Patient-Centered Care and Communication

Patient-centered care establishes a partnership among clinicians, patients, and their families to ensure the patient’s desires, needs, and preferences are met when making decisions as well as supporting the patient to actively participating in healthcare interactions.

While patient-centered communication may be led by the clinician, it is performed jointly by the clinician and the patient. Together, the clinician and patient should enact the following communication tasks:

  1. Fostering the patient-clinician relationship
  2. Exchanging information
  3. Responding to emotions
  4. Managing uncertainty
  5. Making decisions and
  6. Enabling patient self-management.

Fostering the patient-clinician relationship includes building trust and rapport and working to understand each person’s roles and responsibilities in the healthcare interaction.

Exchanging information involves seeking information (e.g., asking questions and exploring beliefs, giving information (e.g., offering explanations, providing test results, sharing histories), and verifying information (e.g., checking for comprehension and accuracy).

Responding to emotions encompasses identifying emotions, acknowledging and then validating those emotions, as well as providing referrals to appropriate services.

Managing uncertainty includes acknowledging uncertainty, framing information based on what is known and what is unknown, active listening, and being empathetic.

Making decisions involves exchanging information, deliberating about clinical information and recommendations, and making a final joint decision.

Enabling patient self-management encompasses navigating the healthcare system, teaching coping skills, and drafting contingency plans for possible outcomes.

You treat a disease,
You win, you lose.
You treat a person,
I guarantee you win –
No matter the outcome.
~ Patch Adams, Film (1998)

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test yourself!

1) During your shift as an OB/GYN, your patient just found out that her baby has jaundice—yellowing of the skin due to liver problems. To help raise the baby’s billirubin levels and reduce the yellowing of the skin, you explain to the mother will have to use a bllilamp before her baby is discharged. You notice your patient can’t take her eyes off her baby and is trying not to cry. You address her negative emotions by acknowledging that this information may cause her to worry; you also affirm that you will be there to listen to any of her concerns and support her during this treatment. What patient-centered communication task does this scenario describe?

A) Exchanging information
B) Responding to emotions
C) Managing uncertainty
D) Making decisions

2) Your patient was diagnosed with Types 2 Diabetes. During her consultation, she discloses that each night she wakes up wondering how the disease will affect her body as well as her quality of life. You suggest some self-care skills such as mediation, positive thinking, and journaling to help her cope. What patient-centered communication task are you suggesting?

A) Exchanging information
B) Managing uncertainty
C) Enabling patient self-management
D) Fostering a healing relationship

3) Your patient recently had a mild heart attack. Your patient needs to decide about putting a stent in his artery. To help your patient decide what to do, you explore his different perspectives about this surgery, deliberate by discussing clinical results for this course of action for men his age, and then support him and his family’s preferences when they decide whether to put a stent in. What patient-centered communication task does this scenario describe?

A) Fostering a healing relationship
B) Enabling patient self-management
C) Managing uncertainty
D) Making decisions

4) You admitted an unconscious 12-year-old boy to your emergency department. His father is with him. First, you ask the father questions to determine what happened to the child to properly diagnosis and treat him. Next, you run some tests, share the results, offer a diagnosis, and construct a treatment plan with the father. Before discharging the child, you ask the father to verify he understands his son’s treatment plan by repeating it back in his own words. What patient-centered communication task does this scenario describe?

A) Responding to emotions
B) Fostering a healing relationship
C) Managing uncertainty
D) Exchanging information

5) During your work as a pharmacist, you are discussing the importance of the patient taking her prescribed medication. Your patient is significantly concerned about possible, uncertain side effects. Instead of discounting her concerns, you actively listen and acknowledge that while there may be some unknown side effects of the medication, research has found the medication to be safe for her illness. What patient-centered communication task does this scenario describe?

A) Responding to emotions
B) Managing uncertainty
C) Making decisions
D) Fostering a healing relationship

6) Your patient has been diagnosed with high blood pressure. This diagnosis will require your patient to make some changes. You and he discuss that he will focus on eating fewer high fat/high calorie foods, consuming less salt, and taking medication. You ask if these steps are feasible given where he lives and his insurance coverage. Additionally, you recommend scheduling a follow-up appointment in 6 weeks to check in, run any needed tests, and make any more suggestions based on his progress. What patient-centered communication task does this scenario describe?

A) Making decisions
B) Fostering a healing relationship
C) Exchanging information
D) Managing uncertainty

Answers – 1) B – 2) C – 3) D – 4) D – 5) B – 6) B

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