Bridging the Gaps to Improved Care

April 7, 2023 | VOLUME 1, ISSUE 1

In medicine, patient care is paramount. Thousands of hours are dedicated to medical education, research, simulation learning, and other learning designed to enhance clinicians’ ability to care for patients effectively and produce better outcomes. Adding to this expectation of care, institutions across the country have focused on patient satisfaction metrics in recent years.

Patient experience factors into the approval rating of the hospital or care center and can also significantly impact care quality and patient outcomes. For example, patients who feel a connection with their provider are more likely to be forthcoming about their symptoms and to convey the struggles they may be experiencing outside of the care setting, such as not having reliable transportation to get to appointments, not having a support system at home, or their inability to afford prescribed medications. All are factors that can impact patient compliance and outcomes.

In 2022, CHEST launched two initiatives focusing on the patient experience: the First 5 Minutes^® and Bridging Specialties^®: Timely Diagnosis for ILD programs.

Each is a distinct educational program with a common thread of improving care by improving the patient experience. The First 5 Minutes program focuses on strengthening the patient/clinician relationship through empathetic listening. The Bridging Specialties program aims to bring together multidisciplinary clinicians to diagnose complex lung diseases more quickly.

The catalyst: CHEST Foundation Listening Tour
In 2020, the CHEST Foundation embarked on a five-city Listening Tour across the United States to understand the challenges individuals face in accessing health care, particularly in under-resourced communities. The message was clear: patients experienced a lack of access, equity, and trust.

Driven to action, CHEST set out to address these barriers. Empathetic listening training emerged as the solution to build trust between patients and clinicians and improve the patient experience. Established in partnership with the Academy of Communication in Healthcare, CHEST launched the First 5 Minutes program focused on developing evidence-based skills in relationship-centered communication proven to establish trust. Through interactive activities on empathetic listening and trust-building communication skills, the program homes in on small changes in a clinician’s approach that establish patient trust to facilitate more efficient and effective communication.

When speaking to the First 5 Minutes initiative during the CHEST Annual Meeting, Nneka Sederstrom, PhD, MPH, MA, FCCP, member of the Board of Regents for the American College of Chest Physicians and Chief Health Equity Officer with Hennepin Healthcare, emphasized to the clinicians in attendance, “This is a significant way to impact care. It’s not the meds, it’s not the education, it’s not ensuring access. It really is building a relationship with another human in a manner that they trust you enough to tell you what’s actually going on and are willing to listen to you because they feel that you actually see their whole self.”

Combining strengths
Beyond the relationship with the clinician, patient experience often hinges on effective and timely treatment. For many ailments, the approach is clear, but for complex lung diseases, the path to diagnosis can be murky.

This is especially true in the case of most interstitial lung diseases (ILDs), the most prevalent of which is pulmonary fibrosis (PF). In part, because many presenting symptoms are common, the average patient with PF waits 1 to 3 years to receive an accurate diagnosis or to be referred to a pulmonologist.

Given that a patient’s first stop of their journey to a diagnosis begins with their primary care provider, Bridging Specialties: Timely Diagnosis for ILD brings together pulmonologists and primary care physicians (PCPs) to define a clearer clinician-guided approach to the diagnosis of complex lung diseases like PF.

In partnership with Three Lakes Foundation, a nonprofit organization focused on accelerating new solutions to diagnose, treat, and cure PF, CHEST assembled an expert steering committee of pulmonary and primary care experts to develop tangible, functional resources that can streamline the approach to diagnosing these diseases.

“Having experts from both pulmonary and primary care medicine as members of the steering committee is critical,” said steering committee member and family medicine physician William Lago, MD. “Patients first see their family medicine or primary care clinicians and, all too often, the most complex lung diseases present in ways that are indistinguishable from more common conditions like asthma, COPD, or any number of cardiac conditions. Bringing together experts in both fields will yield the best results in creating a path to diagnosis.”

Resources created thus far include a sound bite for a PCP to familiarize themselves with the sound of lung crackles (a key symptom of PF), a patient questionnaire, a decision-making guide, and more.

The steering committee will focus next on getting the ILD Clinician Toolkit into the hands of as many practicing PCPs as possible and encouraging pulmonary and primary experts to collaborate more openly and often.

How clinicians can advance the cause
Both the First 5 Minutes program and Bridging Specialties: Timely Diagnosis for ILD look to change the approach to patient care: one through empathetic listening and the other through strategic partnerships to provide the best possible care for the patient.

But the key to achieving these goals lies with those working in the field. Each program offers opportunities for clinicians to bring new skills, information, and tools back to their practice.

Start by reviewing and sharing available materials for the First 5 Minutes and Bridging Specialties initiatives: Try on-the-go resource cards from the First 5 Minutes program to help you improve your empathetic communication in every clinical encounter. Share modules from the Bridging Specialties program with others in your network to enable all clinicians, including PCPs, to be advocates for improved diagnosis for ILDs. Participate in a session to help improve your communication skills and enhance your understanding of the vulnerability patients feel during their medical appointments. Or reach out to CHEST with feedback on any of the offerings currently available through these programs.

Help CHEST expand the impact of these initiatives. Read, share, and engage today.