Improving the quality of physician communication with rapid-throughput analysis and report cards

Michael H. Farrell, Stephanie A. Christopher, Alison La Pean Kirschner, Sara J. Roedl, Faith O. O'Tool, Nadia Y. Ahmad, Philip M. Farrell

Research output: Contribution to journalArticlepeer-review

Abstract

Objective: Problems with clinician-patient communication negatively impact newborn screening, genetics, and all of healthcare. Training programs teach communication, but educational methods are not feasible for entire populations of clinicians. To address this healthcare quality gap, we developed a Communication Quality Assurance intervention. Methods: Child health providers volunteered for a randomized controlled trial of assessment and a report card. Participants provided telephone counseling to a standardized parent regarding a newborn screening result showing heterozygous status for cystic fibrosis or sickle cell disease. Our rapid-throughput timeline allows individualized feedback within a week. Two encounters were recorded (baseline and after a random sample received the report card) and abstracted for four groups of communication quality indicators. Results: 92 participants finished both counseling encounters within our rapid-throughput time limits. Participants randomized to receive the report card improved communication behaviors more than controls, including request for teach-back (. p<. 0.01), opening behaviors (. p=. 0.01), anticipate/validate emotion (. p<. 0.001) and the ratio of explained to unexplained jargon words (. p<. 0.03). Conclusion: The rapid-throughput report card is effective at improving specific communication behaviors. Practice implications: Communication can be taught, but this project shows how healthcare organizations can assure communication quality everywhere. Further implementation could improve newborn screening, genetics, and healthcare in general.

Original languageEnglish (US)
Pages (from-to)248-255
Number of pages8
JournalPatient Education and Counseling
Volume97
Issue number2
DOIs
StatePublished - Nov 1 2014
Externally publishedYes

Bibliographical note

Funding Information:
This project was funded by a grant from the National Institutes of Health – National Heart, Lung and Blood Institute : RC1-HL100819 . We are also grateful for the contributions of our transcriptionist Nadine Desmarais.

Keywords

  • Communication
  • Cystic fibrosis
  • Neonatal screening
  • Professional-patient relations
  • Quality indicators (health care)
  • Sickle cell trait

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