Wednesday, 7 December 2011

It's not magic but 3 + 1 makes 4 good outcomes

I don’t pretend we have all the answers. But the questions are certainly worth thinking about
Arthur C Clarke

Who asks the questions in the interviews you go to? The doctor, the nurse or the patient? The power of ask 3 questions

What are my options?
What are the possible benefits and risks?
How can we make a decision together that is right for me?

was brought home to me recently at a visit to Newcastle to see the Health Foundation MAGIC project. This team have now produced a video; why not put it on the TV loop in your outpatients or surgery to complement printed copies of the 3 questions and support patient engagement? Even more powerful might be to have a poster with the three questions in every consulting room to give patients permission to speak and ask.

On the ward round, one question has now been shown to make a difference. Stopping for a second when the observations and urgent clinical matters have been attended to and asking “is there anything more I can do for you this morning? I have the time” is proving very powerful at increasing patient engagement, identifying issues that might prolong length of stay and improving quality of care while people are in hospital. If you work on a kidney ward or unit try it for a few weeks and if it works in advent, make it systematic in 2012. I am reliably told from several sources that it does not take any more time than the current way we do things. Have a go and do let me know how you get on.

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