1) Effective communication between health professionals and patients is critical for patient safety. It allows clinicians to properly assess patient needs and risks, and involves patients as partners in their own care.
2) Barriers to communication, such as lack of health literacy or hierarchical traditions, can negatively impact patient safety by hindering understanding and efficient teamwork.
3) Strategies like using simple educational materials and confirming patient comprehension can help address these barriers and promote patient empowerment, safety, and better health outcomes through open dialogue and a partnership approach.
The study found that:
1) Ward in-charges' leadership characteristics were average, scoring 69.2% on assessments, indicating a need for continued nursing education.
2) Ward in-charges' performance on managerial activities was below average, at 48.28%, showing room for improvement in nursing management quality.
3) Nursing care status was satisfactory, at a 72.32% assessment score.
4) Environmental sanitation levels were also satisfactory, scoring 65.9% on evaluations.
5
The document discusses trends and issues in nursing that nurses need to study. It covers topics like nursing education, research, management, and services and how trends globally, regionally, and nationally affect them. Other areas discussed include ethics, legal aspects, health advocacy, technology use, emerging nursing roles, and the future direction of healthcare systems and nursing education. The document emphasizes the importance of studying trends and issues for sound decision making and navigating possible future scenarios in nursing.
True professionals and doctrine of informed consent
Abstract
The clinical practices around informed consent in healthcare settings have undergone a revolution for the better over recent decades. However the way doctor obtains informed consent still remains problematic. A number of factors have contributed to the continued dominance of the traditional dentist-patient imbalance of power, but, demands for more patient autonomy are increasing. The reasons for this ambiguity are varied. The complexity of communication in clinical encounter, the role of autonomy and the changing nature of the doctor-patient relationship, have also contributed to this uncertainty which still remains in many clinical settings. The uncertainty is partly due to the conceptual dullness of important core concepts.
This document summarizes a presentation about patient- and family-centered care. It defines patient- and family-centered care as a philosophy that treats patients and families as partners in care decisions and sees them as unique individuals. The presentation outlines 10 core components of patient- and family-centered care like human interaction, information and education, and family involvement. It discusses benefits like better outcomes, satisfaction, and financial performance. It also provides examples of best practice volunteer programs that support this philosophy and ways to evaluate existing programs based on patient- and family-centered care standards.
2 why did you decide to pursue a baccalaureate degree in nursinAASTHA76
This survey asked 65 nurses about their reasons for pursuing a baccalaureate degree in nursing. It identified six main themes in their responses: desire to help others, lifelong dream of being a nurse, ability to advance their career, availability of jobs, earning potential, and loss of a previous job. However, the summary does not provide details about the level of measurement used in the study or how frequently each theme was reported. This information is important for determining what descriptive statistics are most appropriate.
This lecture discusses using technology to improve patient education by allowing patients to access health information when they are ready to learn. It describes various technologies like videos, apps, patient portals and EHR-driven education that empower patients. However, barriers like health literacy, language and limited technology access can still impact patients' ability to manage their own health education. The goal is interactive, on-demand education so patients are better prepared partners in their care.
The study found that:
1) Ward in-charges' leadership characteristics were average, scoring 69.2% on assessments, indicating a need for continued nursing education.
2) Ward in-charges' performance on managerial activities was below average, at 48.28%, showing room for improvement in nursing management quality.
3) Nursing care status was satisfactory, at a 72.32% assessment score.
4) Environmental sanitation levels were also satisfactory, scoring 65.9% on evaluations.
5
The document discusses trends and issues in nursing that nurses need to study. It covers topics like nursing education, research, management, and services and how trends globally, regionally, and nationally affect them. Other areas discussed include ethics, legal aspects, health advocacy, technology use, emerging nursing roles, and the future direction of healthcare systems and nursing education. The document emphasizes the importance of studying trends and issues for sound decision making and navigating possible future scenarios in nursing.
True professionals and doctrine of informed consent Ruby Med Plus
Abstract
The clinical practices around informed consent in healthcare settings have undergone a revolution for the better over recent decades. However the way doctor obtains informed consent still remains problematic. A number of factors have contributed to the continued dominance of the traditional dentist-patient imbalance of power, but, demands for more patient autonomy are increasing. The reasons for this ambiguity are varied. The complexity of communication in clinical encounter, the role of autonomy and the changing nature of the doctor-patient relationship, have also contributed to this uncertainty which still remains in many clinical settings. The uncertainty is partly due to the conceptual dullness of important core concepts.
This document discusses quality of care in healthcare. It defines quality of care according to the WHO as services that improve desired health outcomes. The aims of quality care are identified as safe, effective, timely, efficient and equitable care. Key indicators of quality are also outlined, such as medication errors, bed sores, and urinary tract infections. Improving quality can provide patient-centered care and increase access. Challenges include lack of consent, disrespectful care, and discrimination. The conclusion advocates assessing risks, reporting incidents, engaging in prevention, and providing education to enhance quality of care.
An Evaluation of the Challenges of Doctor- Patient Communicationinventionjournals
1. Effective doctor-patient communication is important for building trust, facilitating information exchange, and involving patients in medical decisions. However, several challenges exist, including doctors' deteriorating communication skills over time, avoidance of discussing emotional issues, and discouraging patient collaboration.
2. Doctors can improve communication through training to develop skills like empathy and active listening. It is also important to understand patients' health beliefs as perceptions may impact treatment. With better communication, outcomes are improved through higher patient understanding, satisfaction, and adherence to care plans.
The document discusses the nursing process in community health nursing. It describes the steps of the nursing process - assessment, diagnosis, planning, implementation, and evaluation. It provides details on how community health nurses assess communities to identify health needs, formulate nursing diagnoses for communities and populations, plan interventions, implement plans through activities like health teaching, and evaluate the impact of nursing care. The nursing process provides structure for community health nurses to systematically address the health needs of communities.
Effective communication in patient safety and healthcareTaher Kagalwala
This document discusses strategies for effective communication in healthcare settings. It identifies challenges to communication such as cognitive load, competence, conflict between parties, and organizational pressures. It promotes assertive communication and provides tools for structured communication. The SBARQ technique outlines communicating situation, background, assessment, recommendation and asking questions. The CUS method serves as a signal phrase when a provider is concerned, uncomfortable or feels a situation is unsafe. The two-challenge rule advises communicating up the chain of command if concerns are not addressed after two assertive attempts. Effective communication is key to preventing medical errors and improving patient safety and outcomes.
This document discusses leadership for patient engagement in the NHS. While the NHS has focused on public consultations and one-off engagement initiatives, true culture change is required to make services patient-centered. Leaders face challenges in shifting beliefs, attitudes, and behaviors away from disease-focused care toward responsive, empowering care centered around patients' needs and preferences. Successful approaches require strategic, system-wide efforts to engage patients in shared decision-making, self-management of long-term conditions, and improving quality by understanding patients' perspectives. Isolated projects are easier than changing mainstream practice to prioritize the patient experience in all interactions and functions.
The document discusses several topics:
1. A new set of criteria has been developed by NCQA and PCPCC to recognize physician practices as patient-centered medical homes based on 7 principles.
2. Matria has partnered with Microsoft to support HealthVault, a new health platform that allows users to store and access personal health information online.
3. A case study describes how Matria client BD integrated disability management with disease management, increasing participation in health programs from 23% to 48%.
Physician-Patient Communication: A Dyadic Approach To C.C. Amd P.S.maxbury
This document proposes a study to examine the relationship between a physician's cultural competence, as perceived by patients, and patient satisfaction. It begins with an introduction discussing the importance of physician-patient communication and cultural competence in healthcare. It then reviews literature showing that patients are more satisfied when they share similarities like age, race or gender with their physician. The document proposes using a survey to collect data from 200 patients at a hospital to analyze whether a physician's cultural awareness, as perceived by patients, correlates with higher patient satisfaction. The goal is to address the research question of whether cultural competence impacts the physician-patient relationship and patient outcomes.
Telenursing; a current trend in nursing practiceArowojolu Samuel
Telenursing: A seminar presentation by Amu Justina. telenursing in nigeria, challenges of telenursing, components of telenursing. telenursing as a current trend in nursing practice. telemedicine, telenursing.
Patient- and Family Centered Care: "Resident Performance from the Patient's V...hanscomhh5
This document summarizes a presentation about patient and family centered care (PFCC) in graduate medical education. It discusses the history and core values of PFCC, provides examples of how PFCC has been successfully implemented at institutions like the Medical College of Georgia, and shares results from a study that assessed resident performance through patient feedback surveys. The study found patient feedback improved residents' communication, patient care, and systems-based practice skills compared to traditional attending evaluations alone. The presentation concludes PFCC can enhance graduate medical education by providing meaningful feedback to help residents improve.
Patient satisfaction the importance of its measurement in improving the quali...Alexander Decker
This document summarizes a study on measuring patient satisfaction in a public pediatric department. The study aimed to identify factors influencing patient satisfaction related to access and care delivery. Researchers conducted surveys of 105 patients to assess satisfaction with various aspects like wait times, facilities, and staff interactions. Statistical analysis found the main dissatisfaction factors were long wait times and the waiting room conditions. Multiple factor analysis identified different patient profiles. Based on the results, the department implemented several actions to improve patient satisfaction.
5 Technologies That Are Changing the Doctor-Patient RelationshipSystems4PT
The existence of the doctor-patient relationship remains constant, while technology does not. These technological innovations require a different perspective and approach in the eyes of both the doctor and the patient. Here are 5 technologies that are rapidly affecting this relationship.
reflection on a conflict situation
critical thinker
critical care
decision maker
analyzing and reflecting on a conflict or any situation being an advocate of a patient how to protect the patients right of right and fair care.
4 replies one for each claudiamajor disasters and emeAASTHA76
This document discusses health policies and their impact on nursing practice, particularly during disasters and emergencies. It notes that health policies provide guidelines for patient care during normal times and can act as a "guiding light" during abnormal situations like disasters. Nurses must be trained on protocols and have a general understanding of what to do in emergencies in order to respond rapidly and effectively. The document also emphasizes that nurses should feel confident in their actions during emergencies and that their experiences can help inform future health policies.
communication Interdisciplinary communication.pdfbkbk37
The document discusses nurse-patient communication and interdisciplinary communication. It defines seven principles of patient-clinician communication: mutual respect, harmonized goals, a positive environment, appropriate decision partners, providing the right information, transparency and full disclosure, and continuous learning. It explains the importance of effective communication between patients and clinicians to improve health outcomes and care quality. Communication must respect both parties' roles and perspectives to establish shared goals and make informed healthcare decisions.
Importance of teamwork communication in nursing practiceAhmed Alkhaqani
In today’s healthcare system, the delivery process includes many interfaces and patient handouts between several health professionals with further education and professional training levels. As a health care science, nursing focuses on serving the needs of humans as biopsychosocial and spiritual beings. Its practice requires scientific knowledge and interpersonal, intellectual, and technical abilities and skills. This means a composition of knowledge, clinical work, and interpersonal communication. Communication is an essential element of nursing in all fields of activity, including prevention, treatment, therapy, rehabilitation, education, and health promotion. Moreover, the nursing process as a scientific method of exercise and implementation of nursing is achieved through dialogue, interpersonal environment, and specific verbal communication skills. Therefore, effective clinical practice involves several cases in which they must clearly communicate important information. Nurses are the heart of the fundamental strengthening of the health system and the basis of providing basic health services. They bring the care that is centered on people to communities where it is most needed, which helps improve overall health results and the cost-effectiveness of the service. Nurses are generally the first responders to complex humanitarian crises and disasters, community protectors, advocates, communication and coordination experts. Nurse communication skills are crucial but difficult to master them.
Peer response’s # 2Rules Please try not to make the responses s.docxdanhaley45372
Peer response’s # 2
Rules: Please try not to make the responses super lengthy, contribute one fact AND include references
HMGT 420
· Wk#3
Talar posted Jun 4, 2016 11:57 PM
Patients who have complex health needs require not only medical. But also social services and support from a variety of caregivers and providers. Facility managers who are part of care coordination could assist patient in receiving optimal care by addressing the challenges in coordinating care for these patients, and offer programmatic changes and policies that help deliver the best services to all patients.
Facility managers can come up with strategic plans based on prior data and make necessary changes based on preexisting conditions. “Patient- centered, comprehensive, coordinated, and accessible care that continuously improved through a systems-based approach to quality and safety” (AHRQ, 2012) are what’s needed to achieve the highest quality care possible in any health care facility.
Patient centered care can’t be achieved with providers only. It requires team work and collaboration among all stakeholders. To improve the quality and safety of patients, health care facility managers can work hand and hand with the coordinated team to provide a system based approach by drawing on decision-support tools, taking into account patient experience, and using population health management approach. Patient preference and needs on what aspects of care to be improved.
Respond to Talar here:
· Vanscoy, Week 3
Sarah posted Jun 5, 2016 11:07 AM
As a facility manager, and part of the care coordination team, I would look into models of care that would assist our situation. With the Affordable Care Act in place, there are accountable care organizations (ACOs), which provide models of care (“Promise,” 2013). There are many different definitions and perspectives on care coordination, but all lead to the goal of meeting patient needs and providing adequate healthcare (“Care,” 2014).
Care coordination is essential because each patient can interact with a variety of professionals each visit. For example, for a routine physical appointment, the patient could meet with the scheduling staff, medical assistants, nurses, doctors, pharmacists, and the billing staff. If each one of these member fails to coordinate as a whole, the patient could be harmed or neglected. As a care coordinator, I would be responsible for discussing an individualized care plan with each patient and ensuring that they understand their responsibilities. All barriers should be identified, such as financial, social (language), psychological, and anything that would effect the patient from following their correct plan of care and interacting with the staff (“Promise,” 2013). Another key point is to ensure the medical staff has reviewed the patient’s medical records and ensure that everyone is on the same page. These are just a few examples, because each case is different and each patient will have different needs. .
This policy brief discusses strategies to increase patient engagement in their own healthcare. It outlines three key areas: improving health literacy, promoting shared decision-making, and supporting self-management of chronic conditions. Effective interventions include providing tailored written and online health information, training healthcare professionals in communication skills, using decision aids and question prompts, and delivering self-management education programs. Governments need a coherent strategy targeting multiple levels to inform and empower patients in their care.
This document discusses patient and family centered care. It explains that patient and family centered care involves working together with providers, patients, and families to improve the patient experience and quality of care. It shares how other organizations have successfully adopted this model of cultural change. This model is referred to as patient and family centered care (PFCC). Facilities that have implemented PFCC have seen benefits like reduced call lights, fewer falls, and lower readmission rates. The adoption of a new PFCC culture takes continual effort from the entire healthcare team.
1. Open communication and information sharing between healthcare providers, patients, and families. This includes involving families in rounds and decision-making.
2. Collaboration where patients and families are viewed as integral parts of the care team and participate in care activities and decisions.
3. Recognition that patients exist within social networks of family and friends whose needs should also be addressed to provide holistic, supportive care.
Healthy thanks to communication . Belim & Vaz de AlmeidaISCSP
This document discusses a model of communication competencies that can optimize health literacy. The model focuses on assertiveness, clear language, and positivity used by healthcare professionals in interactions with patients. The research validating the model included a literature review and focus group with medical experts. The focus group validated the three key concepts of the model and emphasized assertiveness includes active listening, clear language uses simple words and verbs, and positivity involves a positive approach with patients. The results confirm investing in these communication competencies improves patient health literacy and clinical outcomes.
· Normalize the following ER diagram. TABLE TALKTh.docxodiliagilby
· Normalize the following ER diagram.
TABLE TALK
The Growing Role of Patient
Engagement: Relationship-based
Care in a Changing Health Care
System
A
s health care providers, we rarely partici-
pate in discussions, watch interviews, or
read articles about our changing health
care system that do not concern patient engage-
ment. The Center for Advancing Health defines
patient engagement as
Actions individuals must take to obtain the
greatest benefit from the health care services
available to them. . . . Engagement is not syn-
onymous with compliance. . . . [Engagement]
signifies that a person is involved in a process in
which he [or she] harmonizes robust information
and professional advice with his [or her] own
needs, preferences, and abilities in order to
prevent, manage, and cure disease.
1
Patient engagement strategies have been shown
to improve care delivery and translate into better
outcomes related to patient satisfaction and re-
covery. One author captured the importance of
patient engagement with this statement: “If pa-
tient engagement were a [medication], it would
be the blockbuster [medication] of the century
Patient engagement begins with relationship-based care. (Nurse’s warm-up jacket
and cap not shown.)
http://dx.doi.org/10.1016/j.aorn.2014.02.007
� AORN, Inc, 2014 April 2014 Vol 99 No 4 � AORN Journal j 517
http://dx.doi.org/10.1016/j.aorn.2014.02.007
and malpractice not to use it.”
2
Yet widespread
consensus among health care providers about how
to engage patients is still being determined.
The nursing profession’s role in patient engage-
ment and advocacy is key to the care that we de-
liver and continues to evolve to meet the needs of
patients. For example, before the 1970s, there was
not a high demand for patient’s rights.
3
In 2006,
AORN published a position statement on creating
an environment of safety, which set the ground-
work for patient-centered care as an important
element in defining the perioperative culture.
4
A
number of ethical, philosophical, and professional
considerations related to the rights of patients
have led to the nurse’s role as patient advocate.
According to one author, the three components of
this role are
1. informing patients of their rights,
2. providing patients with information necessary
to making informed decisions, and
3. supporting patients in their decisions.5
Regarding the patient’s role in engagement, one
author, who is also a perioperative RN, shared his
experiences as a surgical patient. In his article,
McGowan suggested that almost every patient en-
ters the surgical suite with anxiety and looks to
the perioperative team for reassurances. He be-
lieves that inaccurate portrayals of surgery in the
media “contribute to patients’ perceptions of sur-
gery and not always in a positive way.”
6(p493)
Critical to the health care provider’s ability to
establish trust is communicating in a manner that
informs and empowers the pa ...
The document summarizes key topics covered in a Professional Capstone and Practicum course, as reflected in a student's journal. The journal addresses new practice approaches learned, including evidence-based practice and intraprofessional collaboration. It also discusses healthcare delivery systems, ethics, population health, the role of technology, health policy, leadership models, and health disparities. The student reflects on strengthening their cultural competence and how the course helped them meet competencies.
Effective communication among healthcare workersTty Lim
This document discusses effective communication among healthcare workers and ways to improve it. It contains the following key points:
- Poor communication is a major factor in medical errors, responsible for over 70% of sentinel events according to the Joint Commission. Medication errors and adverse drug effects are often caused by failures in team communication.
- Effective communication in healthcare is defined as a reciprocal, interactive process between sender and recipient to ensure information is received and understood. It is important for accurate diagnosis, detecting patient distress, and gaining patient satisfaction and compliance.
- Ways to improve individual communication abilities include developing assertiveness, active listening, and negotiation skills to challenge decisions respectfully and improve patient safety. Reducing distractions and adopting
How to convince key decisionmakers to integrate health literacyChristopher Trudeau
The document provides tips for convincing key decision makers to integrate health literacy into their organizations. It begins by showing data on the importance of health literacy and its impact on health outcomes. Examples of presentation materials are given to underscore the business case, including impact on costs from issues like readmissions, medical errors, and patient satisfaction. Laws and regulations that encourage clear communication are also reviewed. The document concludes by offering actionable steps for implementation, such as creating a patient advisory council, training on techniques like teach back, and developing pilot projects to test and measure outcomes.
By administering assessments and analyzing the results, targeted aTawnaDelatorrejs
By administering assessments and analyzing the results, targeted and individualized interventions can be determined to best serve the needs of students with disabilities. The actual implementation of the interventions provides teachers opportunities to collect data and gauge the effectiveness of the interventions in addressing documented student needs. Teachers can also gain important skills and knowledge on how to best advocate for practical classroom interventions. Teachers will also be able to collaborate with colleagues and families in mentoring students to take ownership of learning strategies.
Allocate at least 2 hours in the field to support this field experience,
Part 1: Assessment and Interventions
Select at least one student to whom you will administer the informal RTI assessment created in Clinical Field Experience A. Score the assessment and share the results with the student to increase understanding of his or her strengths and areas for improvement.
Collaborate with the certified special education teacher and the student to develop 2-3 interventions based on the student assessment data to support the student’s progress in the classroom. In addition, detail one intervention that can be incorporated at home with family support.
Use any remaining field experience hours to assist the teacher in providing instruction and support to the class.
Part 2: Reflection
In 250-500 words, summarize and reflect upon the following:
· Describe each intervention, including teacher, student, and family roles, where applicable.
· Your experiences administering the assessment, analyzing the results, and providing the student feedback on his or her performance.
· Explain how you expect the interventions you developed to meet the needs of the student, incorporating his or her assessment results in your response.
· Explain how you will use your findings in your future professional practice.
APA format is not required, but solid academic writing is expected.
This assignment uses a rubric. Review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.
You are required to submit this assignment to LopesWrite. A link to the LopesWrite technical support articles is located in Class Resources if you need assistance.
6
Annotated Bibliography
Student’s Name
Course
Instructor’s name.
Institutional Affiliation
October 7, 2021.
Annotated Bibliography
Ali, H., Ibrahem, S. Z., Al Mudaf, B., Al Fadalah, T., Jamal, D., & El-Jardali, F. (2018). Baseline assessment of patient safety culture in public hospitals in Kuwait. BMC Health Services Research, 18(1). https://doi.org/10.1186/s12913-018-2960-x
The researchers conducted a cross-sectional study in 16 public hospitals in Kuwait using the Hospital Survey on Patient Safety Culture (HSOPSC). The study aimed to assess patient safety culture in public hospitals as perceived by hospital staff and relate the findings similar to regional and international ...
- The document discusses ensuring community care is provided in close collaboration with citizens and communities. It emphasizes the importance of patient empowerment, health literacy, digital health, patient involvement, and inclusiveness.
- Patient empowerment in community settings requires a shift towards seeing patients as equal partners in their care. This involves improving health literacy, self-management support, and shared decision-making between patients and healthcare professionals.
- Digital technologies can help facilitate chronic disease management and patient-centered care if designed and implemented in a way that strengthens patient empowerment and health literacy. Meaningful patient involvement in healthcare, research, and policy is also critical.
Please create a response blog to my classmate! APA format is requi.docxstilliegeorgiana
Please create a response blog to my classmate! APA format is required
Question Number 1.
Review the 10 essential public health services
The ten essential public health services serve as a guideline for public health nurses to follow when caring for their community. The public health services focus on the need of health problem education, developing local policies, implementing laws, creating relationships among the community, and evaluating the communities’ health status.
How do managed care organizations benefit from having a public health nurse on staff?
After reviewing the textbook, and the essential public health services and selected nursing activities, I was amazed to learn about the roles and responsibilities of a public health nurse. There are many different benefits to having a public health nurse as part of staffing such as being able to monitor and identify different health issues and illnesses in the community, tracking and studying the public population and health conditions, providing insight from a community standpoint regarding acute health issues, and being able to provide numerous resources to staff and patients regarding health prevention and disease management topics.
Public health nurses are professionals in research and they understand the importance of evidence based practice. They utilize evidence-based research to help protect the health in the community and to also strengthen the health of the public. According to Weum, Bragstad, and Glavin (2018),“public health nurses’ rank their sources of knowledge, it showed that the four most frequently used sources were national plans and guidelines, knowledge acquired while training as a public health nurse, personal experience, and guidelines and procedures issued by their local authorities” (p. 8). Public health nurses focus more on the prevention of diseases and incidents rather than on the care that is required after diseases and incidents occur (Anderson and McFarlane, 2015). According to Teodorowski, Cable, Kilburn, and Kennedy (2019), “community nurses are expected to deliver evidence-based practice, which is challenging given the diversity and breadth of the evidence base from which they can draw” (p. 370). Due to today’s increase in patient access to online health information, it is important for public health nurses to retrieve their information from evidenced-based sources such as the Centers of Disease Control and Prevention and World Health Organization websites.
How could population-based community nursing help prevent these problems – death, disease, or injury?
Community nursing is able to help prevent all three of these topics. These nurses are able to be a resource and also track and educate the community on communicable and sexually transmitted diseases, the importance of wellness checks, and disease prevention. As stated in the previous question, public health nurses focus on prevention. A way to prevent disease would ...
Professional Capstone and Practicum Reflective Journal Paper.docxstudywriters
Through their capstone and practicum experience, the student gained a better understanding of new nursing practices and approaches. They observed interprofessional collaboration between different medical professionals and learned that each member plays a unique and important role in ensuring patient care goals are met. The experience also improved the student's understanding of healthcare delivery systems and the importance of identifying inefficiencies. As a nurse, the student recognizes the importance of considering various ethical principles, providing culturally sensitive care, ensuring patient dignity, and being aware of public health issues and technologies that can enhance care.
Bull World Health Organ 2020;98245–250 doi httpdx.doi.oVannaSchrader3
Bull World Health Organ 2020;98:245–250 | doi: http://dx.doi.org/10.2471/BLT.19.237198
Policy & practice
245
Introduction
Empathy, compassion and trust are fundamental values of
a patient-centred, relational model of health care. In recent
years, the pursuit of greater efficiency in health care, including
economic efficiency, has often resulted in these values being
side-lined, making it difficult or even impossible for health-care
professionals to incorporate them in practice. Artificial intel-
ligence is increasingly being used in health care and promises
greater efficiency, and effectiveness and a level of personalization
not possible before. Artificial intelligence could help improve di-
agnosis and treatment accuracy, streamline workflow processes,
and speed up the operation of clinics and hospital departments.
The hope is that by improving efficiency, time will be freed for
health-care professionals to focus more fully on the human side
of care, which involves fostering trust relationships and engag-
ing with patients, with empathy and compassion. However, the
transformative force of artificial intelligence has the potential
to disrupt the relationship between health-care professionals
and patients as it is currently understood, and challenge both
the role and nature of empathy, compassion and trust in this
context. In a time of increasing use of artificial intelligence in
health care, it is important to re-evaluate whether and how
these values could be incorporated and exercised, but most
importantly, society needs to re-examine what kind of health
care it ought to promote.
Empathy, compassion and trust
Over the past decades, the rise of patient-centred care has
shifted the culture of clinical medicine away from paternalism,
in which the therapeutic relationship, the relationship between
the health-care professional and the patient, is led by medical
expertise, towards a more active engagement of patients in
shared medical decision-making. This model of engagement
requires the health-care professional to understand the pa-
tient’s perspective and guide the patient in making the right
decision; a decision which reflects the patient’s needs, desires
and ideals, and also promotes health-related values.1 The
central point of the patient-centred model of doctor–patient
relationship is that medical competency should not be reduced
to technical expertise, but must include relational moral com-
petency, particularly empathy, compassion and trust.2
Empathy, compassion and trust are broadly recognized as
fundamental values of good health-care practice.3–5 Empathy
allows health-care professionals to understand and share the
patient’s feelings and perspective.6 Compassion is the desire
to help, instigated by the empathetic engagement with the
patient.7,8 Patients seek out and prefer to engage with health
professionals who are competent, but also have the right inter-
personal and emotional skills. The be ...
Partnering with Patients, Families and Communities for Health: A Global Imper...EngagingPatients
Engagement is an essential tool to improving global health. This report introduces a new framework for engagement to help countries assess current programs and think strategically about future engagement opportunities. It spotlights barriers to engagement and offers concrete examples of effective engagement from around the globe.
TABLE TALKThe Growing Role of PatientEngagement Relatio.docxperryk1
TABLE TALK
The Growing Role of Patient
Engagement: Relationship-based
Care in a Changing Health Care
System
A
s health care providers, we rarely partici-
pate in discussions, watch interviews, or
read articles about our changing health
care system that do not concern patient engage-
ment. The Center for Advancing Health defines
patient engagement as
Actions individuals must take to obtain the
greatest benefit from the health care services
available to them. . . . Engagement is not syn-
onymous with compliance. . . . [Engagement]
signifies that a person is involved in a process in
which he [or she] harmonizes robust information
and professional advice with his [or her] own
needs, preferences, and abilities in order to
prevent, manage, and cure disease.
1
Patient engagement strategies have been shown
to improve care delivery and translate into better
outcomes related to patient satisfaction and re-
covery. One author captured the importance of
patient engagement with this statement: “If pa-
tient engagement were a [medication], it would
be the blockbuster [medication] of the century
Patient engagement begins with relationship-based care. (Nurse’s warm-up jacket
and cap not shown.)
http://dx.doi.org/10.1016/j.aorn.2014.02.007
� AORN, Inc, 2014 April 2014 Vol 99 No 4 � AORN Journal j 517
http://dx.doi.org/10.1016/j.aorn.2014.02.007
and malpractice not to use it.”
2
Yet widespread
consensus among health care providers about how
to engage patients is still being determined.
The nursing profession’s role in patient engage-
ment and advocacy is key to the care that we de-
liver and continues to evolve to meet the needs of
patients. For example, before the 1970s, there was
not a high demand for patient’s rights.
3
In 2006,
AORN published a position statement on creating
an environment of safety, which set the ground-
work for patient-centered care as an important
element in defining the perioperative culture.
4
A
number of ethical, philosophical, and professional
considerations related to the rights of patients
have led to the nurse’s role as patient advocate.
According to one author, the three components of
this role are
1. informing patients of their rights,
2. providing patients with information necessary
to making informed decisions, and
3. supporting patients in their decisions.5
Regarding the patient’s role in engagement, one
author, who is also a perioperative RN, shared his
experiences as a surgical patient. In his article,
McGowan suggested that almost every patient en-
ters the surgical suite with anxiety and looks to
the perioperative team for reassurances. He be-
lieves that inaccurate portrayals of surgery in the
media “contribute to patients’ perceptions of sur-
gery and not always in a positive way.”
6(p493)
Critical to the health care provider’s ability to
establish trust is communicating in a manner that
informs and empowers the patient. For example,
he stated that, as a pa.
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Os estudos mais recentes evidenciam o aumento da
prevalência de cuidadores informais. Em Portugal,
verificou-se uma quase duplicação do número de
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1. See discussions, stats, and author profiles for this publication at: https://www.researchgate.net/publication/337283102
COMMUNICATION DETERMINES PATIENT SAFETY
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Communication Determines Patient Safety
November 14, 2019 ‐ PSQH
By Cristina Vaz de Almeida
Partnerships with the patient start with cooperation and commitment, where the health
professional must be close to the patient to act as a true “observer.” Observation allows the
clinician to assess the patient’s needs and “essence,” enabling the relationship to grow and
promoting favorable health outcomes.
Communicating effectively allows us to clearly mark risks and measure patient safety limits.
Partnerships with the patient start with cooperation and commitment, where the health
professional must be close to the patient to act as a true “observer.” Observation allows the
clinician to assess the patient’s needs and “essence” (Egener & Cole-Kelly, 2004), enabling the
relationship to grow and promoting favorable health outcomes.
Ricciardi & Shofer (2019) highlight the need for patients to be involved in their care by asking
health professionals about their diagnosis and treatment through an open dialogue. When
patients are involved as partners, they can detect adverse events and ensure safe care as well
as promote a safety culture.
One of the public health doctors who participated in an in-depth interview for this paper says,
“It is undoubtedly very important to develop communication skills in all their transversality,
both verbal and nonverbal communication techniques, and I stress again the delivery of
reminders/recipes/visual schemes that support the message conveyed.” To this doctor, verbal
and nonverbal communication are critical to establishing effective trust and information
exchange.
There are also useful tools that promote interpersonal relationships. The Agency for
Healthcare Research and Quality (2019), for example, has “My Questions for This Visit,” a
simple and effective card that gives patients a list of questions to ask during the medical
meeting, such as:
1) What are my medications?
3. Página | 2
2) What tests and analyses do I need?
3) What surgery should I undergo?
The AHRQ Health Literacy Universal Precautions Toolkit, Second Edition, enables an
intervention in primary care practices by seeking to reduce the complexity of healthcare;
increase patient understanding of health information; and produce improvements in patient
support at all levels of health literacy (Brega et al., 2015).
Several surveys show that up to 75% of hospital readmissions could be prevented by
interventions aimed at greater patient and family involvement and cooperation, such as health
education; pre-discharge assessment and coordinated home care; and family and patient-
centered care (Mitchell, Heinrich, Moritz, & Hinshaw, 1997).
The subject of patient safety arose from the healthcare quality movement, which has been
defined by the Institute of Medicine as “prevention of harm to patients” (Aspden, Corrigan,
Wolcott, & Erickson, 2004). Emphasis is placed on a healthcare delivery system that avoids
mistakes and learns from those that occur, based on a safety culture involving healthcare
professionals, organizations, and patients.
The AHRQ Patient Safety Network later expanded the definition of harm prevention to include
“the freedom from accidental or preventable injuries caused by medical care” (AHRQ PSNet,
n.d.). Although the definition is not yet complete (Mitchell, 2008), patient safety practices have
been defined as “those that reduce the risk of adverse events related to medical care exposure
in a variety of diagnoses or conditions.”
Mitchell (2008) states that the origins of the patient safety problem are classified in terms of
type (error), communication (e.g., failures between professionals or between patient and
professional, and between professionals and non-medical staff), patient management (e.g.,
inadequate delegation, failure to follow up, incorrect referral, or misuse of resources), and
clinical performance (before, during, and after the intervention).
Strategies to prevent patient safety errors and improve healthcare processes (Hughes, 2008)
include the use of simulators, bar codes, and computerized entry via clinical applications, as
well as team resource management. Communication is an effective way to improve patient
safety, especially if it’s assertive, clear, and positive (Belim & Vaz de Almeida, 2017).
Discussion and results
These reflections resulted from a qualitative study with Portuguese nurses (n = 30) who
participated in five focus groups from August to October 2019 and from five in-depth
interviews with health literacy specialists. The focus groups and interviews were assessed
separately and then combined and compared. Thematic analysis is a very useful approach for
producing quality analyses (WHO, 2019).
As mentioned in the focus groups, with qualitative content analysis, patient support has to be
given in stages, and the health professional must always confirm that the patient has
4. Página | 3
acknowledged and understood the information. In an in-depth interview, an organ transplant
coordinator (a medical doctor) at a large reference hospital in the greater Lisbon area of
Portugal said that sometimes, doctors think certain words or phrases are understandable but
the family does not actually comprehend them. These include “the patient is in a stable
situation,” where the family thinks the patient is about to be in good health, or “the patient
has kidney failure,” where the family simply does not understand what “kidney failure” means.
Any care transition, whether to a different unit in the hospital, to a separate hospital, or to the
patient’s home, increases risk. Communication between the team and the patient or family
should be a factor to consider in risk consequences. In addition to written information, the
health professionals in the focus groups said that communication must be accurately and
intelligibly conveyed to the patient and family, because certain communications are very
difficult to understand.
Focus group participants, especially those in physical medicine and rehabilitation, stressed the
importance of talking clearly, assertively, and respectfully to patients and families. The
components of the healthcare professional’s verbal and nonverbal language may be innate,
but according to focus group participants, professionals “need to be learned and trained to
produce even more effective patient outcomes, especially given the critical need for their
understanding and safety in action.” Harmony and reciprocity between the patient and
professional allows communication that flows easily and is mutually understandable.
Focus groups also noted the need for patient training to be an active partnership.
Empowerment as a way to promote commitment is an established concept for healthcare. In
this clinical and communicative process, an overview of the patient is helpful and promotes
better results.
The health professional should be an “observer” reporting on the rehabilitation health
professionals participating in the focus group. In this domain, the professional should get used
to looking at patients in their physiological, psychological, social, and cultural dimensions.
Cultural beliefs can also be a barrier to real commitment and involvement from both patients
and practitioners. One such barrier is the hierarchical tradition, based on clinicians’ training as
figures of power and authority. The focus groups confirmed that this hegemony of physicians
still exists in some organizations, even between doctors and nurses, contributing to poor
communication as a reflection of patient safety “when teams do not understand each other.”
Ricciardi & Shofer (2019) stress that these more hegemonic styles can lead to a dictatorial style
of management, which in turn can lead to inefficient and insecure teamwork.
We must also mention the spread of universal precautions in health literacy. These precautions
aim to simplify communication and confirm patient understanding, thereby minimizing
miscommunication; easing navigation in the consultation environment and the health system;
and supporting patients’ efforts to improve their health.
With these points on attitude and safety behaviors in mind, we can reflect on the ongoing need
for open dialogue with the patient through assertive behavior and communication, clear
5. Página | 4
language, and positive action where partnership, reciprocity, and a holistic vision of a true
health professional “observer” are always present to improve health outcomes.
Cristina Vaz de Almeida is director of Post Graduate Course on Health Literacy at ISPA in
Portugal; she is also a PhD student in communication science and health literacy at ISCSP.
Figure 1: Communication for Better Health Literacy and Health Outcomes
References
AHRQ PSNet. (2019, June). Tips & tools: Questions are the answer. Retrieved
from https://www.ahrq.gov/patients-consumers/patient-involvement/ask-your-doctor/tips-
and-tools/index.html
AHRQ PSNet. (n.d.). Patient safety. Retrieved from https://psnet.ahrq.gov/glossary/p
Aspden, P., Corrigan, J., Wolcott, J., & Erickson, S. M. (Eds.). (2004). Patient safety: Achieving a
new standard for care. Washington, DC: National Academies Press.
Belim, C., & Vaz de Almeida, C. (2017). Healthy thanks to communication: A model of
communication competences to optimize health literacy: Assertiveness, clear language, and
6. Página | 5
positivity. In V. E. Papalois & M. Theodospoulous (Eds.), Optimizing health literacy for improved
clinical practices (pp. 124–152). Hershey, PA: IGI Global.
Brega, A. G., Barnard, J., Mabachi, N. M., Weiss, B. D., DeWalt, D. A., Brach, C., … West, D. R.
(2015). AHRQ health literacy universal precautions toolkit (2nd ed.). Retrieved from
https://www.ahrq.gov/health-literacy/quality-resources/tools/literacy-
toolkit/healthlittoolkit2.html
Egener, B., & Cole-Kelly, K. (2004). Satisfying the patient, but failing the test. Academic
Medicine, 79(6), 508–510.
Hughes, R. G. (Ed.) (2008). Patient safety and quality: An evidence-based handbook for
nurses. Rockville, MD: Agency for Healthcare Research and Quality.
Mitchell, P. H., Heinrich, J., Moritz, P., & Hinshaw, A. S. (1997). Outcome measures and care
delivery systems: Introduction and purposes of conference. Medical Care, 35(11 Suppl), NS1–
5.
Mitchell, P. H. (2008). Defining patient safety and quality care. In Hughes, R. G. (Ed.), Patient
safety and quality: An evidence-based handbook for nurses (Chapter 1). Rockville, MD: Agency
for Healthcare Research and Quality.
Ricciardi, R., & Shofer, M. (2019). Nurses and patients: Natural partners to advance patient
safety. Journal of Nursing Care Quality, 34(1), 1–
3. https://doi.org/10.1097/ncq.0000000000000377
WHO. (2019). Improving health through health literacy. Public Health Panorama, 5(2–3), 123–
329.
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