The September 2017 issue of JAMA Internal Medicine provides seven new articles about the value of clear and inclusive communication with patients. More art than science, the viewpoints here show just how important it is to collaborate with patients on their diagnosis and treatment plans. All the articles in this series summarize how physicians currently share knowledge, skills and experiences among themselves as a professional community and with the patients they serve. Each article suggests concrete ways in which clinicians can get patients more directly involved in the process of collaborating on their care. And, you don’t have to be a physician to put many of the principles cited in these articles into daily practice.
As Maskrey and Gordon point out in their excellent summary of collaborative care, Shared Understanding with Patients, the top factors influencing whether people believe they have experienced quality care are good interpersonal skills from clinicians and associated staff, including clear communication & empathy; easy access to care, including convenient appointments with a familiar clinician; and direct involvement in care processes, including participation in decisions and self-care support.
For audiologists, this issue of JAMA Internal Medicine underscores the need to build trust, rapport and shared understanding during a finite period of time. It doesn’t matter if you spend 20 minutes conducting a routine audio or more than an hour guiding the patient through a hearing aid consultation, directly involving the patient in the process is more likely to lead to the patient accepting your recommendation or moving ahead with a treatment plan.
In addition to the valuable guidance from this issue of JAMA Internal Medicine, I have found that the REDE (Relationship: Establish, Develop & Engage) Model of Healthcare Communication is an effective way to get patients personally involved in their own care. The REDE system, developed by physicians at Cleveland Clinic about a decade ago, breaks down the face-to-face interaction with a patient into three distinct phases. The primary objective of the three steps is to build trust and rapport that leads to strong buy-in for a course of action. For audiologists, this often means the patient is willing to take action and use hearing aids. You can think of the REDE model as a precursor to using the EDGE Audiology process; using REDE helps execute EDGE more seamlessly.
Here are the three components of Cleveland Clinic’s REDE model. (For tips on how to implement each of the three phases, you can contact me at the email below.)
Phase 1: Establish the Relationship – convey value and respect of the individual, collaboratively set the agenda for the appointment, convey empathy
Phase 2: Develop the Relationship – Explore the patient’s perspective and engage in reflective listening
Phase 3: Engage the Relationship – Share results, collaborate on a treatment plan and provide closure and guidance on next steps
In this era of consumer-driven health care, it’s incumbent for all of us to master new approaches to communication that get patients more actively involved in the decision-making process. The September issue of JAMA Internal Medicine, along with the REDE Model of Healthcare Communication, offers great insights to enhance these skills.