© PCC Institute, 2015

The Scope and Scale of Health Communication Research:

An Interdisciplinary Focus

A Resource of the Palliative Care Communication Institute

www.pccinstitute.com

© PCC Institute, 2015

Changing Healthcare Landscape

• Patient populations– 1/3 of all Veterans involved in combat and exposed to experiences related

to death and dying during duty– 1/3 of adult population are family caregivers– By 2050, 1 in 13 adults age 65 and older will be nonheterosexual, and 42%

of older Americans will belong to a racial or ethnic group – 60% of Americans have at least three chronic conditions

• Advances over the next 20 years are expected to be more rapid than the last five decades– Patients will have longer medical histories, more complex care

management, increased care interventions, and multiple providers

© PCC Institute, 2015 Scope and Scale of Health Communication ResearchInterdisciplinary Priorities

• Measuring health communication effectiveness• Communication education in healthcare• Designing and testing communication

interventions

© PCC Institute, 2015

Priority One:Measuring Effectiveness

• Current approach is patient/family satisfaction with care experience– Approximately 30% of hospitals’ incentive payment is

based on the patient care experience• Hospital Consumer Assessment of Healthcare Providers and Systems

– Four of the eight dimensions of the patient experience of care measure communication:• Communication with physicians, communication with nurses,

communication about medication, and discharge information

© PCC Institute, 2015

• Measures of quality of care experience– Lack strong theoretical framework– Do not address team-based delivery of care– Do not account for trajectory of illness

• Conceptualizes communication as a singular concept, using one question assessment

• No consideration of the process, purpose, or goal of communication

Priority One:Measuring Effectiveness

© PCC Institute, 2015

Priority Two:Communication Education

• Rise in communication education in medical and nursing programs over last 15 years

• Patient simulation and interprofessional education emerging

• Improvements to learner outcomes, but not patient/family reported outcomes

• Protocols developed primarily from medicine

© PCC Institute, 2015

Priority Two: Communication Education

• Development of communication competencies in medicine only– Assumes physician is responsible for all communication

interventions, depict supporting role of others (nurse, social work)

• Primary focus on sharing life-altering information, goals of care, transitions in care– Little attention to social, spiritual discussions

• Minimal preparation and resources for clinical faculty

© PCC Institute, 2015 Priority Three: Communication Interventions

• Dependent upon practice and payment incentives

• Focus on Family Conferences and Advance Care Planning– Non-significant results on patient/family outcomes

© PCC Institute, 2015 Priority Three: Communication Interventions

• Specific communication characteristics remain unknown

• Research needs to address– Timing of the intervention– Placement in care trajectory– Team composite– Interpersonal approaches

Identify Design DeliverScale

Measure

© PCC Institute, 2015

Future Priorities

• Focus is now clearly on the quality and cost of care – New technology– Home care settings – Oral administration of new medicines will be prioritized– New challenges in patient and family education