Group items tagged

"WHAT TO DO WHEN A PATIENT LACKS CAPACITY - The degree and urgency with which to act on findings of impaired capacity depends on multiple factors, including the expected duration of impairment, the severity of the impairment, and the seriousness of the decision. Unless the urgency of a patient's medical condition requires that a substituted decision be made immediately, efforts should be made to identify and correct any reversible causes of the impairment [26]. This is particularly relevant in hospitalized patients with impaired capacity due to delirium. Treatment of the underlying causes of delirium may restore decision-making capacity. Patients with mild to moderate cognitive impairment that is not expected to fluctuate may benefit from more intensive efforts at education to improve understanding of the relevant facts, followed by reassessment of decision-making abilities. A randomized trial found that a memory and organizational aid given to patients with mild stage Alzheimer disease dementia (n = 80) improved performance on understanding, which in turn increased the likelihood of being judged capable of providing informed consent to enroll in a clinical trial [34]. This enhancement was also effective in a randomized trial with middle-aged and older adults with schizophrenia [35]. For patients whose impairments are severe enough that they are judged to lack the capacity to make a decision, there is a clear ethical obligation to seek out a substitute decision maker. Substitute or surrogate decision makers should ideally have been chosen by the patient in advance. In the absence of a designated surrogate, laws may vary in terms of which people can serve in this proxy role and their hierarchy; in general, the order is the spouse, adult children, parents, siblings, and other relatives. (See "Legal aspects in palliative and end of life care", section on 'Surrogate decision makers'.) When making a substituted decision, the proxy should take into consideration

"Students receiving the professional development training showed significant improvements in certain communication skills, but students in both cohorts improved over time. The lack of a relationship between observed communication skills and patient-centred attitudes may be a reflection of students' inexperience in working with patients, resulting in 'patient-centredness' being an abstract concept. Students in the early years of their medical course may benefit from further opportunities to practise basic communication skills on a one-to-one basis with patients. "

The Institute for Health Improvement site which includes free on-line courses. You just need to sign up for a free account to view these. "The Institute for Healthcare Improvement (IHI) is an independent not-for-profit organization helping to lead the improvement of health care throughout the world. Founded in 1991 and based in Cambridge, Massachusetts, IHI works to accelerate improvement by building the will for change, cultivating promising concepts for improving patient care, and helping health care systems put those ideas into action."

The AARP just met with the leadership of the Mayo Clinic, one of the most outstanding medical institutions in the country. They provide excellent care at a cost that is less than most other parts of the healthcare system - and with improved outcomes. We asked them about their secret to success. Mayo has an electronic medical record and all their patients have their information online. The physicians are on salary, so there's no incentive to order unnecessary tests or procedures, and Mayo has an ethic of patient-centered care, with a long history of attracting the best people and rewarding them. If Mayo can do it, why can't everyone else? The AARP believes that the potential is there for most communities to have excellent care - we must emulate the care delivery of institutions like the Mayo Clinic, and put in place payment and information systems that will coordinate care management better. It's a big job and will take some investment, but we have many opportunities to do a better job than we're doing today.

"Our experience with the calculators shows that it helps surgeons improve the quality of care they provide their patients because it improves shared decision making and patient-centered informed consent."

"Despite differences in practice patterns of nurses and physicians in using whiteboards, our findings suggest that all providers value their potential as a tool to improve teamwork, communication, and patient care. Successful adoption of whiteboard use may be enhanced through strategies that emphasize a patient-centered focus while also addressing important barriers to use."

"A patient-centered communication curriculum can improve student knowledge and skills. While some intervention students perceived that they made too many calls, our data suggest that more calls, an increased sense of patient ownership, and role modeling by clerkship faculty may ensure incorporation and application of skills."

"Patient communication skills need to be taught as part of residency training. With limited training, case-specific skills (herein, involving patients with cancer) are likely to improve more than general communication skills."

"Physicians often redirect patients' initial descriptions of their concerns. Once redirected, the descriptions are rarely completed. Consequences of incomplete initial descriptions include late-arising concerns and missed opportunities to gather potentially important patient data. Soliciting the patient's agenda takes little time and can improve interview efficiency and yield increased data."

"Talking to colleagues is an essential skill especially as we advocate for our patients. We should not only know what's going on with our patients, but also how to communicate our thoughts effectively and succinctly with our colleagues."

"drawMD Orthopedics enhances doctor-patient communication by offering a new paradigm for explaining the complex issues surrounding Orthopedic clinical and surgical care. In order to improve patient understanding of medical problems, drawMD utilizes the iPad's unique interface to allow anyone to sketch, stamp, or type directly on the "

"For more than 30 years, the American Academy on Communication in Healthcare (AACH) has been in the forefront of research and teaching relationship-centered healthcare communication. If you are looking for ways to improve patient safety, interdisciplinary teamwork, patient satisfaction scores, or just want to work on individual communication skills, AACH can help."

"The authors present principles derived from three basic theories of human cognition that may help to guide clinicians' instruction of parents and patients."

"# A powerful solution to improve patient safety within your organization. # An evidence-based teamwork system to improve communication and teamwork skills among health care professionals. "

"The PIE group works on multiple projects aimed at improving medical education outcomes. Our work ranges from online patient simulations to three-dimensional anatomical visualizations. "

Guideline Objective(s) * To provide helpful guidance to primary care providers serving individuals who are homeless * To contribute to improvements in both quality of care and quality of life for these patients

"Overall though, the Dash system was successful in improving Dr. Williams' confidence that the implant was correctly placed. The iMedicalApps team previously reported on iPod Touch assisted orthopedic surgery. The Dash system is another method that will benefit patients via the use of mobile technology."

A collection of resources for improving patient literacy

Based on the results of this study, the use of social media applications may be seen as an efficient and effective method for physicians to keep up-to-date and to share newly acquired medical knowledge with other physicians within the medical community and to improve the quality of patient care. Future studies are needed to examine the impact of the meaningful use of social media on physicians' knowledge, attitudes, skills, and behaviors in practice.