Patient engagement and diagnosis: bridging the communication gap

Engaging patients and using plain language is one of the most effective ways to improve communication with patients, and therefore reduce the likelihood of malpractice incidents. According to the National Center for Biotechnology Information, the provider-patient relationship is a major factor influencing patient participation in their care and the decision- making process. They found that engaged patients who take an active role are more likely to provide the type of information providers need to make most diagnoses.   

For example, if a patient is experiencing severe stomach pains and is taking a prescribed medication, the provider may attribute these pains to a side effect of the medication, particularly if the patient doesn’t communicate that the pain started prior to when the medication was prescribed. Due to this miscommunication, a chronic condition may be overlooked.

To support improved communication and thus improved patient outcomes, the National Patient Safety Foundation developed the “Ask Me 3” educational program to encourage providers to get answers from patients and family members to three specific questions during a visit. The three questions and recommendations below explain how providers can successfully communicate with their patients to garner the most meaningful responses. These recommendations are acknowledged to increase engagement, improve communication and reduce risk for diagnostic error.

What is the main problem?

Proper diagnosis requires the patient to provide an accurate family history, current medications and all medical information  deemed relevant. Providers should develop a patient engagement process that fosters communication with the patient to reveal an accurate medical history.  

For example, ask for a detailed explanation of the symptoms they’re experiencing to ensure that the patient understands what information is relevant. This includes questions on timing, severity, onset of symptoms, changes over time, etc.  To get a better sense of severity, ask how these symptoms have impacted their day-to-day life. The more information gathered, the more accurate the diagnosis. 

When communicating a diagnosis, avoid medical terminology. Instead, use plain language when speaking to patients. The Centers for Disease Control and Prevention developed a plain-language thesaurus to find replacement words that patients will better understand. 

What do I need to do?

Once the diagnosis is clearly communicated, the provider should offer the treatment option(s) and explain the risks and benefits of each option. Begin by presenting the recommended treatment options and all pros and cons, followed by alternative options and each of their risks and benefits. 

Illustrations and visuals can improve the communication of treatment options to patients, and providers should allow the patient plenty of opportunity to ask questions and discuss the pros and cons of the options.

For example, telling a patient they have high blood pressure may not clearly relay the potential risks or how other organs may be impacted. A visual illustration serves as a great communication aid by allowing providers to show how the strain of high blood pressure can cause build up in the coronary arteries. 

This will lead to shared decision-making-when a patient demonstrates an understanding of their symptoms and diagnosis, can explain their reasoning behind selecting a specific treatment and the provider works to understand the patient’s preferences. This approach boosts satisfaction because patients feel that their needs and preferences are understood. For example, patients who are making decisions about diabetes management should determine and communicate what issues are most important to them, whether it be blood sugar control, daily testing, weight fluctuation, etc., and refer to these preferences when choosing a treatment option. 

Writing down recommendations is another way providers can ensure their patient leaves the meeting knowing what they need to do. Written recommendations can serve as a reminder and future resource for patients. This can be done in a printed copy or through a secure online patient portal. 

Why is it important for me to do this?

If a patient doesn’t understand the gravity of their situation, it’s likely they will not take the appropriate action following an appointment. 

To ensure a patient is fully aware of their circumstances, use the teach-back method. This method requires asking the patient and his or her family members to explain, in their own words, the situation and what actions are to be taken next. 

Again, use graphics to reinforce the patient’s understanding, ask follow-up questions in person, and be available for any questions that may arise after the appointment. Following these steps, providers will be able to walk away feeling confident in their patients’ understanding and ability to take appropriate action.  

Providers and patients must work together to ensure they reach a full level of understanding. With the “Ask Me 3” method, greater engagement and communication will lead to a stronger provider-patient relationship, increased levels of patient participation and lower risk of communication failures and potential diagnostic errors across an organization.