Ensuring that patients both understand and engage with their healthcare. Yet, when we talk to patients, particularly in the hospital setting, it can be very challenging to be certain that patients (and their families) can engage. If we can pause in our busy days it might help to try and walk a bit in the shoes of our patients. The vast number of these people are not medically trained. Thus, when we talk to our patients, we are speaking a foreign language to them. We may well try to simplify our discussions, but we are often pressed for time and need to move along. When we talk to patients there is often a power differential. We are standing above them and clinicians, they are lying there as patients.
The end result is that patients may not always have the opportunities to ask questions or even participated more actively in their care. So, how might we do a better job at engaging with our patients?
One possibility is the Joint Commission’s Ask campaign (sometimes referred to as “Ask Me 3” or “Speak Up”). This is an initiative aimed at empowering patients to be active participants in their healthcare, particularly within hospital settings. Let’s dig into this more.
Evidence for the Ask Programs’ Effectiveness
Studies have shown that Ask-type programs can contribute to safer and more patient-centered care by:
- Enhancing Patient Engagement: Ask programs encourage patients to ask questions and voice concerns, leading to a more active role in their healthcare decisions (Sharma et al., 2018). This can contribute to improved adherence to treatment plans and a greater sense of control over their health (Longtin et al., 2010).
- Identifying Safety Concerns: Empowered patients are more likely to flag potential errors or misunderstandings in communication or medication administration (AHRQ). Early detection allows healthcare providers to intervene and prevent adverse events.
For instance, a study published in the National Institutes of Health explored educational materials designed to prompt patients to ask healthcare providers about handwashing. The findings indicated an increase in handwashing compliance among healthcare staff when patients inquired about it (Sharma et al., 2018). This exemplifies how programs that encourage patients to enquire about their own care might lead to positive behavioral changes that directly impact patient safety.
Considerations and Potential Limitations
Despite some of the possibilities we see in these programs, some limitations and areas for improvement with Ask-type programs should also be understood so that ongoing improvements can be made:
- Limited Scope: Ask programs often focus on basic communication skills, but healthcare decision-making is complex. Additional support may be needed for patients to fully grasp treatment options and potential risks and benefits (Longtin et al., 2010).
- Literacy and Language Barriers: The effectiveness of Ask programs can be limited by patients’ health literacy and language proficiency. Hospitals need to provide translated materials and ensure clear communication strategies that cater to diverse patient populations (Ringdal et al., 2017 [invalid URL removed]).
- Power Dynamics: The doctor-patient relationship can be hierarchical, and patients may feel hesitant to speak up due to fear of being judged or dismissed by healthcare providers (Joint Commission). Creating a culture of open communication and shared decision-making is crucial for Ask programs to reach their full potential.
Final Thoughts
The Joint Commission’s Ask program is a valuable conceptual step towards enhancing patient engagement in healthcare. There is reason to think that such engagement will have positive impacts on patient safety and satisfaction. However, limitations related to patient empowerment, communication barriers, and existing power dynamics within healthcare settings continue to be barriers. By acknowledging these considerations and continuously improving program implementation, Ask-type initiatives can play a significant role in fostering a collaborative environment where patients are active participants in their care, ultimately leading to better healthcare outcomes.
Next time I will discuss an “Ask” type of program in more detail and then later discuss a program that has been developed in the Veterans Health Administration.