Sunday, April 18, 2010

Ask Me First!

Here is the document that I referred to in the previous blog post. This was originally developed for a project, New Health Partnerships (see link section of this blog), that helped health care teams from forward thinking organizations to enhance the quality of the care they provided to patients.

Patients Activating Doctors – Ask Me First!

After practicing agenda setting with the patient and family team members of the improvement team, the next step is encouraging and educating the patients in your practice to participate with you in real clinical visits.

It may be helpful to encourage patients and families to use specific language to prompt clinicians to “Ask Me First!” during actual visits with trained or even untrained clinicians. For example, a patient might say one of following statements/questions at the beginning of a planned care or follow-up visit for a long term condition to prompt the clinician to “Ask Me First”:

• Hi….before we get started today, would it be ok if I told you what was important for me to accomplish today?
• I know you are pressed for time…so...I thought you might want to know what I am most concerned about…(wait for response)
• I really value the time we have together to review the management of my condition. So, before you tell me what you would like to get done today, I’d like to tell you what I need. Is that ok?
• Before we get started...I would like to tell you some of the things I have been doing to manage my condition. I’d love to get some feedback.
• I know it is hard for many doctors to know the best way to ask about the concerns or troubles that their patients have been having. Would you like to know about the difficulties I have been having taking my medication (or following through with treatments…etc)?

Patients and family members may benefit from having information and tools to help them prepare for a visit by thinking about their needs, concerns and questions before the visit and writing them down in a list to help them to remember to share them during the visit. Some practices have found it helpful to create tools and informational materials to prompt patients to participate in setting the agenda. Attached are two examples:

Patient and family advisors from the MCG Health System in Augusta, GA developed the “Doc Talk Card,” a simple form to help patients and their families organize their thoughts and information in preparation for a healthcare visit. The forms are printed into notepads and are available in the reception area of ambulatory clinics.

The resource, “What You Can Do to Prepare for Your Doctor’s Visit,” was developed by the Partnership for Healthcare Excellence, a statewide initiative in Massachusetts to encourage consumers to get active in their health care. The fact sheet can be downloaded from their website at

Your team can develop your own materials and strategies. Patient and family members on the improvement team can actively encourage other patients and families to prepare for a visit and prompt clinicians to “Ask Me First.” Ideas include:

• Creating a form for patients or families to fill out before their visit.
• Creating a poster that can be displayed in the clinic.
• Developing a brochure to be made available in the reception area/exam rooms.
• Writing an article for a clinic newsletter.
• Creating a short video that shows a clinician and a patient/family setting an agenda at the beginning of a visit.
• Teaching other patients/family members during group visits or peer support or education classes.