Editor’s Note: Today we have a post from Dr. Brian Taylor, HHTM’s new Editor of Hearing News Watch. His bimonthly “Signal & Noise” column that is regularly featured at Hearing Economics is being featured today at Hearing Views for the first time.
Brian Taylor, AuD
One recently published study suggests that hearing care providers spend too much time talking about technology and often fail to meet the individual needs of the hearing impaired patient. In the February, 2015 issue of JAAA, Grenness et al{{1}}[[1]]Grenness, C, et al (2015) The nature of communication throughout diagnosis and management planning in initial audiologic rehabilitation consultations. JAAA. 26, 36-50.[[1]] examined the nature of audiologist-patient communication during the initial consultation process in an Australian clinic. A total of 62 consultations were filmed and analyzed.
In the study, communication was meticulously coded and placed into one of four categories: 1) education & counseling, 2) data gathering, 3) relationship building and 4) facilitation & patient activation.
Forty-eight percent of the audiologists utterances were classified as education and counseling in nature. Within this category, 83% of education and counseling utterances were biomedical in content, which included an explanation of the audiogram and the possible cause of the hearing loss. Results of this study strongly indicate that the patient-provider dialogue is dominated by the audiologist with rapid movement from talk about test results to hearing aid options commonly occurring, and more than 75% of the educational and counseling time revolving around hearing aids.
Recognizing the Importance of Patient-Centered Care
Outside our respective professions of audiology and hearing instrument dispensing, American physicians are beginning to also recognize the need to practice patient-centered care.
Using shared decision making, which is the process of the clinician and patient jointly participating in the health decision after discussing the options, the harms and benefits, and considering the patient’s values preferences and circumstances, physicians are attempting to better meet the demands of a more consumer-oriented era of health care where patient choice is a priority.
Clearly, many professionals involved directly with the care of patients know that more effective collaborative communication strategies are a path to providing superior patient care and improving outcomes.
This bit of new thinking couldn’t come soon enough to our profession, as it is estimated that among Americans over the age of 50 with mild loss or greater, prevalence of hearing aid use is consistently low, ranging from 4.3% in individuals age 50-59 to 22% for those over the age of 80.{{4}}[[4]]Chien, W. & Lin, F. (2012). Prevalence of hearing aid use among older adults in the United States. Archives of Internal Medicine. 172, 292-203.[[4]]
If research indicates we spent too much precious clinical time talking about arcane technological details, how, in fact, should we spend our time? We can look to another recent study to address this important question. Poost-Faroosh, et al (2015){{2}}[[2]]Poost-Faroosh, et al (2015) Comparions of client and clinician views of the importance of factors in client-clinician interaction in hearing aid purchase decisions. JAAA. 26, 247-259.[[2]] evaluated the quality of the professional relationship by comparing patient and clinician ratings of the importance of several factors that contribute to effective communication.
Interview data was collected and placed into one of eight categories that may influence hearing aid purchasing decisions. Much like other patient-centered model of care used in other realms of healthcare, Poost-Faroosh and colleagues determined that the following five components, shown in the outer ring of the figure shown below, are an essential part of patient-centered communication.
At the core of patient-centered communication is participatory care. Participatory care is a model of healthcare in which patients take a more active role in the generation and implementation of treatment options.
In today’s consumer era of healthcare, participatory care appears to be popular among Baby Boomers. It requires a relatively high degree of healthcare literacy on the part of the patient{{3}}[[3]]Gilligan, J. & Weinstein, BE (2014) Health literacy and patient-centered care in audiology –implications for adult aural rehabilitation. Commun Disord Deaf Stud Hearing Aids. 2, 110.[[3]] and involves the use of shared decision making. Shared decision making, which is an essential component of patient-centric communication, is the process in which the patient and the audiologist exchange information about the scale and scope of the patient’s condition, express the preferences of intervention options and collaborate on the implementation and evaluation of a solution.
Shared decision making and participatory care cannot be supported without adequate information provision (Poost-Faroosh, et al 2015). We tackle this topic in the next Signal & Noise.
This is the post 5 in the “Signal & Noise” series. Click here for Post 1 , Post 2 , Post 3 and Post 4.
Brian Taylor, AuD, is Senior Director, Clinical Affairs, for Turtle Beach/Hypersound. He continues to serve as Editor of Audiology Practices, the quarterly publication of the Academy of Doctors of Audiology. During the first fifteen years of his career, he practiced clinical audiology in both medical and retail settings. Since 2005, Dr. Taylor has held a variety of leadership & management positions within the hearing aid industry in both the United States and Europe. He has published over 50 articles and book chapters on topics related to hearing aids, diagnostic audiology and business management. Brian has authored three text books: Fitting and Dispensing Hearing Aids (co-authored with Gus Mueller), Consultative Selling Skills for Audiologists, and Quality in Audiology: Design & Implementation of the Patient Experience. His latest book, Marketing in an Audiology Practice, was published in March, 2015. Brian lives in Golden Valley, MN with his wife and three sons. He can be reached at [email protected] or [email protected].
Congratulations on your new post as Editor of Hearing News Watch!