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- Provider-Patient Communication
Journal Article > Study
Developing and evaluating the success of a family activated medical emergency team: a quality improvement report.
Brady PW, Zix J, Brilli R, et al. BMJ Qual Saf. 2015;24:203-211.
Allowing families to activate medical emergency teams (METs) may aid in the early detection of clinical deterioration. However, physicians have expressed concerns that families do not understand when an MET is necessary and that this responsibility could present an undue stress on family members. This study reports on the experience of family-activated MET calls over a 6-year period at an academic children's hospital. There were 83 family-activated MET calls, representing less than 3% of all MET responses at this hospital. Families most frequently requested METs for concerns regarding clinical deterioration, but less than one-quarter of these calls resulted in patients being transferred to an intensive care unit, compared to 60% of clinician-activated METs. Since families called METs only between one to two times per month, the program was not felt to pose a substantial burden. The authors also point out that some family-activated METs identified other clinically relevant information that may not have otherwise been shared with the primary clinical team, as well as important communication issues that could have led to adverse events.
Journal Article > Commentary
Bogert S, Ferrell C, Rutledge DN. Medsurg Nurs. 2010;19:215-222.
The central tenet behind rapid response systems (RRS) is that any provider should be able to summon prompt assistance if concerned about a patient. In the spirit of the National Patient Safety Goal that calls for engaging patients in safety efforts, some hospitals are now allowing patients and families to call the rapid response team directly. This report from a community hospital discusses the education and implementation process and describes the first series of RRS calls initiated by family members. Many of the family-initiated calls revealed communication issues between patients and clinicians, which the RRS was able to successfully negotiate.
Journal Article > Study
Patient comprehension of emergency department care and instructions: are patients aware of when they do not understand?
Engel KG, Heisler M, Smith DM, et al. Ann Emerg Med. 2009;53:454-7461.e15.
This study assessed emergency department (ED) patients' understanding of their diagnosis, treatment received, post-discharge care, and indications to return to the ED. Most patients had limited comprehension of at least one aspect of their care, most commonly pertaining to their post-discharge care. Although this study did not directly assess patients' health literacy, prior research has found correlations between limited health literacy and misunderstanding of instructions (such as those on prescription drug labels). The Joint Commission has published recommendations for improving patient-provider communication in order to address problems similar to those identified in this study.
Journal Article > Review
Stokes SL, Wu AW, Pronovost PJ. Emerg Med Clin North Am. 2006;24:703-714.
The authors discuss disclosure in emergency medicine, the ethical basis for it, and the process of effective disclosure.