II. Management: Patient-Centered Communication
- Bedside Presence
- Understand patient's agenda
- Introduce patient, provider, family and others in the room
- Welcome new patients
- Start with non-medical break-the-ice topics (if time)
- Ask open ended question (e.g. "How can I help you today")
- Allow patient to speak uninterrupted initially
- Ask, is there something else?
- Actively listen while the patient is speaking without distracting activities
- Understand patient's perspective, psychosocial context
- Avoid judging patient's emotions as appropriate or inappropriate
- Avoid offering premature reassurance or normalizing patient's concerns (e.g. "common reaction")
- Understand patient's expectations from encounter (e.g. work note, reassurance)
- Express empathy and concern
- See Breaking Bad News
- See Discussing Terminal Illness (Discussing Death, End-Of-Life Care)
- Shared treatment goals
- Discuss treatment options (including no treatment or watchful waiting)
- Avoid overwhelming the patient with too much information
- References
III. Management: CLAP Mnemonic
- Curiosity
- Approach conversations with an nonjudgmental attitude, open mind and genuine curiosity
- Listen
- Actively listen and hear the patients concerns
- Aspirations
- What does the patient and their family want from the encounter
- Personal
- Avoid taking conflict personally
IV. Management: Maintain good communication with patients and their families
- Establish a relationship with patient and families
- Listen well
- Avoid missing important details due to interruption
- Direct the patient to the current history and avoid interrupting for at least the first minute
- Gain credibility through reciprocal communication
- Listening to a patient's story allows them to unload details and free-up memory to absorb what medical providers say
- Apologize for medical errors (with administrative Consultation)
- Medical providers should consult with their employers and Risk Management teams prior to disclosure
- Some hospitals have full disclosure policies
- A majority of states have apology laws
- Protect providers and organizations to some extent when they disclose medical errors
- Address patient or family dissatisfaction, anger or other negative emotions associated with the visit
- See Conflict Resolution (for effective methods including better listening)
- See Emergency Department Patient Satisfaction
V. Management: Benevolence correlates with best and most satisfied FP's
- Preserve and Enhance people's welfare
- Patient Descriptions of "Good" physicians
- Helpful
- Honest
- Forgiving
- Loyal
- Responsible
VI. References
- Swadron and Shoenberger in Herbert (2019) EM:Rap 19(7): 1-2
- Henry (2013) Avoid Being Sued, EM Bootcamp, CEME
