期刊
PATIENT EDUCATION AND COUNSELING
卷 73, 期 3, 页码 536-543出版社
ELSEVIER IRELAND LTD
DOI: 10.1016/j.pec.2008.07.037
关键词
Patient-physician communication; Audio-recording; Implementation; Question prompting; Coaching; Shared decision making; Summaries
资金
- The Foundation for Informed Medical Decision Making [0015]
- United States Department of Defense
- National Institute of Child Health and Human Development (NICHD)
- Office of Research on Wornen's Health (ORWH) [5 K12 HD052163]
- [DAMD17-030481]
Objective: We implemented and monitored a clinical service, Consultation Planning, Recording and Summarizing (CPRS), in which trained facilitators elicit patient questions for doctors, and then audio-record, and summarize the doctor-patient consultations. Methods: We trained 8 schedulers to offer CPRS to breast cancer patients making treatment decisions, and trained 14 premedical interns to provide the service. We surveyed a convenience sample of patients regarding their self-efficacy and decisional conflict, We solicited feedback from physicians, schedulers, and CPRS staff on our implementation of CPRS. Results: 278 patients used CPRS over the 22-month study period, an exploitation rate of 32% compared to our capacity. 37 patients responded to surveys, providing pilot data showing improvements in self-efficacy and decisional conflict. Physicians, schedulers, and premedical interns recommended changes in the program's locations; delivery; products: and screening, recruitment and scheduling processes. Conclusion: Our monitoring of this implementation found elements of success while surfacing recommendations for improvement. Practice implications: We made changes based on study findings. We moved Consultation Planning to conference rooms or telephone sessions; shortened the documents produced by CPRS staff; diverted slack resources to increase recruitment efforts; and obtained a waiver of consent in order to streamline and improve ongoing evaluation. (C) 2008 Elsevier Ireland Ltd. All rights reserved.
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