Exam 2 Flashcards
Mindset
is a state of mind or attitude/assumptions we hold that influence our patient-provider encounters
Our mindset influences how we view and interact with others and our environment
Implicit Bias
predicts how we will behave more than our conscious knowledge
Implicit bias is not prejudice
To be mindful of both, implicit bias + prejudice we have to try to understand our beliefs, values, culture, traditions, expectations, past experiences, assumptions, stereotypes and interpersonal personal preferences (positive and negative)
Prejudice
Prejudice is our conscious preconceived attitude, opinion or feeling about a subject.
What is the Humanistic Domain?
The component of the patient-provider interaction that seeks to engage the patient historically through appropriate use of verbal, listening, educational, and instructional skills and the demonstration of respect, empathy and professionalism.
Five Humanistic Domains
Verbal/Listening
Education/Instruction
Respect
Empathy
Professionalism
Verbal skills check-list
Speak clearly and appropriately
speak at the appropriate level of education
avoid medical jargon
open to closed question
keep on task
Listening skills checklist
Observe the patient for use of non-verbal clues
actively model and remodel the differential diagnosis with each answered question
encourage spontaneity of patient storytelling through prompt minimization
recognize and respond to historical clues
collaborate with the patient and gauge his/her responses to treatment plans
avoid repeating questions that were already answered
legitimize patient concerns
Educational/Instructional Checklist
Clearly explain diagnoses
avoiding medical terminology
invest the patient in the outcome by including the patient in the development of his/her plan of treatment
inquire if others should be included in developing a plan of treatment
assure that the treatment plan is logical and easily understood
have the patient restate the treatment plan to assure understanding
Respect Checklist
Begin each new patient encounter with unbiased consideration
be polite
introduce yourself by name, title and role
greet the patient by title and last name
ask how the patient would like to be addressed
shake the patient’s hand unless prohibited by culture
demonstrate kindness
help the patient with position changes
preserve patient dignity
ask permission before examining or exposing the patient
respect the patient’s right to choose
respect differences in culture and background
Empathy Checklist
demonstrate compassion and sympathy
make appropriate eye contact
truly listen to the patient
show interest in patient’s condition
demonstrate investment of time and concern
acknowledge patient’s current life situation
recognize the impacts on patient’s life
Professionalism Checklist
wear professional attire
maintain good hygiene and grooming
prioritize patient concerns verbally
demonstrate compassion and kindness
be confident but avoid egotism
assure and preserve confidentiality
adhere to the highest ethical standards
avoid unprofessional behaviors
What is the average time a patient typically speak fore before being interrupted by their doctor?
12-18 seconds
What percent of patients are able to fully complete their reason for their visit?
23%
What does OLD CARTS stand for?
OLD CARTS
Onset, Location/radiation, Duration, Character, Aggravating factors, Relieving factors, Time and Severity
What percent of adults with chronic conditions underuse medication?
30%
Qhat percent of adults in hospitals can identify their diagnosis?
less than 50%
What is the difference between an open-ended and closed-ended?
Open-ended questions
- questions posed that prompts the patient to answer in their own words, knowledge, and feelings.
- always try to start with open-ended questions
Close-ended questions
- questions posed that narrow a patient responses to yes or no, or a specific selection of choices.
- Use these when the open ended answers are not fruitful to preserve the momentum of a conversation
What is Health Literacy?
The degree to which individuals have the capacity to obtain, process and understand basic health information and services needed to make appropriate health decisions
What is culture?
a dynamic and creative phenomenon, some aspects of which are shared by large groups of people and other aspects of which are the creation of small groups and individuals resulting from particular life circumstances and histories.
What is Cultural competency?
the ability of systems to provide care to patients with diverse values, beliefs, and behaviors, including tailoring the delivery of care to meet patients’ social, cultural and linguistic needs.
What is Cultural humility?
the lifelong commitment to self-evaluation and self-critique, to redressing the power imbalances in the patient-physician dynamic, and to developing mutually beneficial and non-paternalistic clinical and advocacy partnerships with communities on behalf of individuals and defined populations
What are the steps to cultural competency?
Self-awareness, respectful communication, and collaborative partnerships
“Ask me 3” is a tool to…
- facilitate clear communication between patients and physicians
- a simple patient-centered approach to improving health outcomes
- encouraging patients to understand the answers to three questions
- What is my main problem?
- What do I need to do?
- Why is it important for me to do this?
The “4C’s” tool …
improves communication by helping patients articulate their preferences
- Call: What do you call your problem?
- Cause: What do you think has caused or contributed to your problem?
- Concern: What concerns you most that we need to be sure to address?
- Cope: what are you currently doing to cope with your problem.
Patient interview
The process of gathering historical data surrounding the patient’s medical concern while employing the humanistic principles
Confidence
Assurance and belief in oneself and abilities
Confidentiality
the tenant of professionalism assuring that information given by the patient will be kept in strictest confidence
HIPPA
health insurance portability and accountability act of 1996 (HIPPA) was designed to protect the private health information of patients
Medical Ethics
Moral principles and rules of conduct in the practice of medicine
