Monitoring the implementation of Consultation Planning, Recording, and Summarizing in a breast care center

PATIENT EDUCATION AND COUNSELING

卷:73

Article

Belkora, Jeffrey K.¹  Loth, Meredith K.¹  Chen, Daniel F.¹  Chen, Jennifer Y.¹  Volz, Shelley¹  Esserman, Laura J.¹ 

[1] Univ Calif San Francisco, San Francisco, CA 94143 USA

关键词: Patient-physician communication;    Audio-recording;    Implementation;    Question prompting;    Coaching;    Shared decision making;    Summaries;   

DOI  :  10.1016/j.pec.2008.07.037

来源: Elsevier

【 摘 要 】

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.

【 授权许可】

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