PowerPoint Slides for
Communication Techniques in the Office
Presented by Dr. Dennis Boyle Physician Risk Manager COPIC
Copyright 2013 by COPIC. All rights reserved.
Moment with the instructor Introduction to Part 1
Communication Techniques q in the Office: ff Part 1
Course Resources Slide Narrative Course Notes PowerPoint Slides Resource Links
Patient-provider communication
Scenario: Dave arrives at the medical office
The leading cause in the majority of cases Medical errors Non-adherence to treatment P ti t dissatisfaction Patient di ti f ti Reduced staff morale Malpractice claims Course Resources
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Course Notes
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Patient-provider communication
Patient-provider communication
Root causes of sentinel events
Main cause of malpractice claims 80%
Course Resources Slide Narrative Course Notes PowerPoint Slides
70%
Communication Orientation/training Patient assessment Staffing Availability of info Competency/credentialing Procedural compliance Environ. Safety/security Leadership Continuum of care Care planning Organization culture
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Important research Source: The Joint Commission 2007 Annual Report
Important research Source: “Patient Communication,” CE Websource.com
Patient-provider communication
What we’ll cover today Improving communication
Benefits and techniques
Course Resources
Enhance the quality of your interactions
Research
Survey q questions
Course Resources
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Slide Narrative
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Course Notes
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The benefits of effective communication
The benefits of effective communication Improved patient satisfaction
Improving patient satisfaction Empathic
Scenarios
Caring
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Course Notes
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Important research
Important research Source: Patient-Physician Communication--Why and How
Source: Physician-Patient Communication in the Primary Care Office: A Systematic Review
The benefits of effective communication
The benefits of effective communication
Improved personal satisfaction Personal
Improved patient outcomes
Professional 3 out of 4 Americans don’t take medication as prescribed
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Important research Source: Enhancing Prescription Medicine Adherence: A National Action Plan, National Council on Patient Information and Education, August 2007
The benefits of effective communication
The benefits of effective communication
Reduction in malpractice claims
Improved patient outcomes The better that patients understand
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Course Resources
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Slide Narrative
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Course Notes
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The more they act in accordance
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Communication Skills
Quality of Care
Resource Links
The benefits of effective communication
Moment with the instructor Making a connection
Reducing malpractice claims
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Course Resources
Slide Narrative
Slide Narrative
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Course Notes
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Communication skills
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Important research Source: Obstetricians' prior malpractice experience and patients' satisfaction with care
Communication isn’t just a handy tool
Communication isn’t just a handy tool Effective communication is a procedure Number of providers in the office 4 3
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Interactions per day
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Communication is a procedure
Communication is a procedure
Techniques 1. 2. Course Resources
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3. 4. 5. 6. 7.
Survey question
Scenario: Dave has his BP taken
In the past, has your office provided you with training and techniques for improving communication? Click Yes, No or I Don’t Know, then click Submit.
Y Yes No I don’t know Course Resources
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Slide Narrative
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Question to consider
Medical interactions are different More serious More personal
Name three things that make this interaction different from one that might occur at a retail store.
Their own health Their family’s health
Enter y your response p in the space p below and click Submit.
Death and dying Sexuality Other deeply personal issues
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Course Resources
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Course Notes
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Medical interactions are different
Seven communication techniques
Emotions Ideas
Techniques 1. Introducing yourself
Self-diagnoses f g
Ensuring verbal/
2. nonverbal congruence
Can I be helped?
Expectations
3. Building rapport and engagement
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Course Resources
Quality, caring encounters
Slide Narrative
Course Notes PowerPoint Slides Resource Links
Course Notes
Accurate, immediate diagnoses and treatment
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4.Asking open-ended questions 5. Listening reflectively 6. Educating/communicating final instructions
Resource Links
7. Practicing effective phone communication
Scenario: Nurse introduces herself to Dave
Question to consider Give a grade of either A (for excellent), B, C, D or F (for failing) to this introduction and provide at least two reasons for your grade.. Enter y your response p in the space p below and click Submit.
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#1: Introducing yourself
#1: Introducing yourself
Goal: Making a good first impression
Goal: Making a good first impression
Caring
Discussing Accepting
OR Course Resources Course Notes
Adhering
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Frustrating
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3 minutes
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6 minutes
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10 minutes
Important research 30 seconds to a minute
Source: At first sight: Persistent relational effects of get-acquainted Conversations
#1: Introducing yourself
#1: Introducing yourself
Procedure for making an introduction
Procedure for making an introduction
Introducing yourself Start with a simple greeting Course Resources Slide Narrative
“Hello, how are you doing?”
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“Hello, Mrs. Brown, how are you doing? My name is Barry. I’m the physician’s assistant taking care of you today.”
#1: Introducing yourself
#1: Introducing yourself
Procedure for making an introduction
Course Resources Slide Narrative Course Notes PowerPoint Slides Resource Links
“Sorry, I’d love to shake your hand, but I see that you have an upper respiratory infection. If you do, I don’t want to pass it on to others.”
Introducing yourself Start with a simple greeting Put the patient’s name first
Procedure for making an introduction
Introducing yourself Start with a simple greeting Put the patient’s name first Shake the patient’s hand
Introducing yourself Start with a simple greeting Put the patient’s name first Shake the patient’s hand Look at the patient while you’re talking
Course Resources Slide Narrative Course Notes PowerPoint Slides
Maintain level eye contact
Resource Links
#1: Introducing yourself
Survey question
Maintaining a professional appearance
Does everyone in your office use a common introduction technique with patients? Click Yes, No or I Don’t Know, then click Submit.
Course Resources Slide Narrative Course Notes
Avoid offensive behaviors or items
Maintain dress code
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Y Yes No I don’t know Course Resources Slide Narrative Course Notes PowerPoint Slides
Wear your name tag
Resource Links
Moment with the instructor
Scenario: Nurse listens to Dave
Importance of the introduction
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Course Resources
Slide Narrative
Slide Narrative
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Course Notes
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#2: Ensuring congruence
Question to consider
Verbal and nonverbal communication
Give a grade of either A, B, C, D or F to this nurse’s nonverbal communication and provide at least two reasons for your grade.
Verbally
Nonverbally Enter y your response p in the space p below and click Submit.
Words
Voice: Tone
Nonverbally
Speed Course Resources
Course Resources
Body language:
Volume
Slide Narrative
Slide Narrative
Gestures
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Course Notes
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Head and Facial Expressions
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#2: Ensuring congruence
#2: Ensuring congruence
Being aware of the patient
Verbal and nonverbal communication
Observe emotions Respond to emotions
Congruent
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Tilting head
Course Notes
Turning down lips
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Softening voice “I’m really sorry.”
Not congruent Smiling
Course Resources Slide Narrative Course Notes PowerPoint Slides Resource Links
“Is everything OK today? You look sad.”
Survey question
Moment with the instructor Research into nonverbal communication
Does everyone in your office ensure congruence with and awareness of nonverbal communication? Click Yes, No or I Don’t Know, then click Submit.
Course Resources Slide Narrative
Yes No I don’t know
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Course Notes
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#3: Building rapport and engagement
#3: Building rapport and engagement
Actively involve the patient Less likely to sue providers
with Course Resources Slide Narrative Course Notes
Help them feel comfortable talking to you!
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a trusting, respectful relationship
Course Notes
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Important research Source: The relationship with malpractice claims among primary care physicians and surgeons
#3: Building rapport and engagement
#3: Building rapport and engagement
Orienting the patient Orienting the patient
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What you’ll be doing
Connecting with the patient
What’s going on
Course Resources
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Slide Narrative
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Course Notes
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How long to see the doctor
How long for the overall visit
How long the X-rays will take
#3: Building rapport and engagement
#3: Building rapport and engagement
Connecting with the patient
Connecting with the patient
Orienting the patient
Don’t talk only about medical issues
Patient engagementt
Relate what what’ss happening Ask them about their kids “Tell me a little bit about yourself.” Course Resources
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Slide Narrative
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Involved
#3: Building rapport and engagement
#3: Building rapport and engagement
Patients
Active
Barriers to engagement
Providers
Acknowledge health issues Understand options Modify behavior Follow prescribed treatment Course Resources
Course Resources
Slide Narrative
Slide Narrative
Course Notes
Course Notes
PowerPoint Slides Resource Links
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Important research
Resource Links
Source: Patient-Physician Communication--Why and How
#3: Building rapport and engagement
#3: Building rapport and engagement
Barriers to engagement
Barriers to engagement
X X X Course Resources Slide Narrative
Avoid rushing into questions
Don’t try to take control
Don’t interrupt the patient
Within 20 seconds
Course Resources Slide Narrative
Course Notes
Course Notes
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Important research Source: Soliciting the patient's agenda: have we improved?
#3: Building rapport and engagement
#3: Building rapport and engagement
Barriers to engagement
Barriers to engagement
Average visit: 2.7 complaints 24% off visits: i it >3 complaints l i t 14% of visits: >4 complaints Course Resources Slide Narrative
They leave important complaints unaddressed!
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Course Notes
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Survey question
Important research Source: How Many Problems Do Family Physicians Manage at Each Encounter?
Moment with the instructor Giving patients time to talk
Does your office have procedures for engaging the patient? Click Yes, No or I Don’t Know, then click Submit.
Y Yes No I don’t know Course Resources
Course Resources
Slide Narrative
Slide Narrative
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Course Notes
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End of Part 1
Course Resources Slide Narrative Course Notes PowerPoint Slides Resource Links
Copyright py g 2013 3 by y COPIC All rights reserved.
Moment with the instructor Introduction to Part 2
Communication Techniques q in the Office: ff Part 2
Course Resources Slide Narrative Course Notes PowerPoint Slides Resource Links
Scenario: The PA asks the first question
Question to consider Give a grade of either A, B, C, D or F to this first question and provide at least two reasons for your grade.
Enter y your response p in the space p below and click Submit.
Course Resources
Course Resources
Slide Narrative
Slide Narrative
Course Notes
Course Notes
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PowerPoint Slides
Resource Links
Resource Links
#4: Asking open-ended questions
#4: Asking open-ended questions Chief complaint and chief concern
First question: broad, not specific Let patient tell their story
“I have a cough.”
Show them you care
“I need an antibiotic for the cough.” Chief Chief complaint concern
Course Resources
“How can we help you today?”
Course Resources
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Slide Narrative
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Course Notes
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“I’m really congested.”
Closed-ended questions
“I think I need a chest X-ray.”
Open-ended questions
#4: Asking open-ended questions
Survey question
Open-ended and closed-ended questions
Course Resources Slide Narrative Course Notes PowerPoint Slides
Closed-ended questions
Open-ended questions
Yes/No
A more detailed response
Good/Bad
“Why are you here today?”
“How are you sleeping?”
“What seems to be the problem?”
“Can you move your arm?” “Tell me more.”
Resource Links
Does your office staff know the different types of questions to ask and when to ask them? Click Yes, No or I Don’t Know, then click Submit.
Y Yes No I don’t know Course Resources Slide Narrative Course Notes PowerPoint Slides Resource Links
Moment with the instructor
Scenario: The PA listens to Dave
Asking the right questions
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Course Resources
Slide Narrative
Slide Narrative
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Course Notes
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Question to consider
#5: Listening reflectively Confirm you have understood
Give a grade of either A, B, C, D or F to this listening technique and provide at least two reasons for your grade.
Enter y your response p in the space p below and click Submit. Listen to the patient’s words carefully Course Resources
Course Resources
Slide Narrative
Slide Narrative
Course Notes
Course Notes
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Summarize what they’ve said
Note their nonverbal communication
#5: Listening reflectively
#5: Listening reflectively
Effective listening statements
Benefits of reflective listening
“Sounds like…” “I can see that you are…” “Let me see if I understand…” “I think I’m hearing you say…” Course Resources Slide Narrative Course Notes PowerPoint Slides
“Sounds like you’re here for a cough and you want an antibiotic. The last time you had this problem, the antibiotic really helped with your bronchitis. Do I have that right?”
Resource Links
Course Resources Slide Narrative Course Notes PowerPoint Slides Resource Links
#5: Listening reflectively
Helps you capture the story in your mind
Lets the patient set the record straight
Reinforces your connection with the patient
#5: Listening reflectively Qualities of empathy
Empathy
You deeply recognize
complaints, concerns Empathy You get the patient to feel they’re not alone
You understand where the patient is coming from and why. Course Resources
Different from sympathy: “I’m sorry you’re going through this.”
Slide Narrative Course Notes PowerPoint Slides Resource Links
Course Resources Slide Narrative Course Notes
The patient experiences having been seen, heard, understood, accepted
PowerPoint Slides Resource Links
Important research Source: “Let Me See If I Have This Right...”: Words That Help Build Empathy
Survey question
Moment with the instructor Practicing empathy
Do members of your office staff regularly and effectively practice reflective listening? Click Yes, No or I Don’t Know, then click Submit.
Y Yes No I don’t know Course Resources
Course Resources
Slide Narrative
Slide Narrative
Course Notes
Course Notes
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Resource Links
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Scenario: Nurse gives final instructions to Dave
Question to consider Give a grade of either A, B, C, D or F to these final instructions and provide at least two reasons for your grade. Enter y your response p in the space p below and click Submit.
Course Resources
Course Resources
Slide Narrative
Slide Narrative
Course Notes
Course Notes
PowerPoint Slides
PowerPoint Slides
Resource Links
Resource Links
#6: Educating/communicating final instructions
#6: Educating/communicating final instructions
Ensure the patient understands and follows treatment
Step 1: Assess whether the patient understands
Interview Examine
1. Ask the patient about what happened 2. Reassess if the patient understands their responsibility to continue treatment
Treat Course Resources Slide Narrative
Review Educate
Course Resources Slide Narrative
Course Notes
Course Notes
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PowerPoint Slides
Resource Links
Resource Links
#6: Educating/communicating final instructions
“To make sure we communicated, tell me what the doctor did for you today and what medicine you’ll be taking.”
#6: Educating/communicating final instructions
Step 1: Assess the patient’s understanding
Step 2: Close the loop with the patient Should I bring up…?
1. Ask the patient what happened 2. Reassess if the patient understands their responsibility to continue treatment Course Resources Course Notes
3. Listen and give verbal confirmation 4. Clarify and make adjustments
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5. Let them know if they need to follow up
Slide Narrative
Resource Links
Course Resources Slide Narrative Course Notes PowerPoint Slides Resource Links
“The prescription label will indicate that you should take one bill an hour before bedtime.”
“Is there anything else we can do for you today?”
#6: Educating/communicating final instructions
#6: Educating/communicating final instructions
Step 3: Keep your promises on following up
Step 3: Keep your promises on following up
1.Tell the patient you’ll inform them Course Resources
1.Tell the patient you’ll inform them Course Resources
Slide Narrative
Slide Narrative
Course Notes
Course Notes
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Resource Links
“We’ll let you know your lab results by Friday. If you don’t hear from us, call the office.”
Resource Links
2. Confirm the best way to communicate 3. Follow up with the promised results “Can I leave a message on your cellphone? Do other people have access to it?” “Can we send a secure e-mail to this address?”
Survey question
Moment with the instructor Communicating effectively
Does your office have a standard approach to communicating instructions with patients upon discharge? Click Yes, No or I Don’t Know, then click Submit.
Course Resources
Yes No I don’t know
Course Resources
Slide Narrative
Slide Narrative
Course Notes
Course Notes
PowerPoint Slides
PowerPoint Slides
Resource Links
Resource Links
Scenario: Dave calls the receptionist
Question to consider Give a grade of either A, B, C, D or F to this phone call and provide at least two reasons for your grade.
Enter y your response p in the space p below and click Submit.
Course Resources
Course Resources
Slide Narrative
Slide Narrative
Course Notes
Course Notes
PowerPoint Slides
PowerPoint Slides
Resource Links
Resource Links
#7: Practicing effective phone communication
#7: Practicing effective phone communication
Continue or begin engagement
Improving phone skills Answer phone in a friendly manner
Make a positive first impression Course Resources
Course Resources
Slide Narrative
Slide Narrative
Course Notes
Course Notes
PowerPoint Slides
PowerPoint Slides
Resource Links
Resource Links
#7: Practicing effective phone communication
Smile to display your friendliness
#7: Practicing effective phone communication
Improving phone skills Answer phone in a friendly manner
Improving phone skills
Display empathy and ask questions
Use courtesy and respect
Course Resources
Use reflective listening and don’t interrupt
Course Resources
Slide Narrative
Slide Narrative
Course Notes
Course Notes
PowerPoint Slides
PowerPoint Slides
Resource Links
Resource Links
Answer phone in a friendly manner
Display empathy and ask questions
Use courtesy and respect
Consider how to handle multiple calls
Use reflective listening and don’t interrupt
1. Ask if you can put Caller 1 on hold 2. Wait for their response 3. Follow same procedure with Caller 2 4. Return to Caller 1
#7: Practicing effective phone communication
#7: Practicing effective phone communication
Improving phone skills
Course Resources Slide Narrative Course Notes PowerPoint Slides Resource Links
Answer phone in a friendly manner
Display empathy and ask questions
Use courtesy and respect
Consider how to handle multiple calls
Use reflective listening and don’t interrupt
Provide caller with a timeframe for the callback
Ask if they have anything else to discuss
Ensuring 100% accuracy Readbacks = repeating of a message
Course Resources Slide Narrative Course Notes
1. Read back the name, number and message 2. Get confirmation before hanging up
PowerPoint Slides Resource Links
Important research Source: High-Hanging Fruit: Improving Transitions in Health Care
Survey question
Summary
Does every member of your office practice readbacks on phone calls?
Benefits of improved communication Patient satisfaction
Personal satisfaction
Better p patient outcomes
Reduction in malpractice l ti claims l i
Click Yes, No or I Don’t Know, then click Submit.
Yes No I don’t know Course Resources
Course Resources
Slide Narrative
Slide Narrative
Course Notes
Course Notes
PowerPoint Slides
PowerPoint Slides
Resource Links
Resource Links
Summary
Summary
Effective communication is a procedure Focus on one technique and practice it…
Techniques 1. Course Resources
Course Resources
Slide Narrative
Slide Narrative
Course Notes
Course Notes
References
PowerPoint Slides
2. 3.
Resource Links
1‐39
Summary
Summary
Patients reveal serious and deeply personal issues Concerns Emotions Ideas
Techniques 1. Introducing yourself 2. Ensuring verbal/
Can I b helped? be h l d?
3. Self-diagnoses Course Resources Slide Narrative Course Notes PowerPoint Slides
Course Resources
Expectations
Slide Narrative Course Notes References
nonverbal congruence Building rapport and engagement
4. Asking open-ended questions 5. Listening reflectively 6. Educating/communicating final instructions Practicing effective phone communication
7.
Resource Links
1‐42
Summary
Summary Technique #1: Introducing yourself
Technique #2: Ensuring congruence
Body language
Words
Introducing yourself Start with a simple greeting Course Resources Slide Narrative Course Notes PowerPoint Slides
Put the patient’s name first
Avoid offensive behaviors or items
Maintain dress code
Shake the patient’s hand Look at the patient while you’re talking
Course Resources Slide Narrative Course Notes PowerPoint Slides Resource Links
Resource Links
Wear your name tag
“Is everything OK today? You look sad.”
Summary
Summary
Technique #3: Building rapport and engagement
Orienting the patient
What you’ll be doing
Course Resources Slide Narrative
Help them feel comfortable talking to you!
Course Resources Slide Narrative
Course Notes
Course Notes
PowerPoint Slides Resource Links
What’s going on
PowerPoint Slides
Orienting the patient
Connecting with the patient
Resource Links
Summary
Summary
Connect with the patient
Avoid barriers to engagement
X X X
Relate what’s happening in your life Ask what’s what s happening in their life
Course Resources
Course Resources
Slide Narrative
Slide Narrative
Course Notes
Course Notes
PowerPoint Slides
PowerPoint Slides
Resource Links
Resource Links
Avoid rushing into questions
Don’t try to take control
Don’t interrupt the patient
Summary
Summary
Technique #4: Asking open-ended questions
Technique #5: Reflective listening
Let patient tell their story
“Sounds like…”
Show them you care
Course Resources
Empathy
“How can we help you today?”
Course Resources
Slide Narrative Course Notes
Slide Narrative
Closed-ended questions
Open-ended questions
Yes
Patient can respond at length
PowerPoint Slides Resource Links
Course Notes PowerPoint Slides
You understand where the patient is coming from and why.
Resource Links
No
Summary
Summary
Technique #6: Communicating final instructions
Technique #7: Practicing effective phone communication
Step 1: Assess whether the patient understands
Answer phone in a friendly manner
Step 2: Close the loop with the patient Course Resources Slide Narrative Course Notes
“Is there anything else we can do today?”
Step 3: Keep your promises on following up
Use courtesy and respect Course Resources Slide Narrative Course Notes
PowerPoint Slides
PowerPoint Slides
Resource Links
Resource Links
Summary
Consider how to handle multiple calls
Moment with the instructor Becoming a better communicator
Readbacks
Course Resources
Course Resources
Slide Narrative
Slide Narrative
Course Notes
Course Notes
PowerPoint Slides Resource Links
PowerPoint Slides
1. Read back the name, number and message 2. Get confirmation before hanging up
Resource Links
Copyright py g 2013 3 by y COPIC All rights reserved.
