Questions are the Answer: AHRQ Campaign Promotes Better Communication

Date Posted: October 3, 2011

October 3, 2011 - A simple, genuine question can be one of the most effective tools for fostering better patient outcomes. And a new initiative from the U.S. Department of Health and Human Services’ Agency for Healthcare Research and Quality (AHRQ) aims to encourage clinicians and their patients to ask more of those questions--and to listen to what the answers reveal.

AHRQ has launched a new campaign with the theme “Questions are the Answer” in conjunction with the Ad Council. The initiative is designed to promote better two-way communication between providers and patients. This first phase encourages clinicians to ask their patients to prepare questions in advance for appointments and provides materials to help them do so.

“If you partner up with someone, the outcomes are likely to be so much better,” said Jane Kapustin, Ph.D., CRNP, a board-certified diabetes nurse practitioner at the University of Maryland Medical Center in Baltimore.

Kapustin is one of several providers who are featured in a series of short videos, posted on the AHRQ website at www.ahrq.gov/questions. In her video, she emphasizes that she really appreciates it when her patients bring questions to her. “We get a chance to clear up any erroneous information,” she said in the clip.

AHRQ has launched initiatives in the past that focused on getting patients to take a more active role in their healthcare. But, in addition to the videos, this initiative also features new public service ads that are targeted to clinicians, mostly in the primary care and ambulatory care setting, said Farah Englert, associate director for marketing for AHRQ.

“We got feedback from patients that they thought clinicians needed to hear the message as well,” she said. “I think they often (felt) that appointments are often rushed and they didn’t always have time to get their questions answered.”

Encouraging the questions

Unfortunately, patients aren’t always forthcoming with their concerns and questions, said Rachelle Toman, M.D., Ph.D., a family physician in a federally-qualified health center in Washington, D.C., who also appears in one of the AHRQ videos.

“I think people also have a fear of…appearing uneducated and appearing as if they don’t know what’s going on,” she said. “I think (some) people have the concept that they might ask something that they should know and they’ll look stupid for asking.”

Kapustin agreed. Patients can also get overwhelmed by all the information presented to them during a visit; they may not even know what they want to ask. Then the visit ends, and they may not remember what they wanted to ask or what they’re supposed to do next.

“When they walk out of here, they forget,” she noted.

Kapustin works to avoid that by providing written instructions for her patients to take home. But she asks her patients to do some writing, too.

“I always try to get my patients to write down things,” she said. “I like it when they come in with a list.”

That way, Kapustin knows what to concentrate on during the visit because the patient has had time to focus on what he really wants to address. It helps structure the appointments in a more efficient manner, but it also shows the patients that she’s really listening to them and wants to hear their concerns. That establishes trust, a crucial component of good communication.

“Then I think they’re much more likely to come back and to listen to you, and their outcomes will be better,” she said.

Other providers agreed that they’ve found it more than worthwhile to encourage patients to open up and ask questions.

“Taking time to communicate with your patient is really going to save you time in the long run,” said Janie Schumaker, RN, manager at the Center for Performance Excellence at T-System, an emergency medicine solutions company. “Plus you are going to have a much more satisfied patient.”

“The more a patient is involved,” she continued, “the more chances you have for them to be compliant. They understand why you are recommending what you are recommending for them to do.”

Toman said she likes it when patients feel comfortable admitting they have trouble following a treatment plan or taking a medication several times a day. That information is invaluable because it gives her insights into the challenges they face, which in turn helps her refine the course of treatment.

Materials to help

As part of the initiative, AHRQ is providing resources to help patients express their concerns and get their most pressing questions answered. They include brochures with suggestions for patients to become more involved in their healthcare and notepads that can be placed in waiting rooms or exam rooms for patients to prioritize their top questions in writing.

Additionally, providers can steer their patients to the interactive Question Builder program on the AHRQ website. The tool helps them create a list of their questions that they can print and bring to their next appointment.

Online resources can be very helpful for patients who want to prepare in advance for their healthcare appointments, said Kent Bottles, M.D., senior fellow for the Thomas Jefferson University School of Population Health in Philadelphia.

“We probably need to have a lot of aids that help doctors explain things better,” said Bottles, who also serves as the chief medical officer for CareCoach.com, an online program launched by Verilogue to facilitate better provider-patient communication.

His own company’s program can also help patients prepare for conversations with their doctor; they can go online and listen to conversations with patients who have a similar diagnosis to their own. Then they can download an application to their smartphone with a list of questions or even record their conversation with their physician so they can review it at home.

For more information, including access to materials for the AHRQ campaign, visit www.ahrq.gov/questions and click on the Tips and Tools section.

See related story: Good Communication Should Start Early for Physicians