Frequently Asked Questions-Providers

 

 

“How do I know I won’t make things worse for the patient, myself and my colleagues by asking patient if there are any problems in their care?  Won’t I be stirring up patient dissatisfaction and anxiety unnecessarily?”

 

We believe that asking patients can promote trust and, if done correctly, can enhance the patient-provider relationship, leading to better care coordination and patient engagement, and a more satisfying work life for providers.  The WWTK materials have been designed to communicate Medstar’s commitment to providing care of the highest quality, enhance patient trust, and facilitate system and provider learning from their concerns.  Research in this area (Mazor 2012) demonstrates that, contrary to some clinicians’ assumptions, patients often do not mention their concerns about their care, even when these concerns are acute.  This prevents health care providers from learning about patient concerns and addressing these concerns in a timely and appropriate way.

 

“My sense is that patients will bring up concerns that are not actionable, or have nothing to do with the quality or safety of the care my team is providing.  Also, it seems that this information might already be collected and in a more meaningful way through other systems that we already use.  Has the WWTK team found that patient concerns lead to discovery of otherwise unknown, clinically relevant and actionable concerns that could be addressed?”

 

Research comparing patient reports with expert chart reviews indicates that patients do in fact identify genuine quality and safety concerns in the clinical environment.  Also, the issues patients notice are distinct from quality and safety data collected through other systems. Sometimes, patient concerns are based on misinformation or their own misinterpretation.  Addressing these concerns is also very important so that reassurance can be provided.  In cases where there is indeed harm done and it is not possible to change that patient’s clinical outcome, it is still vitally important to promptly address the patient’s concern, and, if appropriate, apologize for the breakdown in care, even when the harm cannot be undone.

 

“How can I possibly manage yet another initiative when I’m already overburdened with work?  And, how can I be sure that the WWTK team will keep me and my team in the loop and up to date about concerns of patients under my care?”

 

The WWTK initiative’s nurse-navigator is skilled in efficiently eliciting and addressing patient concerns early, and before they become a more serious problem, or before the patient acts on a misconception.  This early-warning can provide increased efficiency for you and your team so you can do your work confident that patient concerns are being actively tracked and addressed.  And, as a fellow clinician, the nurse navigator understands provider concerns and priorities as well – including the need to be kept up to date about any significant patient concerns – and will act on this understanding and clinical expertise to assure that you, your team, and your patients feel supported and that trust is built so that timely, effective and efficient care can be delivered.

 

“What if a patient brings up a problem that I don’t have the resources to address?  Won’t that just create more work for me and frustration that I can’t do anything?”

 

The WWTK initiative’s nurse-navigator is available as a resource to help address any problems that patient brings up.  The nurse-navigator will help find solutions to the patient’s problems and follow up to ensure they are satisfactorily resolved, allowing you to focus on the patient’s medical problems.   

“Okay, I’m convinced that it’s important to encourage patients to speak up if they have concerns.  What should I say?”

 

All clinicians have their own style for communicating with patients so it’s most important that you communicate the “We Want To Know” message in a manner that you’re comfortable with.  Here’s a sample of a brief statement we have found to be very effective, and quick to deliver at the time of admission:

“The hospital can be a scary and confusing place.  There may be times when you are concerned about aspects of your care.  If you have any concerns, please speak up about them so we can be sure to help address them”. 

 

We Want To Know is funded by the Agency for Healthcare Research and Quality (Grant #1R18HS022757:K.M. Mazor PI). The project is a partnership between MedStar Health, MedStar Health Research Institute, and Investigators from the University of Massachusetts Medical School and the University of Washington.

 

We Want to Know está financiado por la Agency for Healthcare Research and Quality (Agencia para la Investigación y la Calidad del Cuidado de la Salud), (N.° de subvención 1R18HS022757:K.M. Mazor PI). El proyecto es una colaboración entre MedStar Health, MedStar Health Research Institute (Instituto de Investigación de MedStar Health) e investigadores de la University of Massachusetts Medical School (Facultad de Medicina de la Universidad de Massachusetts) y la University of Washington (Universidad de Washington).