Patient Centered Care Flashcards
Define clinician centered care
The balance of power was centered on the preferences and values of the doctor. The patient’s experience of illness was often ignored or discouraged. A detached perspective developed .. find the broken part and fix it
Define patient centered care
Encourages patients to express what is important to them and to recognize the importance of patient’s expressions of personal concerns, feelings and emotions
Define relationship centered care
An expansion of patient-centered care. It takes into consideration that all illness, care and healing processes occur in the setting of relationships (with self and with others)
Describe the sequence of a full patient assessment
-Preparation
- Health History
- Physical Examination
- Assessment
- Plan
- Documentation
- Presentation
What are examples of positive nonverbal communication?
Rotary hand gestures, make eye contact, direct body orientation, uncross arms and legs, sit level with patient, expectation nod, lean forward with expression of interest, “I see”, “Uh-huh”, “Yes”, “Mmm”
What are examples of negative nonverbal communication?
Backward lean, stare, frequent touch, write/type notes while patient is emotionally engaged, fidgeting, glancing at watch or phone frequently
Why is the medical interview important?
It helps establish meaningful caring relationships with your patients and allows you to be a rigorous diagnostician who carefully collects data.
Why is the patient centered component of the medical interview particularly important?
- Allowing patients to tell their symptom story is diagnostically helpful. - Associated with increased patient and clinical satisfaction
- Leads to improved health outcomes
- Associated with less malpractice suits
Describe the core skills of patient centered interviewing
Core Skills: open ended skills, emotion seeking skills. and empathizing skills.
Describe steps 1-5 of the Smith’s Patient Centered Interview
- Set the stage
- Chief Concern/ Agenda Setting
- Open ended non-focusing HPI (listen to patient story)
- Focus on story, obtain emotional and personal context, open ended skills/emotion seeking skills/empathy skills
- Summarize & Transition
Identify the components of the “Preparation” aspect of patient assessment
Patient’s name, chief concern, past & current medical history, tools, special accommodations
Identify the components of the “Health History” aspect of patient assessment sequence
Identify data, source/reliability, chief concern, history of present illness, past medical history, social history, family history, review of systems
Identify the components of the “Physical Examination” aspect of patient assessment sequence
General survey, vital signs, skin, HEENT, neck, back, posterior & anterior thorax and lungs, breasts/axillae and lymph nodes, cardiovascular system, abdomen, lower extremities, nervous system, genital and rectal exam
Identify the components of the “Assessment” aspect of patient assessment sequence
Analyze findings and use clinical reasoning to identify problems
Identify the components of the “Plan” aspect of patient assessment sequence
Specify next steps
