Clinical Excellence Pearl from Pediatrics Noon Conference

by Academy of Clinical Excellence on April 9, 2014






I  attended a superb pediatrics noon conference last week. The presenter, Dr. Maggie Moon, emphasized the following stategies that can be helpful to use during a difficult patient encounter:

  1. Avoid labeling the patient.
  2. Treat the patient with respect.
  3. Work to establish a trusting relationship with the patient.
  4. Have self-awareness and self-control about negative emotions toward the patient.
  5. Keep a healthy emotional distance from the patient without becoming distant.
  6. Draw upon the virtues of empathy and compassion to understand the patient.
  7. Exhibit patience when working with the patient.
  8. Use non-judgmental listening to elicit the patient’s perspective.
  9. Establish a dialogue to determine if there are cultural, psychosocial, or personal experiential factors contributing to the patient’s behavior.
  10. Create the “third story” as a means of mediating the encounter.
  11. Share control with the patient and make concessions when possible.
  12. Set limits in a straightforward manner.
  13. Be tolerant but do not tolerate verbal or physical abuse.
  14. Involve the patient in the decision-making process.
  15. Negotiate a behavioral contract specifying what the patient is to do and what the staff is to do.
  16. Draw upon the expertise of other members of the healthcare team.
  17. Develop the practical wisdom of knowing how to deal with the inherent uncertainty of the difficult encounter.

- Rosalyn Stewart, MD, MS, MBA

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