Monday, April 19, 2010

Engaging communication experts in a Delphi process to identify patient behaviors that could impact communication in medical encounters.

Communication between patients and physicians is a very important area of study in the world of communication. The article states that evidence supports the Four Habits Model has a link between specific behaviors of the physicians with improved outcomes of the care provided.


Utilizing the Four Habits Model as a starting point, a four round Delphi process was conducted with 17 international experts in communication research, medical education, and health care delivery. Each round was conducted via the internet.
Implementation of the Delphi Process:
Round 1: The experts reviewed a list of proposed patient verbal communication behaviors, identified based on a review of communications literature, within the Four Habits Model framework. The experts chose from the options of: approving the proposed list, adding new behaviors, or modifying existing behaviors from the list.
Rounds 2, 3, and 4: Each of these rounds was the same. Each behavior was rated for its fit, by agreeing or disagreeing, with a particular habit. After each round, the percentage of agreement for each behavior was calculated and the data was used for the determination of behaviors to be analyzed in following rounds. Behaviors that received more than 70% of the experts’ votes were considered as achieving consensus.


Throughout the course of the four rounds, the experts started with the 14 originally proposed patients verbal communication behaviors, of which they modified 12, added 20 behaviors. They eventually retained only 22 behaviors, which included such obvious behaviors as asking questions, expressing preferences, and summarizing information.


The use of the Delphi appears to work very well for the expectation of finding out more effective ways of communication for physicians and patients. Without the notes of the actual rounds and how everything worked out when the experts voted on what they believed was right or wrong it’s difficult to actually make an assessment of the Delphi process.

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