply need to communicate “smarter” by making better use of the time you've got.

• to communicate smarter with your patients you'll need to refine the basic communication skills you already have

make the necessary adjustments in your communication style to accommodate today's more participatory style of care, and take steps to go the extra mile.

KEY POINTSKEY POINTS::

• Most patients today prefer a partnership with their physicians and want to share responsiblity for their care.

• Meeting these new patient needs isn't time consuming, but it does require adjusting the communication skills you already have.

KEY POINTSKEY POINTS::

• An efficient office will enhance your relationships with your patients and save time for you and your staff — time that you can spend with patients.

• Your staff also represents you to your patients. It's important that they receive proper training in effective patient communication.

Refining the basicsRefining the basics

If you're like most physicians, you've probably already mastered the basic communication skills .

You listen empathetically. You have a keen understanding of nonverbal behaviors. You always try to give well-reasoned explanations. But because time is in increasingly short supply, you may feel you need to reduce your talk time.

Be forewarnedBe forewarned

Taking shortcuts too often or in the wrong places may weaken the doctor-patient relationship you've worked so hard to build, and it also may keep you from obtaining crucial information necessary to your patients' care.

To maintain the qualityTo maintain the quality

To maintain the quality of your communication in today's fast times, make sure you're doing all those things you already know you're supposed to be doing:

1- 1- Don't omit the pleasantriesDon't omit the pleasantries

patients are more likely to follow advice if they have a good relationship with their doctor.

it's an essential part of patient care.

22--Verbal communicationVerbal communication

This also includes the tone and rate of speech which can convey understanding, sympathy, empathy or acknowledgement.

33--Non-verbal communicationNon-verbal communication

93% of communication is non-verbal. doctors who showed a high level of non-verbal immediacy, such as sitting forward or smiling, had a positive impact on patient satisfaction, and perception of the quality of medical care received. It also reduced patients’ fears of communication with their doctor.

•

4- how you enter a room4- how you enter a room

Even with time at a premium, walk into the exam room with a smile, shake the patient's hand, call the patient by name (first name or surname, whichever the patient prefers), and sit down. “Sitting down places the doctor at eye level or below eye level . “This relaxes the patient so that he or she will communicate more openly.”

5- Don't appear rushed 5- Don't appear rushed (even if you are)(even if you are)

Patients are greatly irritated when their doctors appear hurried .

refrains from two specific non-verbal behaviors: looking at his watch and keeping one hand on the doorknob. “These behaviors imply that the patient in the room isn't as important as the one who's coming in next . “It's important to make each patient feel that they are in the center of the universe

Once you're in the exam room, make sure you're really there: Focus your attention on the patient and stop yourself from being preoccupied with what's happening on the other side of the exam-room door.

6- Keep conversations on track6- Keep conversations on track

helping patients stay on track is key to increasing efficiency and maximizing the value of the time you have with them

you should gently guide them back to the matter at hand.”

7- Listen without interrupting7- Listen without interrupting

Studies have shown that the patient normally speaks for an average of 18 seconds before the doctor interrupts

But if the doctor lets them speak for three to four minutes, they tell you 90 percent of what's wrong with them.”

It's also a good idea to check your listen:talk ratio

8- Relate with your eyes8- Relate with your eyes = eye connection = eye connection • Avoid spending the patient visit focusing

on a computer screen, writing down information or reading a chart. Really look into the patient's eyes. Your eye contact should be direct but intermittent (not staring), and it should be sincere and convey interest.

• patients often perceive they have spent more time with you than they have

9- Organize your interviews9- Organize your interviews

MEDICAL PATIENT 1- GENERAL EMPRESSION (age – sex – race – appearance - etc

2- CHIEF COMPLAINT 3- OPQRST & SAMPLE 4- vital signs – physical exam – investigation 5- Decision

Organize your interviewsOrganize your interviews

TRAUMA PATIENT Initial Assessment

• General impression• Initial level of consciousness (AVPU)• Manual stabilization of cervical spine• ABCs

Prioritizes patient • Determines existence of immediately

life-threatening conditions

10-Making necessary adjustments10-Making necessary adjustments

Being an excellent clinician and a master of basic communication skills may no longer be enough to ensure patient retention in your practice — especially considering how patients' expectations have changed. today's patients want to be partners in health care decision making; they no longer want to be told what to do. They want reasoning and proof to replace a patient-physician relationship that was traditionally built on blind trust. Given these changing dynamics, what adjustments should you make in your professional style? Some that you may want to consider include the following:

1- Make an extra effort to build 1- Make an extra effort to build trust trust

Patients who were able to ask questions and offer opinions about the treatment process were found to have measurably better outcomes. To move toward this participatory style of care, physicians need to encourage adult interactions, keep conversation at the patient's level of understanding and let the patient do most of the talking

2- Empower your patients 2- Empower your patients

• Even though many patients prefer a more participatory role in their health care, you'll continue to encounter some patients who may find you intimidating. “A lot of patients perceive an imbalance in the relationship and think that all the power is in the doctor's favor

• these patients will feel a greater sense of participation in their care if the options available to them are explained by the doctor or a staff member.

3- Provide more information in less3- Provide more information in less time time• One way to provide more information to your patients

without a larger time commitment is to integrate patient education materials into the office visit. “We keep a file of the patient education handouts . “So, if I have a patient with hypertension, I ask the nurse to give the patient that handout. While the patient is reading it, I see another patient, and then come back in and answer the patient's questions. In some cases, if I need to save time, I ask the nurse to go back in to explain it.”

• provide more information more efficiently by delegating some patient education tasks to nurses and other qualified staff members. nurses can provide patient education on medications, drug interactions, diabetes management and other subjects.

The benefitsThe benefits

• The single most important criterion by which patients judge you as a physician is

the way you interact with them..

The benefitsThe benefits

with shorter patient visits now a reality, you have even less time to “make or break” the patient-physician relationship. It is therefore vital that you develop your understanding of your own communication style and adjust that style to meet the

needs of various patients.

The benefitsThe benefits

Many patients today want to be part of the treatment team. If you include your patients as fully informed partners in their care, they'll pay you back with increased satisfaction and better compliance and

retention rates for your practice .

The benefitsThe benefits

In the process, it's likely you'll discover more satisfaction in your work, renewed motivation and increased productivity