A method to assess the organizing behaviors used in physicians' counseling of standardized parents after newborn genetic screening.
Well-organized conversation can improve people's ability to comprehend and retain information. As part of a long-term effort to adapt Quality Improvement techniques for communication, we developed an explicit-criteria method to assess usage of three organizing behaviors (OBs): 'opening behaviors' to establish goals; 'structuring behaviors' to guide patients through conversation; and 'emphasizing behaviors' that signal a need for attention. Pairs of abstractors independently reviewed transcripts in a demonstration sample of conversations between physicians and standardized parents after newborn screening identifies carrier status for sickle cell disease. Criteria for at least one OB were identified in 50/84 transcripts (60%), including 27 with at least one opening behavior (32%), 5 with at least one structuring behavior (6%), and 38 with at least one emphasizing behavior (45%). The limited number of OBs raises concern about communication after newborn screening. Assessment and improvement of OB usage may improve understanding and allow parents to more actively participate in health care.
Center for Patient Care and Outcomes Research, Medical College of Wisconsin, USA. schristopher@mcw.edu
Stephanie A
SA
Christopher
Department of Family and Community Medicine, Medical College of Wisconsin, USA.
Nadia Y
NY
Ahmad
Medical College of Wisconsin, USA.
Lisa
L
Bradford
Center for Patient Care and Outcomes Research, Medical College of Wisconsin, USA.
Jenelle L
JL
Collins
PCOR, Medical College of Wisconsin, USA.
Kerry
K
Eskra
PCOR, Medical College of Wisconsin, USA.
Alison la Pean
Al
Kirschner
Center for Patient Care and Outcomes Research, Medical College of Wisconsin, USA.
Faith O
FO
O'Tool
Center for Patient Care and Outcomes Research, Medical College of Wisconsin, USA.
Sara J
SJ
Roedl
PCOR, Medical College of Wisconsin, USA.
Michael H
MH
Farrell
D000368:Aged; D000755:Anemia, Sickle Cell / Q000235:genetics; D001519:Behavior; D003142:Communication; D003376:Counseling / Q000379:methods*; D005260:Female; D005820:Genetic Testing; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D015997:Neonatal Screening / Q000523:psychology*; D010290:Parents / Q000523:psychology*; D016544:Patient Simulation; D010817:Physician-Patient Relations; D010820:Physicians / Q000523:psychology*