Our sixth instructional exercise for helping physicians build their contextualization skills has been posted on the Resources page.
And with the help of The Book Stall, we’ll be signing books and speaking at a luncheon at the Union League Club of Chicago on June 17. For ticket information, visit the EventBrite page.
We are pleased to embark on the next phase of our work inviting patients to collect data during their medical visits for the purpose of improving quality of care. With a recently approved $1.1M grant from the Department of Veterans Affairs, Health Services Research & Development, we will expand our research in Chicago to include Veterans care facilities in Madison, Milwaukee, Cleveland and Los Angeles. The regional Veterans Integrated Services Network (VISN 12) will provide $130-$150/year in additional funds over three years to support the project.
Entitled “Evaluating Use of Patient-Collected Audio Recorded Encounters for Provider Audit Feedback to Reduce Contextual Errors,” the study will evaluate the efficacy of a quality improvement initiative we developed in which patients audio record their visits, and the data is then employed to identify and implement opportunities to improve contextualization of care. The study has two aims: to identify and address obstacles to implementation of a patient-collected audio audit and feedback quality improvement process, optimizing the extent to which the process is perceived as safe, not burdensome and valuable by clinicians and patients; and to compare the effectiveness of two methods of providing clinicians with feedback on their performance to determine the intensity of the intervention necessary to improve clinician performance at contextualizing care and health care outcomes, and to lower costs.
A powerful blog post at the Altarum Institute web site by Dr. Michael Wasserman, who was one of the advance reviewers of our book. My favorite quote of his post:
Ironically, a fair portion of what we “know” becomes obsolete within 10–20 years. What we teach students with regard to compassion and communication will never be obsolete, yet in this regard, we fail miserably.
Join Saul and Alan at Buzz Cafe in Oak Park for a discussion and signing of Listening for What Matters: Avoiding Contextual Errors in Health Care. The event will take place from 6:30 – 8:30pm on March 2, 2016. Buzz Cafe is located at 905 S. Lombard Ave, Oak Park, IL, and offers a full dinner menu as well as coffee and desserts.
More thoughts on the importance of direct observation of care, at the Oxford University Press blog:
From Saul Weiner, via the Diane Rehm Show blog, on doctor burnout and how engagement with patients prevents it:
Alan and Saul discuss how their undercover recordings of doctors and patients reveal the mistakes doctors make when they don’t know their patients’ life contexts, and what to do about them, with Larry Rifkin on “Talk of the Town” on WATR AM 1320 radio in Waterbury, Connecticut.
Find the show at http://www.rifkinradio.com/?p=495
Saul participated in a panel on the Diane Rehm Show focused on Improving Doctor-Patient Communication in a Digital World.
We spent the morning of February 2 live on the air with Geoffrey Riley and Emily Cureton on The Jefferson Exchange on Jefferson Public Radio in Oregon, discussing the book, contextualizing care, and unannounced standardized patients.
You can listen at http://cpa.ds.npr.org/ksor/audio/2016/02/The_Jefferson_Exchange_02_03_2016_Hr2_0.mp3 or use the embedded player here:
There wasn’t time for us to address one of the points brought up by listener Connie, about doctors “locking in” to diagnoses. In the decision making world, we call that “premature closure”, and it’s a reflection of the general human propensity that it’s easy to come to a (first) conclusion than to change your mind. As we discuss in the book, doctors are taught to develop a “differential diagnosis” – a list of additional possible medical explanations for the symptoms – as a way to keep them from focusing solely on what they first believe is most likely; we have written about the additional value of developing a “contextual differential diagnosis” – a list of possible contextual factors that could also be contributing to the patient’s problem.
John Aeillo has reviewed Listening for What Matters for the Electric Review blog. Read the review here: