RT Book, Section
A1 Kravitz, Richard L.
A1 Street, Richard L.
SR Print(0)
ID 1181984132
T1 Negotiating with Hospitalized Patients and Their Families
T2 Understanding Clinical Negotiation
YR 2021
FD 2021
PB McGraw Hill
PP New York, NY
SN 9781260462494
LK accessmedicine.mhmedical.com/content.aspx?aid=1181984132
RD 2024/04/19
AB Clinical  Take-AwaysThe  nature  of  the  hospital  setting  (acute  illness,  compressed  timelines,  unfamiliar  environment,  involvement  of  family,  increased  power  differential)  makes  clinical  negotiation  both  more  important  and  more  difficult.Different  issues  for  clinical  negotiation  tend  to  arise  at  the  beginning,  middle,  and  end  of  each  hospital  stay.Children,  people  with  cognitive  or  communication  disabilities,  and  patients  with  limited  English  proficiency  need  special  attention  in  the  negotiating  process.Clinicians  working  in  hospital  inpatient  settings  should:Apply  principles  of  “etiquette-based  medicine”  (ask  permission  to  enter,  introduce  self,  sit  down,  explain  role,  ask  how  hospital  stay  is  going).When  negotiating  about  admission  decisions,  show  empathy;  demonstrate  interest;  deflect,  don’t  repel;  and  use  substitution,  contingency,  and  availability  when  possible,  rather  than  direct  confrontation  or  “scare  tactics.”Recognize  and  respond  to  patients’  attempts  to  manage  uncertainty  (e.g.,  “why  won’t  anyone  tell  me  what’s  going  on?”  “all  you  guys  seem  to  be  doing  is  putting  me  through  more  tests”).Discuss  goals  of  care  (including  criteria  for  and  expected  timing  of  discharge)  early  and  often.Recognize  that  high-quality  hospital  care  requires  a  team  consisting  of  health  care  workers  of  all  stripes  as  well  as  patients  and  their  families.