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Grossman ES, Berger I. Inclusion of a computerized test in ADHD diagnosis process can improve trust in the specialists' decision and elevate adherence levels. Sci Rep 2024; 14:4392. [PMID: 38388799 PMCID: PMC10884014 DOI: 10.1038/s41598-024-54834-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Accepted: 02/16/2024] [Indexed: 02/24/2024] Open
Abstract
Attention deficit and hyperactivity disorder (ADHD) affects many life aspects of children and adults. Accurate identification, diagnosis and treatment of ADHD can facilitate better care. However, ADHD diagnosis and treatment methods are subject of controversy. Objective measures can elevate trust in specialist's decision and treatment adherence. In this observational study we asked whether knowing that a computerized test was included in ADHD diagnosis process results in more trust and intention to adhere with treatment recommendations. Questionnaires were administered to 459 people, 196 men, average age = 40.57 (8.90). Questions regarding expected trust and adherence, trust trait, trust in physician and health-care-institutions, and ADHD scales followed a scenario about parents referred to a neurologist for sons' ADHD diagnosis. The scenario presented to the test group (n = 185) mentioned that a computerized test was part of the diagnostic process. The control group scenario didn't mention any computerized test in the diagnostic process. Test group participants expressed more trust in the diagnosis and greater levels of intention for treatment adherence. Group differences in intention for treatment adherence were mediated by trust in decision. Inclusion of a computerized test in ADHD diagnosis process can improve trust in the specialists' decision and elevate adherence levels.
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Affiliation(s)
| | - Itai Berger
- Pediatric Neurology, Pediatric Division, Faculty of Health Sciences, Assuta Ashdod University Medical Center, Ben-Gurion University of the Negev, Beer-Sheva, Israel
- The Paul Baerwald School of Social Work and Social Welfare, The Hebrew University of Jerusalem, Jerusalem, Israel
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2
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Ryan L, Weir KA, Maskell J, Bevan L, Le Brocque R. 'What are you hiding from me?' A qualitative study exploring health consumer attitudes and experiences regarding the patient-led recording of a hospital clinical encounter. Health Expect 2022; 25:3096-3104. [PMID: 36229999 DOI: 10.1111/hex.13617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Revised: 09/11/2022] [Accepted: 09/13/2022] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVE Health consumers (patients, their family, friends and carers) are frequently using their smartphones to record hospital clinical encounters. However, there is limited research which has explored the social interaction surrounding this behaviour. Understanding the consumer perspective is key to informing policy and practice. This study explored consumer attitudes and experiences regarding patient-led recordings. METHODS Semistructured interviews were undertaken with 20 hospital consumers. Participants were recruited via advertising, posters and invitation letters. Interviews were digitally recorded and transcribed. Data were analysed using thematic analysis. FINDINGS Four main themes were identified relating to participant perspectives of patient-led recordings: (1) consumers viewed clinician consent as important, although they reported different experiences of the consent process, (2) consumers indicated that a clinician refusing the recording had the potential to undermine the consumer-clinician relationship, (3) consumers were both uninformed and misinformed regarding relevant policy and legislation and (4) consumers expressed a number of expectations regarding their rights to record and of the health service in supporting this practice. CONCLUSION Consumers want to record their clinical encounters with the consent of their clinician but are unprepared to navigate consent discussions. Health services and clinicians should inform consumers who want to record about their rights and responsibilities, to support the consent process and safe recording environments. Clinician refusal to consent to a patient-led recording may not lead to increased covert recording; however, clear communication about the reasons for refusing a recording is needed to protect the consumer-clinician relationship. PATIENT OR PUBLIC CONTRIBUTION A health consumer was part of the research team and was involved in all stages of this study, including the design, data analysis and reviewing of the manuscript.
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Affiliation(s)
- Laura Ryan
- Allied Health Research, Gold Coast Health, Gold Coast University Hospital, Southport, Queensland, Australia
| | - Kelly A Weir
- Allied Health Research, Gold Coast Health, Gold Coast University Hospital, Southport, Queensland, Australia.,Menzies Health Institute Queensland, Griffith University, Southport, Queensland, Australia
| | - Jessica Maskell
- Social Work Services, Gold Coast Health, Southport, Queensland, Australia
| | - Lily Bevan
- School of Nursing, Midwifery, and Social Work, The University of Queensland, St Lucia, Australia, Queensland
| | - Robyne Le Brocque
- Gold Coast Health Consumer Advisory Group, Gold Coast Health, Southport, Queensland, Australia
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3
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Hewson T, Abraham S, Randles N, Akinola A, Cliff R, Byrne P, Ramkisson R. The recording of mental health consultations by patients: clinical, ethical and legal considerations. BJPsych Bull 2022; 46:133-137. [PMID: 34533115 PMCID: PMC9347263 DOI: 10.1192/bjb.2021.89] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
The topic of patients recording healthcare consultations has been previously debated in the literature, but little consideration has been given to the risks and benefits of such recordings in the context of mental health assessments and treatment. This issue is of growing importance given the increasing use of technology in healthcare and the recent increase in online healthcare services, largely accelerated by the COVID-19 pandemic. We discuss the clinical, ethical and legal considerations relevant to audio or visual recordings of mental health consultations by patients, with reference to existing UK guidance and the inclusion of a patient's perspective.
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Affiliation(s)
- Thomas Hewson
- Health Education North West School of Psychiatry, UK
| | - Seri Abraham
- Pennine Care NHS Foundation Trust, UK.,Manchester Metropolitan University, UK
| | | | - Adeola Akinola
- Pennine Care NHS Foundation Trust, UK.,University of Manchester, UK
| | | | | | - Roshelle Ramkisson
- Pennine Care NHS Foundation Trust, UK.,University of Manchester, UK.,University of Bolton, UK
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4
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Ryan L, Weir K, Maskell J, Le Brocque R. Smartphone standoff: a qualitative study exploring clinician responses when a patient uses a smartphone to record a hospital clinical encounter. BMJ Open 2022; 12:e056214. [PMID: 35459670 PMCID: PMC9036419 DOI: 10.1136/bmjopen-2021-056214] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVES Patients are initiating recordings of their clinical encounters using a smartphone. While this is an important, universal issue, little is known about the clinician viewpoint. Understanding clinician perspectives and behaviours is key to ensuring the protection of patient and clinician interests. This study aimed to gain a deep understanding of clinician attitudes and behaviours to patient-led recordings of hospital clinical encounters. DESIGN Semistructured interviews were conducted with 20 hospital clinicians. Participants were recruited using a combination of purposive and snowball sampling. Interviews were digitally recorded and transcribed. Transcripts were analysed using thematic analysis. SETTING This study took place at two hospitals in the metropolitan area of Gold Coast, Australia. PARTICIPANTS Participants included clinicians with varying levels of experience, or clinical managers in the roles of: medical, nursing and midwifery, and allied health staff. RESULTS The 20 participants interviewed were from a range of health disciplines and clinical areas and most had experienced a patient-led recording. Three themes emerged when exploring participant attitudes. First, that recording was a significant and controversial topic. Second, that experiences often informed clinician attitudes and many clinicians held conflicting views. Finally, a perceived loss of control was a significant stressor. A further three themes emerged relating to clinician behaviours when a patient asks to record. Decision-making involved balancing multiple factors often in pressurised situations. Shared decision-making was shaped by power dynamics and, finally, decision-making was not informed by hospital policy. CONCLUSIONS While patient-led recordings were viewed as beneficial, clinician welfare and patient safety may be at risk when a patient records a clinical encounter. Current safeguards, such as hospital policies, are not used and may not meet the needs of clinicians when decision-making is complicated by power dynamics. More research is needed to better understand how clinicians can be supported in this critical domain.
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Affiliation(s)
- Laura Ryan
- Social Work, Gold Coast Hospital and Health Service, Southport, Queensland, Australia
| | - Kelly Weir
- Allied Health Research, Gold Coast Hospital and Health Service, Southport, Queensland, Australia
- Griffith Health, Griffith University, Gold Coast, Queensland, Australia
| | - Jessica Maskell
- Social Work, Gold Coast Hospital and Health Service, Southport, Queensland, Australia
| | - Robyne Le Brocque
- School of Nursing, Midwifery, and Social Work, The University of Queensland-Saint Lucia Campus, Saint Lucia, Queensland, Australia
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García AT. Reflexiones clínicas sobre la grabación de entrevistas de atención psicológica ¿Qué podemos pensar sobre la situación en que el paciente pide grabar su entrevista psicológica? CLÍNICA CONTEMPORÁNEA 2021. [DOI: 10.5093/cc2021a2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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6
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Bourhill J, Lee JJ, Frie K, Aveyard P, Albury C. What Makes Opportunistic GP Interventions Effective? An Analysis of Behavior Change Techniques Used in 237 GP-Delivered Brief Interventions for Weight Loss. Ann Behav Med 2020; 55:228-241. [PMID: 32686819 DOI: 10.1093/abm/kaaa046] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Evidence shows that clinician-delivered brief opportunistic interventions are effective in obesity, and guidelines promote their use. However, there is no evidence on how clinicians should do this, and guidelines are not based on clinical evidence. PURPOSE A trial (Brief Interventions for Weight Loss [BWeL]) showed that brief opportunistic interventions on obesity that endorsed, offered, and facilitated referral to community weight management service (CWMS) led to 77% agreeing to attend, and 40% attending CWMS, as well as significantly greater weight loss than control at 12 months. We assessed which behavior change techniques (BCTs) doctors used that were associated with CWMS attendance. METHODS We coded 237 recorded BWeL interventions using the behavioral change techniques version one taxonomy. We also coded the BWeL training video to examine delivery of recommended BCTs. Mixed effects logistic regression assessed the association between each BCT, the total number of BCTs, and delivery of recommended BCTs, with patient's agreement to attend and actual CWMS attendance. RESULTS Of 237 patients, 133 (56%) agreed to attend and 109 (46%) attended. Thirteen BCTs were used more than eight times but none of the 13 were associated with increased attendance. One, "practical social support," was significantly associated with increased patient agreement (odds ratio [OR] = 4.80, 95% confidence interval [CI] = 1.15, 20.13). Delivery of recommended BCTs and the total number of BCTs used were both associated with increased agreement (OR = 1.56, 95% CI = 1.09, 2.23 and OR = 1.34, 95% CI = 1.03, 1.75, respectively), but not attendance at CWMS (OR = 1.20, 95% CI = 0.98-1.47 and OR = 1.08, 95% CI = 0.94-1.24, respectively). CONCLUSIONS There is no evidence that particular BCT can increase the effectiveness of brief opportunistic interventions for obesity in adults. However, using more BCTs and delivery of recommended BCTs may increase agreement to attend community weight management services.
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Affiliation(s)
- Jana Bourhill
- University of Oxford Medical School, Osler House, John Radcliffe Hospital, Headley Way, Headington, Oxford, UK.,Brasenose College, University of Oxford, Oxford, UK
| | - Joseph J Lee
- Medical Sciences Division, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Kerstin Frie
- Medical Sciences Division, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Paul Aveyard
- Medical Sciences Division, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Charlotte Albury
- Medical Sciences Division, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
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7
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Osman R, Gunderman RB. When Patients Ask to Record Radiologic Procedures. J Am Coll Radiol 2020; 17:819-820. [PMID: 32105646 DOI: 10.1016/j.jacr.2020.01.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2019] [Revised: 01/20/2020] [Accepted: 01/25/2020] [Indexed: 10/24/2022]
Affiliation(s)
- Radya Osman
- Department of Radiology, Indiana University School of Medicine, Indianapolis, Indiana
| | - Richard B Gunderman
- Department of Radiology, Indiana University School of Medicine, Indianapolis, Indiana.
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Hyatt A, Lipson-Smith R, Morkunas B, Krishnasamy M, Jefford M, Baxter K, Gough K, Murphy D, Drosdowsky A, Phipps-Nelson J, White F, White A, Serong L, McDonald G, Milne D. Testing Consultation Recordings in a Clinical Setting With the SecondEars Smartphone App: Mixed Methods Implementation Study. JMIR Mhealth Uhealth 2020; 8:e15593. [PMID: 31961333 PMCID: PMC7001044 DOI: 10.2196/15593] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2019] [Revised: 09/30/2019] [Accepted: 10/20/2019] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Health care systems are increasingly looking to mobile device technologies (mobile health) to improve patient experience and health outcomes. SecondEars is a smartphone app designed to allow patients to audio-record medical consultations to improve recall, understanding, and health care self-management. Novel health interventions such as SecondEars often fail to be implemented post pilot-testing owing to inadequate user experience (UX) assessment, a key component of a comprehensive implementation strategy. OBJECTIVE This study aimed to pilot the SecondEars app within an active clinical setting to identify factors necessary for optimal implementation. Objectives were to (1) investigate patient UX and acceptability, utility, and satisfaction with the SecondEars app, and (2) understand health professional perspectives on issues, solutions, and strategies for effective implementation of SecondEars. METHODS A mixed methods implementation study was employed. Patients were invited to test the app to record consultations with participating oncology health professionals. Follow-up interviews were conducted with all participating patients (or carers) and health professionals, regarding uptake and extent of app use. Responses to the Mobile App Rating Scale (MARS) were also collected. Interviews were analyzed using interpretive descriptive methodology; all quantitative data were analyzed descriptively. RESULTS A total of 24 patients used SecondEars to record consultations with 10 multidisciplinary health professionals. In all, 22 of these patients used SecondEars to listen to all or part of the recording, either alone or with family. All 100% of patient participants reported in the MARS that they would use SecondEars again and recommend it to others. A total of 3 themes were identified from the patient interviews relating to the UX of SecondEars: empowerment, facilitating support in cancer care, and usability. Further, 5 themes were identified from the health professional interviews relating to implementation of SecondEars: changing hospital culture, mitigating medico-legal concerns, improving patient care, communication, and practical implementation solutions. CONCLUSIONS Data collected during pilot testing regarding recording use, UX, and health professional and patient perspectives will be important for designing an effective implementation strategy for SecondEars. Those testing the app found it useful and felt that it could facilitate the benefits of consultation recordings, along with providing patient empowerment and support. Potential issues regarding implementation were discussed, and solutions were generated. TRIAL REGISTRATION Australia and New Zealand Clinical Trials Registry ACTRN12618000730202; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=373915&isClinicalTrial=False.
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Affiliation(s)
- Amelia Hyatt
- Cancer Experiences Research, Peter MacCallum Cancer Centre, Melbourne, Australia
| | - Ruby Lipson-Smith
- Cancer Experiences Research, Peter MacCallum Cancer Centre, Melbourne, Australia
| | - Bryce Morkunas
- Cancer Experiences Research, Peter MacCallum Cancer Centre, Melbourne, Australia
| | - Meinir Krishnasamy
- Cancer Experiences Research, Peter MacCallum Cancer Centre, Melbourne, Australia.,Department of Nursing, University of Melbourne, Melbourne, Australia.,Victorian Comprehensive Cancer Centre, Melbourne, Australia.,Centre for Cancer Research, The University of Melbourne, Melbourne, Australia
| | - Michael Jefford
- Cancer Experiences Research, Peter MacCallum Cancer Centre, Melbourne, Australia.,Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Australia
| | - Kathryn Baxter
- Health Information Management, Peter MacCallum Cancer Centre, Melbourne, Australia
| | - Karla Gough
- Cancer Experiences Research, Peter MacCallum Cancer Centre, Melbourne, Australia.,Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Australia
| | - Declan Murphy
- Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Australia
| | - Allison Drosdowsky
- Cancer Experiences Research, Peter MacCallum Cancer Centre, Melbourne, Australia.,Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Australia
| | - Jo Phipps-Nelson
- Cancer Experiences Research, Peter MacCallum Cancer Centre, Melbourne, Australia.,Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Australia
| | - Fiona White
- Cancer Experiences Research, Peter MacCallum Cancer Centre, Melbourne, Australia
| | - Alan White
- Cancer Experiences Research, Peter MacCallum Cancer Centre, Melbourne, Australia
| | - Lesley Serong
- Cancer Experiences Research, Peter MacCallum Cancer Centre, Melbourne, Australia
| | - Geraldine McDonald
- Prevention and Wellbeing, Peter MacCallum Cancer Centre, Melbourne, Australia
| | - Donna Milne
- Cancer Experiences Research, Peter MacCallum Cancer Centre, Melbourne, Australia.,Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Australia
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9
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van Bruinessen IR, Leegwater B, van Dulmen S. When patients take the initiative to audio-record a clinical consultation. PATIENT EDUCATION AND COUNSELING 2017; 100:1552-1557. [PMID: 28302340 DOI: 10.1016/j.pec.2017.03.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/26/2016] [Revised: 02/28/2017] [Accepted: 03/01/2017] [Indexed: 06/06/2023]
Abstract
OBJECTIVE to get insight into healthcare professionals' current experience with, and views on consultation audio-recordings made on patients' initiative. METHOD 215 Dutch healthcare professionals (123 physicians and 92 nurses) working in oncology care completed a survey inquiring their experiences and views. RESULTS 71% of the respondents had experience with the consultation audio-recordings. Healthcare professionals who are in favour of the use of audio-recordings seem to embrace the evidence-based benefits for patients of listing back to a consultation again, and mention the positive influence on their patients. Opposing arguments relate to the belief that is confusing for patients or that it increases the chance that information is misinterpreted. Also the lack of control they have over the recording (fear for misuse), uncertainty about the medico-legal status, inhibiting influence on the communication process and feeling of distrust was mentioned. For almost one quarter of respondents these arguments and concerns were reason enough not to cooperate at all (9%), to cooperate only in certain cases (4%) or led to doubts about cooperation (9%). PRACTICE IMPLICATIONS the many concerns that exist among healthcare professionals need to be tackled in order to increase transparency, as audio-recordings are expected to be used increasingly.
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Affiliation(s)
| | - Brigit Leegwater
- Netherlands Institute for Health Services Research (NIVEL), Utrecht, The Netherlands
| | - Sandra van Dulmen
- Netherlands Institute for Health Services Research (NIVEL), Utrecht, The Netherlands; Department of Primary and Community Care, Radboud University Medical Center, Nijmegen, The Netherlands; Faculty of Health Sciences, University College of Southeast Norway, Drammen, Norway
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Barr PJ, Dannenberg MD, Ganoe CH, Haslett W, Faill R, Hassanpour S, Das A, Arend R, Masel MC, Piper S, Reicher H, Ryan J, Elwyn G. Sharing Annotated Audio Recordings of Clinic Visits With Patients-Development of the Open Recording Automated Logging System (ORALS): Study Protocol. JMIR Res Protoc 2017; 6:e121. [PMID: 28684387 PMCID: PMC5519830 DOI: 10.2196/resprot.7735] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2017] [Revised: 05/22/2017] [Accepted: 05/23/2017] [Indexed: 01/10/2023] Open
Abstract
Background Providing patients with recordings of their clinic visits enhances patient and family engagement, yet few organizations routinely offer recordings. Challenges exist for organizations and patients, including data safety and navigating lengthy recordings. A secure system that allows patients to easily navigate recordings may be a solution. Objective The aim of this project is to develop and test an interoperable system to facilitate routine recording, the Open Recording Automated Logging System (ORALS), with the aim of increasing patient and family engagement. ORALS will consist of (1) technically proficient software using automated machine learning technology to enable accurate and automatic tagging of in-clinic audio recordings (tagging involves identifying elements of the clinic visit most important to patients [eg, treatment plan] on the recording) and (2) a secure, easy-to-use Web interface enabling the upload and accurate linkage of recordings to patients, which can be accessed at home. Methods We will use a mixed methods approach to develop and formatively test ORALS in 4 iterative stages: case study of pioneer clinics where recordings are currently offered to patients, ORALS design and user experience testing, ORALS software and user interface development, and rapid cycle testing of ORALS in a primary care clinic, assessing impact on patient and family engagement. Dartmouth’s Informatics Collaboratory for Design, Development and Dissemination team, patients, patient partners, caregivers, and clinicians will assist in developing ORALS. Results We will implement a publication plan that includes a final project report and articles for peer-reviewed journals. In addition to this work, we will regularly report on our progress using popular relevant Tweet chats and online using our website, www.openrecordings.org. We will disseminate our work at relevant conferences (eg, Academy Health, Health Datapalooza, and the Institute for Healthcare Improvement Quality Forums). Finally, Iora Health, a US-wide network of primary care practices (www.iorahealth.com), has indicated a willingness to implement ORALS on a larger scale upon completion of this development project. Conclusions Upon the completion of this project we will have developed a novel recording system that will be ready for large-scale testing. Our long-term goal is for ORALS to seamlessly fit into a clinic’s and patient’s daily routine, increasing levels of patient engagement and transparency of care.
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Affiliation(s)
- Paul J Barr
- The Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine, Dartmouth College, Lebanon, NH, United States
| | - Michelle D Dannenberg
- The Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine, Dartmouth College, Lebanon, NH, United States
| | - Craig H Ganoe
- Department of Biomedical Data Science, Geisel School of Medicine, Dartmouth College, Lebanon, NH, United States
| | - William Haslett
- Department of Biomedical Data Science, Geisel School of Medicine, Dartmouth College, Lebanon, NH, United States
| | - Rebecca Faill
- Department of Biomedical Data Science, Geisel School of Medicine, Dartmouth College, Lebanon, NH, United States
| | - Saeed Hassanpour
- Department of Biomedical Data Science, Geisel School of Medicine, Dartmouth College, Lebanon, NH, United States.,Department of Computer Science, Dartmouth College, Hanover, NH, United States.,Department of Epidemiology, Geisel School of Medicine, Dartmouth College, Lebanon, NH, United States
| | - Amar Das
- The Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine, Dartmouth College, Lebanon, NH, United States.,Department of Biomedical Data Science, Geisel School of Medicine, Dartmouth College, Lebanon, NH, United States
| | | | - Meredith C Masel
- Oliver Center for Patient Safety and Quality Healthcare, University of Texas Medical Branch, Galveston, TX, United States
| | | | | | - James Ryan
- Ryan Family Practice, Ludington, MI, United States
| | - Glyn Elwyn
- The Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine, Dartmouth College, Lebanon, NH, United States
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11
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Benson K, Nanan R. Recording consultations: a win-win situation for physicians and patients. Med J Aust 2016; 204:175-6. [PMID: 26985839 DOI: 10.5694/mja15.00750] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2015] [Accepted: 12/08/2015] [Indexed: 11/17/2022]
Affiliation(s)
| | - Ralph Nanan
- Charles Perkins Centre, University of Sydney, Sydney, NSW
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12
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Varela J. [Need for changes in hospitals: 10 recommendations to improve efficiency, quality and effectiveness]. Med Clin (Barc) 2016; 146:133-7. [PMID: 26243252 DOI: 10.1016/j.medcli.2015.06.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2015] [Revised: 06/26/2015] [Accepted: 06/29/2015] [Indexed: 11/18/2022]
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13
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Kapur N, Parand A, Soukup T, Reader T, Sevdalis N. Aviation and healthcare: a comparative review with implications for patient safety. JRSM Open 2016; 7:2054270415616548. [PMID: 26770817 PMCID: PMC4710114 DOI: 10.1177/2054270415616548] [Citation(s) in RCA: 101] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Safety in aviation has often been compared with safety in healthcare. Following a recent article in this journal, the UK government set up an Independent Patient Safety Investigation Service, to emulate a similar well-established body in aviation. On the basis of a detailed review of relevant publications that examine patient safety in the context of aviation practice, we have drawn up a table of comparative features and a conceptual framework for patient safety. Convergence and divergence of safety-related behaviours across aviation and healthcare were derived and documented. Key safety-related domains that emerged included Checklists, Training, Crew Resource Management, Sterile Cockpit, Investigation and Reporting of Incidents and Organisational Culture. We conclude that whilst healthcare has much to learn from aviation in certain key domains, the transfer of lessons from aviation to healthcare needs to be nuanced, with the specific characteristics and needs of healthcare borne in mind. On the basis of this review, it is recommended that healthcare should emulate aviation in its resourcing of staff who specialise in human factors and related psychological aspects of patient safety and staff wellbeing. Professional and post-qualification staff training could specifically include Cognitive Bias Avoidance Training, as this appears to play a key part in many errors relating to patient safety and staff wellbeing.
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Abstract
OBJECTIVE To examine the motivations of patients recording clinical encounters, covertly or otherwise, and why some do not wish to record encounters. DESIGN Mixed-methods analysis of survey data and nested semistructured interviews. SETTING Survey to UK audience, using social media and radio broadcast. PARTICIPANTS 168 survey respondents, of whom 161 were 18 years of age or older (130 completions). Of the 56 participants who agreed to be contacted, we included data from 17 interviews. RESULTS 19 (15%) respondents indicated having secretly recorded a clinical encounter and 14 (11%) were aware of someone who had secretly recorded a clinical encounter. 45 (35%) said they would consider recording secretly and 44 (34%) said they would record after asking permission. Totally, 69% of respondents indicated their desire to record clinical encounters, split equally between wanting to do so covertly or with permission. Thematic analysis of the interviews showed that most patients are motivated by the wish to replay, relisten and share the recording with others. Some are also motivated by the idea of owning a personal record, and its potential use as verification of a poor healthcare experience. The rationale for permission seeking was based on the wish to prioritise a trusting relationship with a health professional. Those who preferred to record covertly described a pre-existing lack of trust, a fear that recording would be denied, and a concern that an affronted clinician would deny them access to future care. There was a general wish that recording should be facilitated. CONCLUSIONS Patients' prime motivation for recording is to enhance their experience of care, and to share it with others. Patients know that recording challenges the 'ceremonial order of the clinic', and so some decide to act covertly. Patients wanted clearer, more permissive policies to be developed.
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Affiliation(s)
- Glyn Elwyn
- The Preference Laboratory, The Dartmouth Institute for Health Policy and Clinical Practice, Dartmouth College, Hanover, New Hampshire, USA
| | - Paul James Barr
- The Preference Laboratory, The Dartmouth Institute for Health Policy and Clinical Practice, Dartmouth College, Hanover, New Hampshire, USA
| | - Stuart W Grande
- The Preference Laboratory, The Dartmouth Institute for Health Policy and Clinical Practice, Dartmouth College, Hanover, New Hampshire, USA
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Affiliation(s)
- Barry Main
- NIHR Doctoral Research Fellow, School of Social and Community Medicine, University of Bristol, Bristol
| | - Glyn Elwyn
- Professor and Senior Scientist, The Dartmouth Institute for Health Policy and Clinical Practice, Hanover, NH 03755, USA
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