Patient-Centered Approach to AT Services




The Sports Medicine Broadcast show

Summary: <br> Dr. Zachary Winkleman is leading his students to provide Athletic Training services from a Patient-Centered Approach.<br> <br> <br> <br> <br> <br> <br> <br> <br> <br> Consider the Social Support system - <br> <br> <br> <br> Hey do you want me to talk to your family...or do you have someone you want me to call.<br> <br> <br> <br> By doing everything for the patients you are enabling them and preventing them from owning their own health care.<br> <br> <br> <br> Walk them through the process instead of doing it for them.<br> <br> <br> <br> Do your patients understand what you are saying...or handing them?<br> <br> <br> <br> The average reading level of America is 6th grade….So all of our forms need to be revised to that reading level<br> <br> <br> <br> An affluent suburb may not appear to have health literacy issues, but you need to look at the support system and handle this individually.<br> <br> <br> <br> Consent and assent are both important.<br> <br> <br> <br> Set and agree upon goals in your patient centered approach<br> <br> <br> <br> SMART goals - what do want to get out of the appointment today?<br> <br> <br> <br> Sometimes they only want to know they are OK...not how to get better.<br> <br> <br> <br> You can give them options.<br> <br> <br> <br> 1 - do exactly what I say<br> <br> <br> <br> 2 - part of what I say<br> <br> <br> <br> 3 - none of what I say<br> <br> <br> <br> Your choice but the outcomes will be...for each<br> <br> <br> <br> Coordination - our job is coordinating NOT EXECUTING<br> <br> <br> <br> Making sure patients feel powerful and not powerless.<br> <br> <br> <br> Fear and anxiety may not be more prevalent, but they are more willing to talk about it.<br> <br> <br> <br> PHq9 and screen patients is a good tool<br> <br> <br> <br> Communicate - What do you normally ask during your evaluation.<br> <br> <br> <br> 5 step interview - patient centered approach<br> <br> <br> <br> Step One<br> <br> <br> <br> * Welcome the patient* Use their name* Introduce yourself and ID your role* Ensure patient readiness* Remove barriers to communication (sit down) - removes the powerful struggle* Ensure comfort and put the patient at ease* A patient had been sexually assaulted in the prayer pose...therefore any sort of rehab in that pose triggered her.<br> <br> <br> <br> Step Two<br> <br> <br> <br> * Indicate time available* Forecast what you would like to happen during the visit* Obtain list of all issues the patient wants to discuss* Summarize and finalize<br> <br> <br> <br> Step 3<br> <br> <br> <br> * Start with open-ended questions* Use non-focused skills (silence and non-verbal encouragement)<br> <br> <br> <br> Step 4<br> <br> <br> <br> * Echo the patient’s words back* Request* Elicit emotional story (allow them to tell you their story<br> <br> <br> <br> Step 5<br> <br> <br> <br> * Summarize* Check accuracy* Indicate the style* Ask permission to touch<br> <br> <br> <br> The Golden rule does not really work...you are not the patient, their experiences are not yours.<br> <br> <br> <br> Shift your mindset one piece at a time.  Choose one thing to implement in your practice.<br> <br> <br> <br> 8% of athletes believe the AT could not make a health status decision without the coach.<br> <br> <br> <br> Twitter question:<br> <br> <br> <br> Talk with parent and determine the goal and reasoning<br> <br> <br> <br> Educate about the bigger picture<br> <br> <br> <br> Discuss with patient<br> <br> <br> <br> Do not put yourself on opposite teams as the patient/parent.<br> <br> <br> <br> When we teach people <br> <br> <br> <br> A common question we ask is “do you have any questi...