Physicians have long relied upon checklists to provide proper medical care to patients for everything from diagnosis to preparation for surgery. Can this same tool be used to improve patients' emotional care and connection with physicians? Experts echo emerging research that say yes.
"For physicians, checklists should be seen as a convenience both for the provider and their patients," says Doug Levy, JD, a consultant on physician communications, who formerly taught a course called Foundations of Patient Care at the University of California at San Francisco Medical School.
Any tool that fosters improved physician-patient communication can go a long way toward helping patients regulate their emotions, better understand medical information, and allow physicians to better assess their patients' needs and expectations, according to a 2010 study in The Ochsner Journal.
"Patients reporting good communication with their doctor are more likely to be satisfied with their care, and especially to share pertinent information for accurate diagnosis of their problems, follow advice, and adhere to the prescribed treatment," the authors write.
Research of this nature convinced the team at Hawaii Pacific Health in 2016 to initiate a checklist of steps for physicians to perform during every office or hospital visit, with the goal of improving patients' emotional well-being, and to encourage deeper trust between physicians and patients.
From a template, physicians identified items they already practiced, and then had to choose two more from the checklist to add to their own. These ranged from clearing their minds of distractions in order to be present, to listening to the patient for several minutes without interrupting. The result of this change in practice was a more than 20 percent improvement on a physician communication score within a year of implementation.
Checklists Can Be Formal or Informal
While the idea of a checklist may sound like an additional task to add to a physician's already full day, many doctors already have an informal process in place and it's a matter of making it more overt and consistent.
For Karen Sibert, MD, president of the California Society of Anesthesiologists and an associate clinical professor of anesthesiology at UCLA Health, the idea of this kind of patient well-being checklist is a no-brainer. She's long followed a mental list designed to do just this.
"I have a consistent approach in my mind that has these steps I repeat," she says. Sibert says she believes strongly in a quality personal interaction because "it's so critical to the patients having confidence in you, what you're going to do for them, and feeling comfortable with it."
She always begins by addressing her patients formally and establishing herself as a physician in her introduction, which creates "an atmosphere of clear communication" that includes being respectful to the patient. She emphasizes that it's important to ask questions in the interaction rather than just reading from a chart.
After decades of practice, Sibert is keenly aware that she has "roughly 10 minutes to make the patient feel as though they want to put their life in my hands."