Effective communication is a bidirectional process, yet the majority of patients have not had any sort of training nor background on how to have these specific conversations with their physicians or other health care professionals.
As caregivers, we can partner with patients to effectively engage in conversations that will determine what matters most to them and will also help ensure high-value care delivery.
The key to an effective patient-clinician relationship is for both to realize that the patient is the main driver of their own health. Actively building and maintaining healthy habits and mindsets, taking ownership of one’s own health, is important and empowering.
This section will provide you with tools and resources that you can use in patient encounters to encourage patient activation and partnership.
As we discussed in MODULE 5, the Choosing Wisely campaign has developed resources for patients, such as “5 Questions to Ask Your Doctor Before You Get Any Test, Treatment, or Procedure”:
A number of clinicians have placed these cards within their offices and they encourage their patients to engage in these conversations with them and with their other caregivers.
There are other question prompt lists available that can help patients select questions they with to ask their health care team. Another strategy is to ask patients to generate their own list of questions prior to a visit so that they can be adequately addressed. Some clinics give patients health cards or patient agenda forms with a list of topics for the patient to consider asking about.
“The purpose of a question prompt list is to support patients in seeking information concerning their diagnosis and treatment; to address their concerns; to enhance the communication between the patient/consumer and the treating clinician; to promote patient participation; and to potentially enhance shared decision making within the health consultation.”2
Patient decision aids help people make informed choices that take into account their personal values and preferences. Decision aids can encourage active participation by patients in health care decisions.3
For example, see this decision aid to help with selecting an antidepressant with a patient:
Different patients are likely to have different priorities and may select different tradeoffs. A decision aid like this can help them understand those choices. See JAMA’s article4 to see a depression treatment decision aid to use with patients.
An “A-to-Z” list
of patient decision aids is available from the Ottawa Hospital Research Institute (and endorsed by AHRQ): https://decisionaid.ohri.ca/index.html
Remember, motivational interviewing is another strategy that can be effective in communicating with patients, especially when navigating behavioral changes.5
“Studies have shown that 40-80% of the medical information patients are told during office visits is forgotten immediately, and nearly half of the information retained is incorrect.”7
One tool to improve this situation is the “teach-back” method. The teach-back method is a way to check understanding by asking patients to state in their own words what was just discussed. It is a way to confirm that you have explained things in a manner your patients understand.
You can learn more about how to use the teach-back method with this AHRQ toolkit
Here are some key tips from this toolkit:
Think about how you will ask your patients to teach back the information. For example:
“We covered a lot today and I want to make sure that I explained things clearly. So let’s review what we discussed. Can you please describe the 3 things you agreed to do to help you control your diabetes?”
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Decision aids can be a very effective tool to help patients make treatment decision. Read about the effect of decision aid adoption in a large health system in Washington state.
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