title: Improving the quality of physician communication with rapid-throughput analysis and report cards.
abstract: OBJECTIVE
  Problems with clinician-patient communication negatively impact newborn screening, genetics, and all of healthcare. Training programs teach communication, but educational methods are not feasible for entire populations of clinicians. To address this healthcare quality gap, we developed a Communication Quality Assurance intervention.
  
  
  METHODS
  Child health providers volunteered for a randomized controlled trial of assessment and a report card. Participants provided telephone counseling to a standardized parent regarding a newborn screening result showing heterozygous status for cystic fibrosis or sickle cell disease. Our rapid-throughput timeline allows individualized feedback within a week. Two encounters were recorded (baseline and after a random sample received the report card) and abstracted for four groups of communication quality indicators.
  
  
  RESULTS
  92 participants finished both counseling encounters within our rapid-throughput time limits. Participants randomized to receive the report card improved communication behaviors more than controls, including request for teach-back (p<0.01), opening behaviors (p=0.01), anticipate/validate emotion (p<0.001) and the ratio of explained to unexplained jargon words (p<0.03).
  
  
  CONCLUSIONS
  The rapid-throughput report card is effective at improving specific communication behaviors.
  
  
  CONCLUSIONS
  Communication can be taught, but this project shows how healthcare organizations can assure communication quality everywhere. Further implementation could improve newborn screening, genetics, and healthcare in general.
authors.affiliation: Center for Patient Care and Outcomes Research, Medical College of Wisconsin, Milwaukee, USA; Aurora University of Wisconsin Medical Group, Center for Urban Population Health, Milwaukee, USA; Program in Genomics and Ethics, Center for Bioethics and Medical Humanities, Medical College of Wisconsin, Milwaukee, USA; Department of Pediatrics, University of Wisconsin-Madison School of Medicine and Public Health, Madison, USA. Electronic address: michaelhfarrell@yahoo.com.
authors.forename: Michael H
authors.initials: MH
authors.lastname: Farrell
authors.affiliation: Center for Patient Care and Outcomes Research, Medical College of Wisconsin, Milwaukee, USA.
authors.forename: Stephanie A
authors.initials: SA
authors.lastname: Christopher
authors.affiliation: Center for Patient Care and Outcomes Research, Medical College of Wisconsin, Milwaukee, USA; Program in Genomics and Ethics, Center for Bioethics and Medical Humanities, Medical College of Wisconsin, Milwaukee, USA.
authors.forename: Alison
authors.initials: A
authors.lastname: La Pean Kirschner
authors.affiliation: Center for Patient Care and Outcomes Research, Medical College of Wisconsin, Milwaukee, USA.
authors.forename: Sara J
authors.initials: SJ
authors.lastname: Roedl
authors.affiliation: Center for Patient Care and Outcomes Research, Medical College of Wisconsin, Milwaukee, USA.
authors.forename: Faith O
authors.initials: FO
authors.lastname: O'Tool
authors.affiliation: Center for Patient Care and Outcomes Research, Medical College of Wisconsin, Milwaukee, USA; Department of Family and Community Medicine, Medical College of Wisconsin, Milwaukee, USA.
authors.forename: Nadia Y
authors.initials: NY
authors.lastname: Ahmad
authors.affiliation: Department of Pediatrics, University of Wisconsin-Madison School of Medicine and Public Health, Madison, USA.
authors.forename: Philip M
authors.initials: PM
authors.lastname: Farrell
mesh_terms: D000328:Adult; D000755:Anemia, Sickle Cell / Q000175:diagnosis* / Q000235:genetics; D002648:Child; D003142:Communication; D003376:Counseling; D003550:Cystic Fibrosis / Q000175:diagnosis* / Q000235:genetics; D005260:Female; D005820:Genetic Testing; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D015997:Neonatal Screening / Q000379:methods*; D010290:Parents / Q000523:psychology; D011368:Professional-Family Relations; D058996:Quality Improvement; D019984:Quality Indicators, Health Care; D013997:Time Factors
keywords: Communication; Cystic fibrosis; Neonatal screening; Professional–patient relations; Quality indicators (health care); Sickle cell trait