Lecture 5: Patient Encounter Flashcards
What are two common clinical approaches for setting the agenda for a visit?
Open ended question to negotiate priorities and orient the patient.
Indicate time available, forecast what needs to happen today, obtain list of pt’s probs, and summarize and finalize visit agenda.
What are some barriers to eliciting concerns for patients?
Time
Embarrassment
Language barrier
Intimidated
Deaf
Trust
Mental handicaps
What are some barriers to eliciting concerns for providers?
Time
Hypocrisy
Bias/prejudice
Cultural differences
Frequent fliers
Composure
Person/emotional conflict
Inattentive patients
What are the two major portions of the HPI?
Patient-centered
Provider-centered
What skills fall under patient-centered HPI?
Focusing open-ended skills
Emotion-seeking skills
Empathy skills (NURS)
NURS = naming, understanding, respecting, and supporting
When do you switch to a clinician-centered HPI?
Once you have obtained a majority of the patient’s information and need specific, close-ended questions.
What are the 4 ways to cover patient education?
Ask for permission to explain critical info to the pt.
Ask what the pt already knows.
Tell the pt info at an appropriate education level.
Ask the pt to repeat back key elements.
How do we start shared decision making?
Summarizing H&P findings/test results.
Explain the likely diagnoses and options for further testing/treatment.
What is the deliberation model?
What are some decision support materials for patients?
Provider discussion
Option grids
Take-Home Handouts
Care That Fits (Decision aids)
Videos
Collaboration with outside educators
What are some patient barriers to ending a visit?
Failure to comprehend education
Continuous questions
Casual conversation
New complaint at end of encounter
Family members
What are some provider barriers to ending a visit?
Poor flow of patient encounter
Lack of proper communication with patient
Failure to enforce the end of the visit
Casual conversation
