Good communication equals better outcomes

duhThe Affordable Care Act brought with it increased attention to reducing patient readmission rates. A new finding will surprise many in the medical community and affirm many in other helping professions, like counseling and social work–good communication between caregivers and patients improves readmission rates.

. . . findings from our research using six years of data from nearly 3,000 acute-care hospitals suggest that it is the communication between caregivers and patients that has the largest impact on reducing readmissions. In fact, the results indicate that a hospital would, on average, reduce its readmission rate by 5% if it were to prioritize communication with the patients in addition to complying with evidence-based standards of care.

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If these results are that powerful, why aren’t hospitals focusing on improving this patient experience dimension? The answer is that improving the communication-focused dimension involve significant training costs, in no small part because health care traditionally has focused on the evidence-based process of care rather than the patient experience. This bias is reflected in medical education, which teaches technical skills to caregivers and puts relatively little emphasis on the importance of interacting with the patient.

As there is increasing pressure to medicalize addiction treatment, this casts a light on an important culture difference between medical providers and addiction providers. This brings sharp differences into focus about the role of the patient and the caregiver, as well as philosophical issues about what heals. All of this informs whether the caregiver emphasizes pills, procedures, lifestyle interventions, symptom reduction, hope, choice, self-determination, social support and/or quality of life.

This brings to mind a talk from Kevin McCauley:

I listened to a talk by Dr. Kevin McCauley this morning in which he addressed objections to the disease model. One of the objections was that the disease model lets addicts off the hook. His response was that, given the cultural context, there were grounds for this concern. BUT, the contextual problem was with the treatment of diseases rather than classifying addiction as a disease. He pointed out that our medical model positions the patient as a passive recipient of medical intervention. As long as the role of the patient is to be passive, this concern has merit. He suggests we need to expect and facilitate patients playing an active role in their recovery and wellness.


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