Creating a Zone of Openness to Increase Patient-Centered Care
December 2012 - June 2015
Sponsor: Patient-Centered Outcomes Research Institute (PCORI)
Open Communication was a pilot study to design a novel intervention with patient and healthcare team stakeholders that targeted both patients and providers to enhance patient–provider communication. The pilot study was a cluster randomized controlled trial of the new intervention (Open Communication) comparing it to an existing patient intervention called Ask Share Know (ASK) to obtain data to guide the design of a large-scale comparative effectiveness study (Open and Ask).
A brief description of the Open Communication and ASK programs are described below. Additional detail on the study can be found here.
Open Communication Study Arm
The Open Communication program consisted of three parts:
- A two-minute video to help patients prepare for a doctor visit.
- A four-page booklet patients can bring to their doctor visit, including space to write down what they want to discuss during the visit and what they need to do after their visit.
- A training session for doctors on good communication strategies, such as setting an agenda for the visit or discussing next steps.
ASK Study Arm
The ASK program provided patients and doctors with a handout with three questions to guide their conversations:
- What are my options?
- What are the possible benefits and harms of each option?
- How likely is it that any of those benefits and harms will happen to me?
Patients who participated in the Open Communication program by itself felt more involved in their care than patients who went to clinics that used the other three approaches. Patients from the clinics that used either Open Communication or ASK believed that doctors helped them feel involved in making a decision more than patients at the clinics that used usual care or a combination of the two programs together.
By listening to the audio recordings, the researchers found that doctors and patients using either Open Communication or ASK participated in more shared decision making than doctors and patients who used the other two approaches. Visits with patients who did not have a college education contained less shared decision making than visits with patients who did have a college education.
Additional detail on the research findings can be found here.