Hypertension Best Practice Session 4 Communication

1. Hypertension Best Practice Session 4 Communication

2. Hypertension best practice elements Blood pressure (BP) measurement: include two BP readings if first is high (≥140/90 mmHg) Timely follow up: monthly visits until BP controlled Treatment algorithm: low-cost, once-daily meds Communication: building trusting relationships Outreach: using a registry

3. Learning objectives Improve recognition and handling of emotions Enhance verbal and nonverbal expressions of empathy Increase ability to elicit and negotiate patient concerns

4. Session outline Empathy Video Review Key Communication Strategies Role Play Demonstration Practice Skills (with each other in small groups) Discuss Homework

5. Empathy video Empathy: The Human Connection to Patient Care

6. Communication strategies Build rapport I – Introduce yourself, attend to comfort D – Describe what’s next (including wait time) E – Elicit patient concerns A – Articulate/express empathy L – Leave in a positive way

7. Identifying patient beliefs and eliciting concerns What do you believe is the cause of this problem? What course do you expect it to take? How serious is it? How does it affect your body and your mind? What do you most fear about this condition? What do you most fear about the treatment?(Box 2 Kleinman et al., 2006)

8. Strategies associated with higher patient satisfaction scores Focus on patient’s agenda. Draw out the story. “OK”; head-nodding; listen to 3-5 sentences uninterrupted; opportunity to express patient concerns; ask probing questions; tell about yourself. Demonstrate understanding.Respond empathically; show caring; show familiarity with medical or social history. Provide detailed explanation.What is happening and why; present options to patients. Complete the patient’s agenda. Deliver what was promised or negotiate until later. (Table 1 Tallman et al., 2007)

9. Non-verbal communication strategies Sitting down Leaning in toward the patient Nodding Eye contact Dealing with computers in the room

10. Role Play Demonstration

11. Practice skills outline Break up into small groups 2. Role play one to two cases a) Case 1: identifying and dealing with emotion b) Case 2: eliciting and negotiating patient concerns Discuss homework Choose a communication skill (Question 1) to practice for next time

12. Disclaimer Use of these slides alone will not improve blood pressure control within your practice. Blood pressure control will be achieved through active quality improvement efforts in conjunction with these slides. Practice coach consultation is available to assist you in improving outcomes.

13. Acknowledgements This work was made possible with funding from: The Mt. Sinai Healthcare Foundation U.S. Centers for Disease Control and Prevention Special thanks to: Better Health Partnership participating clinics Health Improvement Partnership-Cuyahoga (HIP-Cuyahoga)

14. Contact Info For questions about the online toolkit or assistance with implementation, please contact our coaching team at info@betterhealthpartnership.org.

15. Thank you!