title: Improving doctor-patient communication in the outpatient setting using a facilitation tool: a preliminary study.
abstract: OBJECTIVE
  Patients often do not fully understand medical information discussed during office visits. This can result in lack of adherence to recommended treatment plans and poorer health outcomes.
  
  
  METHODS
  We developed and implemented a program utilizing an encounter form, which provides structure to the medical interaction and facilitates bidirectional communication and informed decision-making.
  
  
  METHODS
  We conducted a prospective quality improvement intervention at a large tertiary-care academic medical center utilizing the encounter form and studied the effect on patient satisfaction, understanding and confidence in communicating with physicians. The intervention included 108 patients seen by seven physicians in five sub-specialties.
  
  
  RESULTS
  Ninety-eight percent of patients were extremely satisfied (77%) or somewhat satisfied (21%) with the program. Ninety-six percent of patients reported being involved in decisions about their care and treatments as well as high levels of understanding of medical information that was discussed during visit. Sixty-nine percent of patients reported that they shared the encounter form with their families and friends. Patients' self-confidence in communicating with their doctors increased from a score of 8.1 to 8.7 post-intervention (P-value = 0.0018). When comparing pre- and post-intervention experiences, only 38% of patients felt that their problems and questions were adequately addressed by other physicians' pre-intervention, compared with 94% post-intervention.
  
  
  CONCLUSIONS
  We introduced a program to enhance physician-patient communication and found that patients were highly satisfied, more informed and more actively involved in their care. This approach may be an easily generalizable approach to improving physician-patient communication at outpatient visits.
authors.affiliation: Department of Medicine, University of California, San Francisco (UCSF), San Francisco, CA, USA.
authors.forename: Naama
authors.initials: N
authors.lastname: Neeman
authors.forename: Thomas
authors.initials: T
authors.lastname: Isaac
authors.forename: Suzanne
authors.initials: S
authors.lastname: Leveille
authors.forename: Clementina
authors.initials: C
authors.lastname: Dimonda
authors.forename: Jacob Y
authors.initials: JY
authors.lastname: Shin
authors.forename: Mark D
authors.initials: MD
authors.lastname: Aronson
authors.forename: Steven D
authors.initials: SD
authors.lastname: Freedman
mesh_terms: D000046:Academic Medical Centers / Q000458:organization & administration*; D000328:Adult; D000368:Aged; D002983:Clinical Competence; D003142:Communication; D003657:Decision Making; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009819:Office Visits; D010353:Patient Education as Topic; D010358:Patient Participation; D017060:Patient Satisfaction; D010817:Physician-Patient Relations; D011446:Prospective Studies; D058996:Quality Improvement / Q000458:organization & administration*; D012959:Socioeconomic Factors