Take Action: Clinicians
A key focus of The Patient Revolution is on activating and encouraging patients to push their stories into clinical spaces but of course this small act of rebellion works best if clinicians are enthusiastic and welcoming partners. We've highlighted some videos, tools and programs below that can provide a starting place to clinicians and clinical groups.
Many of these tools and programs were developed with our partners at the Knowledge and Evaluation Research Unit at Mayo Clinic and where relevant we've included links to published papers about development and evaluation.
We are always looking for collaborators and partners. If you are a clinician with a story to tell about the value of patient stories in clinical care, a tip or trick that you've developed and want to share, or a program or tool you think we need in the world to achieve our mission, please reach out.
In the near future, we will be looking for community and clinical partners to explore developing careful and kind concepts at the organizational and systems level. If you think your community might be a good fit, let us know.
how do we make evidence care?
"The job of caring must rise above the knowing and spewing the literature or the plain recitation of guidelines, no matter how evidence-based they say they are or how much easier they make our lives. We must care, and to care, we must help resolve the situation of the patient, identifying what is best for this patient and for his family, not what makes our quality parameters look better or improves our income. The process is best when it explicitly accounts for what we know (and ignore) and the degree of trustworthiness that the body of pertinent literature merits, not when we refer to the latest paper or recommendation without appreciating their value or when we practice in an evidence vacuum or under the tyranny of evidence, i.e. the immediate application of the results of a highly publicized trial. Thus, practices like shared decision making that satisfy themselves in sharing information with patients or in asking them to make choices, fall short of the ideal of EBM. Carefully considering the situation and how best to resolve it in a manner that reflects what patient’s value and the science of medicine better describes the job.
Evidence does not care. But, that is the job: it is to care. In doing so, we must be careful and we must be kind. The rest are important adjectives."
Excerpted from a blog post on the BMJ website in connection with EvidenceLive. Read the whole post, Transforming the communication of evidence for better health.
ICAN DISCUSSION TOOL
The Instrument for Patient Capacity Assessment (ICAN) discussion tool was developed by our partners at the Knowledge and Evaluation Research (KER) Unit to help enhance conversations between patients with chronic conditions and their clinicians with the goal of minimizing treatment burden and identifying care plans for patients that are feasible given their resources and capacity.
Download the tool and see interview with clinicians who are using the tool on the Minimally Disruptive Medicine website.
The team wrote a paper about the development process for the tool. Like almost all the tools and programs development by the KER Unit and The Patient Revolution, the tool was developed using a design approach and in collaboration with clinicians and patients. Meaningful conversations in living with and treating chronic conditions: development of the ICAN discussion aid
A simplified version of the ICAN tool was developed in collaboration with the clinicians and patients at Yale New Haven Hospital's Adult Primary Care practice. The questionnaire asks 4 questions.
- What is one non-medical thing about your life you think your doctor should know?
- What is one thing your doctor is asking you to do for your health that feels like a burden or feels harder than it should?
- What is one thing your doctor is asking you to do for your health that is helping you feel better?
- Where do you find the most joy in your life?
This simple questionnaire was given to patients before their clinical visit while they were waiting in the exam room before their doctor came in.