quick health paper

Patient-Provider Communication: Provider Perspective

Day 16

Agenda

Review

Provider Perspective

Activity

Homework

Z I M C O R E H U B S | C O M P A N Y C U L T U R E H A N D B O O K

anyone who offers health-related services to patients or clients

Physicians

Nurses

Therapists

Medical Technicians

Public Health Practitioners

Campaign Workers

Nutritionists

Health Educators

Any more?

Health Care Provider....

05

larger-scale or broad factors from outside the immediate context of the health care provider/patient interaction

localized influences within the immediate context of the health care provider/patient interaction

M A C R O - L E V E L I N F L U E N C E S

M I C R O - L E V E L I N F L U E N C E S Organizational influences Interpersonal influences Cultural influences Power dynamics

1.

2.

3.

4.

(Mattson & Hall, 2011, p. 157)

MOST work within an org. setting & MUST function within the rules and confines of that org. & other org. they

interact with

ORG Influences Managed Care

health care system with administrative control over primary health care services within a medical group

practice that serves prepaid subscribers

HMOs and PPOs

aim to control medical costs & streamline processes for efficiency

Organizational Culture "actions, ways of thinking, practices, stories, and artifacts that characterize a particular organization"

(Eisenberg, Goodall, & Trethewey, 2007, p. 127)

Organizational Rules & Guidelines explicit or understood regulations that guide behavior within a particular environment

(Mattson & Hall, 2011)

Organizational Influences

Women-longer, less technical, more PCC

Gender

Interpersonal Influences

Different areas of medical care interact

with patients differently

Specialty

older, trained in more traditional methods-

paternalistic approach-more

knowledgeable and experienced

Age

some are more direct than others

Communication Style

(Mattson & Hall, 2011)

(Mattson & Hall, 2011)

Benefits of (PCC) for Providers Increased patient compliance which means patients are more likely to follow what their health care providers direct them to do increases providers' sense of accomplishments because patients are more likely to have improved health outcomes

Fewer malpractice claims less likely to sue health care providers for mistreatment because they feel a connection with them and have their best interests in mind incorporation of PCC are more likely to understand the complexity of patients' conditions & can treat their health issues more efficiently

Greater patient satisfaction when patients feel that providers listen to them, seriously consider their concerns, and work with them to find solutions, they are generally more satisfied with their providers more likely to become repeat patients

1. a.

b.

2. a.

b.

3. a.

b.

Active listening Therapeutic interviewing Advice giving Empathy Bad news delivery

1. 2. 3. 4. 5.

(Mattson & Hall, 2011)

Provider Skills for (PCC)

genuinely listening to what patients are saying and if necessary encouraging

patients to talk more

listening without interrupting

maintaining eye contact

avoid distracting gestures

use encouraging nonverbals and verbals

nodding, murmuring phrases such as "yes" or "I see"

listen both to what patients say and to what they do not say

in tune with patients' tone and body language

repeat and clarify

Clarify: "In other words..."; "I mean..."; "I am trying to say.."; "I am not sure

what you mean."; "Could you please repeat/explain what you mean?"

focusing attention on their patients by suspending their own grames of reference and judgment

Active Listening1.

(Mattson & Hall, 2011)

"an interpersonal exchange using verbal and nonverbal messages that culminates in someone's being helped" (van servellen, 2009, p. 169).

2. Therapeutic Interviewing

Therapeutic Interviewing (TI) Goals:

Question Asking Closed-ended questions (need specific details) Open-ended questions (most information) Clarifying questions (questions of fact that ensure they understand what patients are saying)

Probing questions (determine additional information and expand on what they said)

Ex: "Why do you think this is the case?"; "How did you decide?";

"What is the connection between...and..?"

Common Language

Obtaining full descriptions of patients'

conditions and concerns

Reducing patients' emotional distress

Offering support

Listing primary and secondary health

problems

Establishing collaborative relationship

Two Key Interviewing Skills Providers Need for TI

(Mattson & Hall, 2011)

"act of disclosing what one thinks or feels about another's experience, namely, what you think they should do, think, or feel" (van servellen, 2009, p. 169)

3. Advice Giving

when patients ask for advice from providers, they tend to be more receptive to it

patients are not as receptive if they perceive providers to be dominating or controlling

providers need to be sensitive when giving unsolicited advice to patients

advice should be coupled with logical reasons & potential outcomes

Examples "You might want to consider..."

"An option you could take would be to..."

(Mattson & Hall, 2011)

4. Empathy providers come to understand patients' situations and the struggles patients face

challenging because providers are concerned about maintaining professional boundaries while showing

genuine concern for patients

Emotional Contagion having an affective response that consists of parallel emotions to another or "feeling with another"

Empathetic Concern having an affective response that consists of nonparallel emotions to another of "feeling for another"

more communicatively effective stance for providers to take with patients

PCC can be difficult to teach as it involves adjusting providers' thought processes-not just their COM

behaviors

practice empathy

practice active listening

acknowledging patients' experiences and feelings, agreeing with patients and conveying positive

feelings

identification with or vicariously experiencing the feelings or thoughts of another

(Mattson & Hall, 2011)

Will be discussed on Friday!

5. Bad News Delivery

RA 9 DUE TONIGHT WORK ON PODCAST RA 10 DUE FRIDAY READ NGO-METZGER ET AL. (2008) A PROVIDER'S PERSPECTIVE