Diagnosis Dialogue

Bettygene Egan Bettygene.Egan at KP.ORG
Mon Jan 27 16:45:43 UTC 2014

Hi Ilene,

We created a guide for patients to help them prepare for their
appointments and to encourage them to be more engaged with their
clinician.  The guide begins with suggestions of how to prepare for the
appointment and what to discuss with the clinician.  During the visit we
encourage the patient to confirm why they are there... not just what was
listed as their chief complaint, as this may have been determined by
someone else and not the actual reason the patient is there.  Also, it is
very important to encourage the patient to express fears and concerns as
this not only helps the clinician but also could provide medical history
that the clinician is not aware of.  The guide promotes patients asking
clinicians "what else could it be?" about a diagnosis or "could there be
more than one thing going on?"  At the end of the visit we create a teach
back approach for patients.  Make sure they understand what their
diagnosis is, what they need to do next, what their treatment plan is, and
most importantly to state if they cannot follow or do any of the tasks
asked of them.

We ran a small pilot at one of our medical offices with 8 medicine
physicians.  Our objective was to determine if the patient would

1) use the guide at future visits
2) if they didn't ask the question "what else could it be" would they at a
future visit, and
3) did they find the guide helped them to be better prepared for their

Nearly 86% of the 509 patients who responded to our survey said "yes" they
would use the guide at a future visit.  Of the 509 patients 36% said "no"
they did not ask the provider "what else could it be" however, of those
36% that said no, 64% said they would ask at a future visit.  And nearly
73% said they found the guide helped them to be better prepared for their
visit.  We continue to pilot the SMART Partners Guide in diverse
demographics to expand our data collection.

I am attaching a copy of our draft guide.

Bettygene Egan, MBA
Sr. Project Manager
National Risk Management
One Kaiser Plaza, 18 Bayside
Oakland, CA 94612
Office: (510) 271-5713  TL: 8-423-5713
Cell: (510) 912-5148
Fax: (510) 271-6988

Administrative Support:
Van B Nguyen - (510) 267-4892

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From:   PULSE516 at AOL.COM
Date:   01/25/2014 07:34 AM
Subject:        [IMPROVEDX] Diagnosis Dialogue


We are developing a handout to distribute to the public about how to have
a conversation for the best diagnosis.

Can you share the:

3 most important things that a patient should ask their doctor / clinician
when getting a diagnosis?

3 most important things they should tell their doctor / clinician to get a

3 most important things a patient / family should be concerned
about-question when getting a diagnosis?

Thank you

Ilene Corina, President
(516) 579-4711
Registration open for March 3, 2014, Patient Safety Awareness Week

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Moderator: Lorri Zipperer Lorri at ZPM1.com, Communication co-chair, Society
for Improving Diagnosis in Medicine

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