Michael H Farrell1, Stephanie A Christopher2, Alison La Pean Kirschner3, Sara J Roedl2, Faith O O'Tool2, Nadia Y Ahmad4, Philip M Farrell5. 1. Center for Patient Care and Outcomes Research, Medical College of Wisconsin, Milwaukee, USA; Aurora University of Wisconsin Medical Group, Center for Urban Population Health, Milwaukee, USA; Program in Genomics and Ethics, Center for Bioethics and Medical Humanities, Medical College of Wisconsin, Milwaukee, USA; Department of Pediatrics, University of Wisconsin-Madison School of Medicine and Public Health, Madison, USA. Electronic address: michaelhfarrell@yahoo.com. 2. Center for Patient Care and Outcomes Research, Medical College of Wisconsin, Milwaukee, USA. 3. Center for Patient Care and Outcomes Research, Medical College of Wisconsin, Milwaukee, USA; Program in Genomics and Ethics, Center for Bioethics and Medical Humanities, Medical College of Wisconsin, Milwaukee, USA. 4. Center for Patient Care and Outcomes Research, Medical College of Wisconsin, Milwaukee, USA; Department of Family and Community Medicine, Medical College of Wisconsin, Milwaukee, USA. 5. Department of Pediatrics, University of Wisconsin-Madison School of Medicine and Public Health, Madison, USA.
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.
RCT Entities:
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.
Authors: R C Smith; J S Lyles; J Mettler; B E Stoffelmayr; L F Van Egeren; A A Marshall; J C Gardiner; K M Maduschke; J M Stanley; G G Osborn; V Shebroe; R B Greenbaum Journal: Ann Intern Med Date: 1998-01-15 Impact factor: 25.391
Authors: Michele Heisler; Reynard R Bouknight; Rodney A Hayward; Dylan M Smith; Eve A Kerr Journal: J Gen Intern Med Date: 2002-04 Impact factor: 5.128
Authors: Alison La Pean; Jenelle L Collins; Stephanie A Christopher; Kerry L Eskra; Sara J Roedl; Audrey Tluczek; Michael H Farrell Journal: Genet Med Date: 2012-02 Impact factor: 8.822
Authors: Michael H Farrell; Clair R Sprenger; Shelbie L Sullivan; Bree A Trisler; Jessica J F Kram; Erin K Ruppel Journal: J Patient Cent Res Rev Date: 2017-01-31