Doctor-patient communication: a review and a rationale for using an assessment framework

2018 ◽  
Vol 32 (7) ◽  
pp. 891-907 ◽  
Author(s):  
Ariel Belasen ◽  
Alan T. Belasen
Keyword(s):  
Healthcare Delivery ◽  
Healthcare Providers ◽  
Critical Factor ◽  
Patient Communication ◽  
Assessment Framework ◽  
Content Type ◽  
Doctor Patient Communication ◽  
Communication Assessment ◽  
Operational Issues ◽  
The Impact

Purpose The purpose of this paper is to explore the extent to which improving doctor–patient communication (DPC) can address and alleviate many healthcare delivery inefficiencies. Design/methodology/approach The authors survey causes and costs of miscommunication including perceptual gaps between how physicians believe they perform their communicative duties vs how patients feel and highlight thresholds such as the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) used by hospitals to identify health outcomes and improve DPC. Findings The authors find that DPC correlates with better and more accurate care as well as with more satisfied patients. The authors utilize an assessment framework, doctor–patient communication assessment (DPCA), empirically measuring the effectiveness of DPC. While patient care is sometimes viewed as purely technical, there is evidence that DPC strongly predicts clinical outcomes as well as patients’ overall ratings of hospitals. Research limitations/implications More research is needed to extend our understanding of the impact of the DPC on the overall HCAHPS ratings of hospitals. The authors think that researchers should adopt a qualitative method (e.g. content analysis) for analyzing DPC discourse. Practical implications When a sufficient amount of DPCA training is initiated, a norming procedure could be developed and a database may be employed to demonstrate training program’s efficacy, a critical factor in establishing the credibility of the measurement program and nurturing support for its use. Originality/value The authors highlight clinical and operational issues as well as costs associated with miscommunication and the need to use metrics such as HCAHPS that allow consumers to see how hospitals differ on specific characteristics.

Doctor–patient communication, patient knowledge and health literacy: how difficult can it all be?

2014 ◽  
Vol 96 (6) ◽  
pp. e9-e13 ◽  
Author(s):  
S Kyle ◽  
D Shaw
Keyword(s):  
Health Literacy ◽  
Orthopaedic Surgery ◽  
Patient Communication ◽  
Patient Knowledge ◽  
Doctor Patient Communication ◽  
The Impact

Patients who understand their injuries, the aims and potential of their treatment are likely to experience superior outcomes. We review the literature on positive, encouraging doctor–patient communication, and the impact of health literacy and education on patient knowledge in medicine and surgery, with a particular emphasis on orthopaedic surgery. We also highlight methods of improving doctor–patient communication and patient knowledge.

scholarly journals Benefits of Understanding Systemic Racism in Forming Clinician-Patient Relationships to Reduce Black Infant Mortality

2020 ◽  
Vol 3 (3) ◽  
pp. 11-15
Author(s):  
Michelle A. Gotto ◽  
Laura Morello ◽  
Marsha Michie
Keyword(s):  
Black Women ◽  
Infant Mortality ◽  
Ecological Model ◽  
The United States ◽  
Patient Communication ◽  
Infant Mortality Rate ◽  
Systemic Racism ◽  
Doctor Patient Communication ◽  
Public Health Researcher ◽  
The Impact

Background: The United States lags far behind other developed nations in our overall infant mortality rate. Public health researcher Arline Geronimus has described a "weathering" effect of chronic racial stress among Black women that contributes to high rates of preterm birth, the leading cause of infant death. Trusting relationships between clinicians and patients may play a role in reducing infant mortality for Black mothers. Based on a social-ecological model of health care communication around infant mortality, we focus here on doctor-patient communication and correlations between clinicians' understandings of systemic racism and their communication with Black pregnant patients.Methods: This paper reports the findings from interviews with 5 maternal health clinicians (prior to recruitment being temporarily paused due to COVID-19) practicing at Cuyahoga County hospitals that serve large populations of Black women. Qualitative coding methods based in grounded theory were used to draw out themes from interview transcripts.Results: Doctor-patient communication was an emergent theme in these interviews. Results suggest an association between clinicians' understanding of the impact of systemic racism and their ability to communicate successfully and form positive bonds with pregnant mothers who are at higher risk of infant mortality.Conclusion: Acknowledging systemic racism as the cause of poor social determinants of health, which in turn contribute to higher rates of infant mortality, may provide clinicians a pathway to more positive communication and higher levels of trust with their patients, which in turn may play a role in reducing infant mortality in the Black community. Further research should investigate these associations.

Turnaround of struggling plant of DJSL Limited: capital investment or operational improvement

2018 ◽  
Vol 8 (3) ◽  
pp. 1-26
Author(s):  
Somnath Chakrabarti ◽  
Nripendra Kumar ◽  
Anupam Upadhyay
Keyword(s):  
Operations Management ◽  
Capital Investment ◽  
Swot Analysis ◽  
Subject Area ◽  
Content Type ◽  
Turnaround Strategies ◽  
People Development ◽  
Operational Issues ◽  
Functional Experience ◽  
The Impact

Subject area Strategy. Study level/applicability The case can primarily be used for a Strategic Management course for teaching the revival strategies for financially weak plants. The case highlights the need to shift from a product manufacturing perspective to a market orientation perspective and, hence, may add value as an add-on case in a Strategic Marketing course. The case also covers the topic of benchmarking which may be of use in an Operations Management course. Case overview DJSL Ltd. is the largest engineering and manufacturing enterprise in India in the energy-related/infrastructure space in the public sector. Its Lucknow unit, manufacturing porcelain insulators and wear resistant ceramic lining (CERA LINING), has started reporting losses. A change of management took place in October 2015, whereby Mr. S P Singh was appointed as the Head of the Lucknow Unit. Mr. Singh had rich functional experience of 30 years, mainly in the domains of strategy, project execution and commercial aspects. He was asked to come up with a revival plan for the Unit by the top management of DJSL. The case highlights the importance of operational issues in turnaround management. Expected learning outcomes Students may be encouraged to debate the benchmarking practices that are best suited for the Lucknow unit. They can also discuss the impact of benchmarking efforts upon turnaround strategy. Students are also encouraged to understand the constraints which may limit the success of initiatives impacting operational improvements. Students need to develop the understanding of marketing strategy to perform a SWOT analysis of each product of the Lucknow unit and to sense the business opportunities in and around the environment. Students need to discuss how productivity may be improved with the adoption of appropriate people development strategies. Students are encouraged to discuss the revival/turnaround strategies and to identify the influence of improvement in operational efficiency/productivity upon revival plan. Supplementary materials Teaching Notes are available for educators only. Please contact your library to gain login details or email [email protected] to request teaching notes. Subject code CSS: 11: Strategy.

Re-examining manufacturing strategy from knowledge advantages

2017 ◽  
Vol 37 (10) ◽  
pp. 1475-1495 ◽  
Author(s):  
Jue-Fan Wang ◽  
David D.C. Tarn
Keyword(s):  
Critical Factor ◽  
Competitive Advantages ◽  
Manufacturing Strategy ◽  
Mediating Effects ◽  
Content Type ◽  
Organizational Goals ◽  
Knowledge Diversity ◽  
Knowledge Convergence ◽  
Knowledge Depth ◽  
The Impact

Purpose During this current era of the knowledge economy, knowledge activities have greatly impacted manufacturing activities, with knowledge being treated as a critical factor that creates and sustains competitive advantages. Past studies tended to relate knowledge works with organizational tasks and assumed that knowledge workers implement those tasks to achieve organizational goals. Accordingly, the purpose of this paper is to employ the perspective of task domain as the basis to clarify the impact of manufacturing task domains on the manufacturing strategy, as well as the mediating effects of knowledge advantage on such an impact. Design/methodology/approach The authors follow Becerra-Fernandez and Sabherwal’s (2001) task which focus/task breadth dichotomy as the basis to define market-based task domains, employs Leonard-Barton’s (1995) T-shaped skill as the theoretical base to construct knowledge advantages, i.e., knowledge depth (I-shaped skill), diversity (hyphened skill), and convergence (T-shaped skill), and uses the conventional typology to measure the manufacturing strategy (i.e. cost, quality, flexibility, and delivery). The empirical study is conducted via a questionnaire survey and selects Taiwan’s top 600 manufacturers as the population and accordingly collects 131 effective observations. Findings The empirical evidence indicates that firms’ priorities on cost and delivery are positively caused by the focus orientation of the tasks, while their priorities on quality and flexibility are positively caused by both focus and diversity orientations of the tasks. The results also signify that knowledge advantages perform complete mediation on the previous relationships. In more detail, knowledge depth presents mediation on focus orientation, and knowledge convergence exhibits mediating effects both on focus and breadth orientations. The statistics point out that knowledge depth has the highest impact on the manufacturing strategy, but knowledge diversity fails to significantly explain the manufacturing strategy. Originality/value Literature assumed that knowledge activities are task-driven issue; this study hence examines knowledge advantage based on the task domain perspective to clarify the architecture and contents of knowledge advantages.

scholarly journals Longitudinal impact of Welsh clinical leadership fellowship

2020 ◽  
Vol 33 (1) ◽  
pp. 1-11
Author(s):  
Suzanne Phillips ◽  
Alison Bullock
Keyword(s):  
Clinical Practice ◽  
Medical Training ◽  
Healthcare Delivery ◽  
The Body ◽  
Longitudinal Impact ◽  
Structured Interviews ◽  
Clinical Leadership ◽  
Content Type ◽  
Training Programmes ◽  
The Impact

Purpose This paper aims to evaluate the longer-term impact of the 12-month Welsh clinical leadership fellowship. Design/methodology/approach Semi-structured interviews with 10 out of 14 trainee doctors who were fellows between 2013-2016, exploring how leadership knowledge and skills were used in clinical practice, impact on patient care and influence on careers. Data, gathered in 2017 when participants had completed the fellowship between 1-3 years, were analysed thematically. Findings All found the fellowship rewarding. The experience was felt to advantage them in consultant interviews. They gained insight into the wider influence on organisations and the complexity of issues facing senior clinicians. Although subtle, the impact was significant, equipping fellows with negotiation skills, enabling them to better influence change. Indirect impact on clinical practice was evidenced by enhanced confidence, teamworking skills and progression of improvement projects. However, the use of skills was limited by lack of seniority within teams, demands of medical training and examinations. The negativity of others towards management and leadership was also noted by some. Research limitations/implications Small participant numbers limit generalisability. Practical implications The fellowship is designed to equip participants with skills to lead improvements in healthcare delivery. Those more advanced in their medical training had greater opportunity and seniority to lead change and were better placed to apply the learning. This has implications for whom the training should be targeted. Originality/value A rare study exploring the longer-term impact of a leadership programme on later clinical practice, which adds to the body of knowledge of impact and efficacy of leadership training programmes in healthcare environments.

scholarly journals Knowing in Nurses’ Belief and Attitude about Patient Activation: A Validation of the Korean Clinician Support for Patient Activation Measure Using Rasch Analysis

Healthcare ◽  
2020 ◽  
Vol 8 (4) ◽  
pp. 571
Author(s):  
Suhyeon Choi ◽  
Yun Hee Ham ◽  
Kihye Han ◽  
Eunjung Ryu
Keyword(s):  
Rasch Analysis ◽  
Healthcare Delivery ◽  
Healthcare Providers ◽  
Patient Activation ◽  
Critical Factor ◽  
Cross Sectional ◽  
Korean Version ◽  
Patient Activation Measure ◽  
Ranking Order ◽  
Clinician Support

Background: Patient engagement is considered a critical factor in improving healthcare delivery. This study aimed to test the Korean version of the Clinician Support for Patient Activation Measure (CS-PAM) using Rasch analysis, and to explore nurses’ beliefs about patient self-management. Methods: A cross-sectional, exploratory study design was employed. The staff nurses who were recruited from six hospitals were requested to complete the Korean CS-PAM. Their responses were subsequently subjected to Rasch analysis to validate the Korean CS-PAM. The CS-PAM was paraphrased into Korean using the standardized forward–backward translation method. Results: The internal consistency of the scale had good Cronbach’s alpha value. For all items, the infit and outfit statistics fell well within the acceptable range of 0.5–1.5. This measure formed a unidimensional Guttman-like scale that explained 54.7% of the variance. Conclusions: The Korean version of the CS-PAM showed good psychometric properties and appeared to be consistent with the meaning of the original CS-PAM. However, the items have a somewhat different ranking order when compared to the English and Dutch versions. The instrument might be useful for identifying the supportive beliefs and attitudes of nurses or healthcare providers in order to improve patient activation in healthcare.

Bridging strategic and operational issues for project business through managing trust

2010 ◽  
Vol 3 (3) ◽  
pp. 422-442 ◽  
Author(s):  
Magnus Gustafsson ◽  
Hedley Smyth ◽  
Elena Ganskau ◽  
Tomas Arhippainen
Keyword(s):  
Social Capital ◽  
Trust Management ◽  
Balance Sheet ◽  
Customer Relationships ◽  
Self Awareness ◽  
Business Relationships ◽  
Content Type ◽  
Trust Development ◽  
Operational Issues ◽  
The Impact

PurposeOrganisational trust is analysed through observation of operations or strategic prescription. The management and project management literature is largely prescriptive. The purpose of this paper is to examine the role and potential of strategic trust development and management to improve operations in the project business and enhance client satisfaction, analysing trust as social capital.Design/methodology/approachThe analysis is supported by the method of and data gathered through CROL®: a process for managing business relationships and interfaces. The case in question focuses on over 30,000 customer relationships covering five years of global operations by companies in the project business.FindingsThe analysis focuses on the connection between self‐awareness, performance, improvement and the impact upon both relationships and financial performance – social capital in the “balance sheet”. The objective is to identify the extent to which trust management can help bridge the gap between prescriptive strategy and operations. Bridging this gap entails linking trust as social capital with organisational culture, operational systems and routines, and behaviours.Research limitations/implicationsThe analysis shows the importance of self‐awareness in managing business relationships.Practical implicationsThe paper outlines on a conceptual level how companies can manage trust and capture the value in business relationships.Originality/valueThe paper shows how companies through systematic forced reflection can manage trust in individual business relationships.

Risks and older adults with atrial fibrillation in rural communities: an integration lens

2016 ◽  
Vol 24 (4) ◽  
pp. 188-200 ◽  
Author(s):  
Kathy L Rush ◽  
Nelly D Oelke ◽  
R. Colin Reid ◽  
Carol Laberge ◽  
Frank Halperin ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Older Adults ◽  
Rural Communities ◽  
Health Service ◽  
Healthcare Delivery ◽  
Healthcare Providers ◽  
Health Service Delivery ◽  
Decision Makers ◽  
System Level ◽  
Content Type

Purpose – Older adults with atrial fibrillation (AF) have put growing demands on a poorly integrated healthcare system. This is of particular concern in rural communities with rapid population aging and few healthcare resources elevating risk of stroke and mortality. The purpose of this paper is to explore healthcare delivery risks for rural older adults with AF. Design/methodology/approach – This qualitative study collected data from AF patients, healthcare providers and decision makers. Ten patients participated in six-month care journeys involving interviews, logs, photos, and chart reviews. In total, 13 different patients and ten healthcare providers participated in focus groups and two decision makers participated in interviews. Findings – Three key health service risks emerged: lack of patient-focussed access and self-management; unplanned care coordination and follow-up across the continuum of care; and ineffective teamwork with variable perspectives among patients, providers, and decision makers. Originality/value – This study extends the understanding of risks to the health system level. Results provide important information for further research aimed at interventions to improve health service delivery and policy change to mitigate risks for this population.

scholarly journals COVID-19 outbreak: implications on healthcare operations

2020 ◽  
Vol 33 (1) ◽  
pp. 247-256 ◽  
Author(s):  
Higor Leite ◽  
Claire Lindsay ◽  
Maneesh Kumar
Keyword(s):  
Supply Chain ◽  
Just In Time ◽  
Healthcare Operations ◽  
Research Directions ◽  
Economic Implications ◽  
Content Type ◽  
Lean Practices ◽  
Trade Offs ◽  
Operational Issues ◽  
The Impact

PurposeThe COVID-19 pandemic is considered a major disruptive event of this decade, raising unforeseen socio-economic implications worldwide. This novel virus has increased the influx of patients in hospitals, and healthcare organisations are facing unprecedented constraints in their operations to deal with increased demand and pressed capacity. Thus, this article evaluates the impact of the COVID-19 pandemic on healthcare systems' demand, resources and capacity and provides research directions.Design/methodology/approachThis is a viewpoint article and uses timely information on healthcare operations from both scholars and managers, published by diverse sources during the COVID-19 outbreak.FindingsThe authors discuss the focus on “flattening the curve of infection” as a measure to protect healthcare, delay the impact of increased demand and reorientate healthcare supply chain practices. Furthermore, the authors evaluate the role of lean practices on managing demand and capacity and improving quality across healthcare operations and supply chain. Finally, the authors suggest research directions on modern operational issues that emerged during this pandemic, such as discussions around the sustainability of lean post-pandemic, “just in time” practices, inventory trade-offs and lack of organisational responsiveness during untenable events.Originality/valueIn this article, the authors provide a contemporary assessment of the implications of the COVID-19 pandemic on healthcare operations, underscoring main economic and operational elements that can be affected, such as unforeseen demand, resources and capacity shortage. Therefore, the authors assess that healthcare organisations, practitioners and governments have to anticipate operational and economic impacts and, ultimately, to reassess their plans to deal with such adverse events.

Psychological contract violation and patient’s antisocial behaviour

2020 ◽  
Vol 31 (4) ◽  
pp. 647-664
Author(s):  
Po-Chien Chang ◽  
Ting Wu ◽  
Juan Du
Keyword(s):  
Psychological Contract ◽  
Antisocial Behaviour ◽  
Patient Communication ◽  
Patient Relationship ◽  
Patient Trust ◽  
Doctor Patient Relationship ◽  
Content Type ◽  
Doctor Patient Communication ◽  
Psychological Contract Violation ◽  
Contract Violation

Purpose The purpose of this study is to examine the dual effects of the violation of psychological contract on patient’s antisocial behaviour via the mediator of patient trust and the role of doctor-patient communication as a critical contingent variable in the psychological contract violation of patient’s antisocial behaviour relationship. Design/methodology/approach The data were collected from 483 hospitalized patients distributed in Shanxi province, China by using a self-administered survey. Findings The results indicated that psychological contract violation is positively associated with patient antisocial behaviour via patient trust. Moreover, the study found that doctor-patient communication moderates the mediated effects of psychological contract violation on patient’s antisocial behaviour through patient trust; that is, the mediated effect on antisocial behaviour is weaker when both doctor and patients have more communication. Research limitations/implications Due to a cross-sectional design in nature, the causal relationship cannot be developed based on the results. Despite the limitation, the present study provides insights for improving doctor-patient relationship by emphasizing the importance of increasing patient trust and doctor-patient communication. Practical implications To improve the quality of doctor-patient relationship, this study addresses the significance of properly showing understandings and care to regain mutual trust and reducing the likelihood of patient’s antisocial behaviour. Social implications The research findings have implications for both the health system and medical schools in China to reinforce the professional ethics and improve their medical humanities as the main concerns to generate a more sustainable doctor–patient relationship. Originality/value This study includes patient trust as a mediator and doctor-patient communication as a moderator to investigate the moderated mediation relationship among patients and medical professionals. By further examining the doctor-patient relationship, the results may not only help improve the efficient implementation of medical practices but also support the institutes and develop medical professionals for more positive doctor-patient relationships.

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