Monday, April 8, 2013

5 Tenets of Excellent Patient Education

Patient education is something that is woven into the fabric of a healthcare practitioner. For the physical therapist, failing your patient is a guarantee if the education given is anything but deeply sincere, resoundingly convincing, and perfectly salient. It is under these conditions when the patient performs with "compliance"  (a term I don't quite appreciate) and attains desired outcomes.

I dedicate this post to the many hardworking #DPTstudent's that labor to master this important skill.

Here are my 5 Tenets of Excellent Patient Education:

1. Assurance
Almost every patient, regardless of setting, is emotionally unsettled with one very simple fact: they are a patient. Especially in the hospital setting, patients are in a very scary, unpredictable, and undesirable set of circumstances. The most important thing you can do is to make that emotional connection with your patient, let them know you care, assure them that "it's going to be okay", and a sense of calm to their experiential equation.

2. Validation
Perhaps a core necessity to the human condition is the need to be validated; "tell me I'm not crazy!" Especially when a person is in a strange, frightening, and disorienting situation, validation is particularly important. Whether it be pain, fear, anxiety, a sense of debility, or complete lack of situational control - validating these thoughts, emotions, and mental states is important in developing a rapport with the patient and family.

3. (Re)-Direction
Most of the time, education will include redirecting a person away from a fear-based-preconceived-notion. Other times, education simply requires for any direction to be given - period - the patient feels lost. Regardless of what is required, it is the job of the practitioner to set the tempo from the get-go. Much like force redirection in martial arts, the power of the human mind must be channeled in the right direction for good patient outcomes.

4. Explanation
Education would not be education unless the situation was thoroughly explained. On the Twitterverse, I have to give credit to Dr. Joe Brence for consistently conveying that the word "doctor" comes from the Latin verb doc─ôre which means "to teach." Being teachers of health is a core function of a healthcare practitioner. When patients fully understand and grasp their situation due to your teaching, they will also begin to trust your expertise, placing their well-being in your hands.

5. Reassurance
I feel that reassurance is the best closure for a patient education experience. Start with assurance, end with reassurance. At the end of even the best and most convincing educational discourse, patients are still in the midst of their situation. I feel that it is very important to the human experience for clinicians to wrap up  moments of patient education with the reassurance that: "We have a plan. I'll be here every step of the way. Everything is going to be okay." Ultimately, healthcare is a person serving another person; we must respect the humanity of each patient experience to be truly effective educators.

Some Closing Thoughts:
Perhaps one of the most important aspects of this topic is that an excellent patient education experience yields highly satisfied patients. To center my own practice upon this, I always try to answer the three cardinal questions that every patient has:
  • What's wrong with me?
  • What can you do about it?
  • How long will it take?
If you can answer these three questions keeping close with these 5 tenets, your patients will be thoroughly satisfied, will trust you and do just about everything you say, and, will achieve the expected results that you set forth.

4 comments:

  1. Hi Dr. Fung,

    I am currently working inpatient. How do you answers these 3 questions without crossing scope of practice? I am very comfortable with dealing these questions in Outpatient but at inpatient, I can't say what is exactly wrong with them since it's a nonskeletal medical condition and not familiar with the prognosis.
    "What's wrong with me?
    What can you do about it?
    How long will it take?"
    If you can give me an example, that would be great!
    Kay

    ReplyDelete
  2. Typically, I answer "what's wrong" by saying, your physician sent you here because they gave you a medical diagnosis based on their training and approach in healthcare. I'm a PT and I give a physical diagnosis based on your movement and pain experience. We can do these things to improve your health based on your phase of healing. And, it typically takes 2 weeks for your nervous system to get used to a new healing pattern; it's very important be faithful with your exercises until then. It also takes 6 weeks for muscles to grow at the microscopic level -- so it will take some time, but you'll see improvements very quickly as we go through this together.

    These are acceptable and appropriate spiels that don't cross boundaries be it inpatient or outpatient. Even in the hospital, I'll answer what the physician has diagnosed you with and add on that the PT approach builds on that by considering physical condition and pattern of healing.

    Hope that helps!
    Best,
    -Ben

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