Patient-Provider Interactions and Patient Outcomes

1989 ◽  
Vol 15 (2) ◽  
pp. 134-138 ◽  
Author(s):  
ROBERT W. SANSON-FISHER ◽  
ELIZABETH M. CAMPBELL ◽  
SELINA REDMAN ◽  
DEBORAH J. HENNRIKUS
Keyword(s):  
Health Care ◽  
Patient Outcomes ◽  
Communication Skills ◽  
Health Care Providers ◽  
Clinical Competence ◽  
Patient Adherence ◽  
Video Feedback ◽  
Care Providers ◽  
Teaching Techniques ◽  
Treatment Beliefs

Research shows that a number of provider interactional skills are empirically related to patient adherence, making interaction skills a necessary and important part of clinical competence. These skills fall into three broad categories: techniques to elicit and modify patients' health and treatment beliefs, to aid recall of information, and to aid adherence. Specific skills in each category are discussed. Research further shows that health care providers can be taught effective communication skills, and that one of the most effective teaching techniques is audio or video feedback in which the provider's interaction with a patient is judged by tutor and peers using explicit, empirically based criteria.

Cultural Considerations in the Management of Chronic Pain

CAND Journal ◽  
2021 ◽  
Vol 28 (4) ◽  
pp. 11-13
Author(s):  
Shakila Mohmand ◽  
Sumar Chams
Keyword(s):  
Health Care ◽  
Chronic Pain ◽  
Cultural Competency ◽  
Patient Outcomes ◽  
Health Care Providers ◽  
Cultural Beliefs ◽  
Coping Mechanisms ◽  
Care Providers ◽  
Pain Experience ◽  
Cultural Considerations

Cultural competency within health care helps eliminate racial and ethnic health disparities. When assessing and treating patients with chronic pain, practitioners should feel confident in using information regarding a patient’s individual cultural beliefs due to their significant impact on the pain experience. Culture impacts perception, outlook, and communication of pain, as well as coping mechanisms. These are aspects of subjective history that influence important decisions regarding the management of chronic pain. Becoming more aware of what to look for and which questions to ask can allow naturopathic doctors and other health-care providers to continue improving therapeutic relationships and patient outcomes.

scholarly journals General practitioner perceptions of clinical medication reviews undertaken by community pharmacists

2010 ◽  
Vol 2 (3) ◽  
pp. 225 ◽  
Author(s):  
Linda Bryant ◽  
Gregor Coster ◽  
Ross McCormick
Keyword(s):  
Health Care ◽  
General Practitioner ◽  
Patient Outcomes ◽  
Health Care Providers ◽  
Community Pharmacists ◽  
Resource Utilisation ◽  
Utilization Review ◽  
Care Providers ◽  
Factors Influencing ◽  
Medication Reviews

INTRODUCTION: Delivery of current health care services focuses on interdisciplinary teams and greater involvement of health care providers such as nurses and pharmacists. This requires a change in role perception and acceptance, usually with some resistance to changes. There are few studies investigating the perceptions of general practitioners (GPs) towards community pharmacists increasing their participation in roles such as clinical medication reviews. There is an expectation that these roles may be perceived as crossing a clinical boundary between the work of the GP and that of a pharmacist. METHODS: Thirty-eight GPs who participated in the General Practitioner–Pharmacists Collaboration (GPPC) study in New Zealand were interviewed at the study conclusion. The GPPC study investigated outcomes of a community pharmacist undertaking a clinical medication review in collaboration with a GP, and potential barriers. The GPs were exposed to one of 20 study pharmacists. The semi-structured interviews were recorded and transcribed verbatim then analysed using a general inductive thematic approach. FINDINGS: The GP balanced two themes, patient outcomes and resource utilisation, which determined the over-arching theme, value. This concept was a continuum, depending on the balance. Factors influencing the theme of patient outcomes included the clinical versus theoretical nature of the pharmacist recommendations. Factors influencing resource utilisation for general practice were primarily time and funding. CONCLUSION: GPs attributed different values to community pharmacists undertaking clinical medication reviews, but this value usually balanced the quality and usefulness of the pharmacist’s recommendations with the efficiency of the system in terms of workload and funding. KEYWORDS: Family physicians; community pharmacy services; drug utilization review; primary healthcare; health plan implementation; qualitative research; interprofessional relations

scholarly journals Medical Students’ Experiences and Outcomes Using a Virtual Human Simulation to Improve Communication Skills: Mixed Methods Study (Preprint)

2019 ◽  
Author(s):  
Timothy C Guetterman ◽  
Rae Sakakibara ◽  
Srikar Baireddy ◽  
Frederick W Kron ◽  
Mark W Scerbo ◽  
...  
Keyword(s):  
Health Care ◽  
Mixed Methods ◽  
Medical Students ◽  
Communication Skills ◽  
Health Care Providers ◽  
Mixed Methods Study ◽  
Virtual Human ◽  
Care Providers ◽  
Empathic Communication ◽  
Nonverbal Skills

BACKGROUND Attending to the wide range of communication behaviors that convey empathy is an important but often underemphasized concept to reduce errors in care, improve patient satisfaction, and improve cancer patient outcomes. A virtual human (VH)–based simulation, MPathic-VR, was developed to train health care providers in empathic communication with patients and in interprofessional settings and evaluated through a randomized controlled trial. OBJECTIVE This mixed methods study aimed to investigate the differential effects of a VH-based simulation developed to train health care providers in empathic patient-provider and interprofessional communication. METHODS We employed a mixed methods intervention design, involving a comparison of 2 quantitative measures—MPathic-VR–calculated scores and the objective structured clinical exam (OSCE) scores—with qualitative reflections by medical students about their experiences. This paper is a secondary, focused analysis of intervention arm data from the larger trial. Students at 3 medical schools in the United States (n=206) received simulation to improve empathic communication skills. We conducted analysis of variance, thematic text analysis, and merging mixed methods analysis. RESULTS OSCE scores were significantly improved for learners in the intervention group (mean 0.806, SD 0.201) compared with the control group (mean 0.752, SD 0.198; <italic>F</italic><sub>1,414</sub>=6.09; <italic>P</italic>=.01). Qualitative analysis revealed 3 major positive themes for the MPathic-VR group learners: gaining useful communication skills, learning awareness of nonverbal skills in addition to verbal skills, and feeling motivated to learn more about communication. Finally, the results of the mixed methods analysis indicated that most of the variation between high, middle, and lower performers was noted about nonverbal behaviors. Medium and high OSCE scorers most often commented on the importance of nonverbal communication. Themes of motivation to learn about communication were only present in middle and high scorers. CONCLUSIONS VHs are a promising strategy for improving empathic communication in health care. Higher performers seemed most engaged to learn, particularly nonverbal skills.

scholarly journals MP31: Debriefing critical incidents in health care: a review of the evidence

CJEM ◽  
2018 ◽  
Vol 20 (S1) ◽  
pp. S51-S52 ◽  
Author(s):  
E. Katherine Conrad ◽  
R. DB. Morrison
Keyword(s):  
Systematic Review ◽  
Health Care ◽  
Patient Outcomes ◽  
Health Care Providers ◽  
Critical Incident ◽  
Critical Incidents ◽  
Well Being ◽  
Stressful Events ◽  
Care Providers ◽  
Inclusion Criteria

Introduction: Emergency health care providers (HCPs) regularly perform difficult medical resuscitations that require complex decision making and action. Critical incident debriefing has been proposed as a mechanism to mitigate the psychological effect of these stressful events and improve both provider and patient outcomes. The purpose of this updated systematic review is to determine if HCPs performing debriefing after critical incidents, compared to no debriefing, improves the outcomes of the HCPs or patients. Methods: We performed a librarian assisted systematic review of OVID Medline, CINAHL, OVID Embase and Google Scholar (January 2006 to February 2017) No restrictions for language were imposed. Two investigators evaluated articles independently for inclusion criteria, quality and data collection. Agreement was measured using the Kappa statistic and quality of the articles were assessed using the Downs and Black evaluation tool. Results: Among the 658 publications identified 16 met inclusion criteria. Participants included physicians, nurses, allied health and learners involved in both adult and pediatric resuscitations. Findings suggest that HCPs view debriefing positively (n=7). One moderate quality study showed that debriefing can enhance medical student and resident knowledge. Several studies (n=8) demonstrated at least some improvement in CPR and intubation related technical skills. Debriefing is also associated with improved short term patient survival but not survival to discharge (n=5). Two studies reported benefits to HCPs mental health as evidenced by improved ability to manage grief and decreased reported symptoms of Post-Traumatic Stress Disorder (PTSD). Conclusion: We found HCPs value debriefing after critical incidents and that debriefing is associated with improved HCP knowledge, skill and well-being. Despite these positive findings, there continues to be limited evidence that debriefing significantly impacts long term patient outcomes. Larger scale higher quality studies are required to further delineate the effect of structured debriefing on patient and provider outcomes.

Does Sludge/Debris Exist in Today's Vascular Access Ports?

2014 ◽  
Vol 19 (1) ◽  
pp. 23-26 ◽  
Author(s):  
Michael Dalton ◽  
Natan Pheil ◽  
Jim Lacy ◽  
Jordan Dalton
Keyword(s):  
Health Care ◽  
Patient Outcomes ◽  
Health Care Providers ◽  
Vascular Access ◽  
Bloodstream Infections ◽  
Health Care Facilities ◽  
Care Providers ◽  
Care Facilities ◽  
Vascular Access Ports ◽  
Improve Patient

Abstract Sludge is defined as a slushy mass, deposit, or sediment. In vascular access ports (VAPs), it appears to be the buildup of clotted blood, blood components, drug and mineral precipitates or residues, and lipids that adhere to or reside in the internal path of the reservoir. Several studies note the presence of sludge as a risk factor for increased incidence of VAP-related bloodstream infections as well as higher occlusion rates. Overall, the occurrence of sludge in implanted vascular ports may increase patient-associated risks and costs to health care providers by as much as $40,000 per incident. Understanding the significance of these associated risks and costs may lead to solutions that save health care facilities money; better serve health care providers; and ultimately, improve patient outcomes.

scholarly journals The Impact of Visualization Dashboards on Quality of Care and Clinician Satisfaction: Integrative Literature Review (Preprint)

2017 ◽  
Author(s):  
Saif Sherif Khairat ◽  
Aniesha Dukkipati ◽  
Heather Alico Lauria ◽  
Thomas Bice ◽  
Debbie Travers ◽  
...  
Keyword(s):  
Health Care ◽  
Literature Review ◽  
Patient Outcomes ◽  
Health Care Providers ◽  
Care Setting ◽  
Data Gathering ◽  
Clinical Information ◽  
Care Providers ◽  
Life Threatening

BACKGROUND Intensive Care Units (ICUs) in the United States admit more than 5.7 million people each year. The ICU level of care helps people with life-threatening illness or injuries and involves close, constant attention by a team of specially-trained health care providers. Delay between condition onset and implementation of necessary interventions can dramatically impact the prognosis of patients with life-threatening diagnoses. Evidence supports a connection between information overload and medical errors. A tool that improves display and retrieval of key clinical information has great potential to benefit patient outcomes. The purpose of this review is to synthesize research on the use of visualization dashboards in health care. OBJECTIVE The purpose of conducting this literature review is to synthesize previous research on the use of dashboards visualizing electronic health record information for health care providers. A review of the existing literature on this subject can be used to identify gaps in prior research and to inform further research efforts on this topic. Ultimately, this evidence can be used to guide the development, testing, and implementation of a new solution to optimize the visualization of clinical information, reduce clinician cognitive overload, and improve patient outcomes. METHODS Articles were included if they addressed the development, testing, implementation, or use of a visualization dashboard solution in a health care setting. An initial search was conducted of literature on dashboards only in the intensive care unit setting, but there were not many articles found that met the inclusion criteria. A secondary follow-up search was conducted to broaden the results to any health care setting. The initial and follow-up searches returned a total of 17 articles that were analyzed for this literature review. RESULTS Visualization dashboard solutions decrease time spent on data gathering, difficulty of data gathering process, cognitive load, time to task completion, errors, and improve situation awareness, compliance with evidence-based safety guidelines, usability, and navigation. CONCLUSIONS Researchers can build on the findings, strengths, and limitations of the work identified in this literature review to bolster development, testing, and implementation of novel visualization dashboard solutions. Due to the relatively few studies conducted in this area, there is plenty of room for researchers to test their solutions and add significantly to the field of knowledge on this subject.

scholarly journals The Influence of Online Health Information Seeking Before a Consultation on Anxiety, Satisfaction, and Information Recall, Mediated by Patient Participation: Field Study

10.2196/23670 ◽  
2021 ◽  
Vol 23 (7) ◽  
pp. e23670
Author(s):  
Melanie de Looper ◽  
Julia C M van Weert ◽  
Barbara C Schouten ◽  
Sifra Bolle ◽  
Eric H J Belgers ◽  
...  
Keyword(s):  
Health Care ◽  
Patient Outcomes ◽  
Health Care Providers ◽  
Patient Participation ◽  
Information Seeking ◽  
Care Providers ◽  
Word Count ◽  
Information Recall ◽  
Relative Contribution ◽  
Online Health Information Seeking

Background Today, many cancer patients engage in online health information seeking (OHIS). However, little is known about how patients differ in their OHIS levels. In addition, OHIS might influence patient participation during a consultation with a physician, which might mediate the effects on patient outcomes. Objective The aim of this study is twofold: first, to provide insight into which personal characteristics and psychosocial factors affect patients’ OHIS levels and, second, to test the hypothesis that the effects of OHIS on patient outcomes are mediated by patient participation during the consultation. Methods Patient participation was operationalized in terms of patients’ absolute word count; the relative contribution of the patient, compared with the health care provider; and the number of questions and assertions expressed during the consultation. The patient outcomes measured were anxiety after the consultation, satisfaction with the consultation, and information recall. Participants in this study were patients recently diagnosed with colorectal cancer recruited from 6 hospitals in the Netherlands (n=90). Data were collected using questionnaires and audio-recorded consultations of patients with health care providers before their surgery. Results The results showed that younger patients, higher educated patients, patients with a monitoring coping style, and patients who experienced more cancer-related stress engaged more in OHIS. In turn, OHIS was related to patient participation in terms of the patient’s absolute word count but not to the relative contribution to the consultation or expressing questions and assertions. We did not find a relation between OHIS and anxiety and OHIS and recall mediated by patient participation. However, we found that patients’ absolute word count significantly mediated the positive association between OHIS and patients’ satisfaction with the consultation. Conclusions Results indicate positive implications of OHIS for patients’ care experience and, therefore, the importance of helping patients engage in OHIS. However, the results also suggest that OHIS is only successful in increasing a single aspect of patient participation, which might explain the absence of relations with anxiety and recall. The results suggest that more beneficial effects on patient outcomes may be achieved when health care providers support patients in OHIS.

scholarly journals Effect of Financial Relationships on the Behaviors of Health Care Professionals: A Review of the Evidence

2012 ◽  
Vol 40 (3) ◽  
pp. 452-466 ◽  
Author(s):  
Christopher Robertson ◽  
Susannah Rose ◽  
Aaron S. Kesselheim
Keyword(s):  
Health Care ◽  
Patient Outcomes ◽  
Health Care Providers ◽  
Health Care Professionals ◽  
Conflicts Of Interest ◽  
Care Providers ◽  
Conflicts Of Interests ◽  
Conflicting Interests ◽  
Care Costs ◽  
Financial Relationships

Physicians, scholars, and policymakers continue to be concerned about conflicts of interests among health care providers. At least two main types of objections to conflicts of interest exist. Conflicts of interests may be intrinsically troublesome if they violate providers’ fiduciary duties to their patients or they contribute to loss of trust in health care professionals and the health care system. Conflicts of interest may also be problematic in practice if they bias the decisions made by providers, adversely impacting patient outcomes or wastefully increasing health care costs. This latter objection may be observed in differences in the prescriptions written, procedures performed, or costs billed by health care professionals who have conflicting interests, when compared to those that do not have such financial relationships.

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