A patient is hesitant to voice their preferences. How can you ensure their needs are met effectively?

When I was a patient advocate for women undergoing gynecologic surgeries, I would suggest that they write their questions down and when they presented themselves for their appointments, they should ask to the office staff to make a copy of the list to put in their chart. That way, even if they became nervous about asking their provider a question face-to-face from their copy of the list, the provider would already have their questions in their chart and would hopefully address them anyway.

Establish a rapport with the patient by actively listening, showing empathy, and respecting their privacy and confidentiality. Demonstrating genuine concern for their well-being can help them feel more comfortable sharing their preferences.

Create a trusting environment that fosters a sense of safety and comfort by being non- judgemental, approachable, and respectful in your communication. Show empathy and give them time to express themselves without rushing or interrupting.

In addition to these recommendations it can also be helpful to display visual support including signs, information packets, and pins. I proudly wear an LGBT and Autism pin daily.

In my involvement with the IMI PREFER project on patient preferences, I aimed to contribute to building trust by prioritizing these principles. Through active engagement and a commitment to understanding patient needs, we can foster a trusting relationship that empowers patients to share their preferences and make informed decisions about their care.

Be patient enough to know what's making it difficult for them to verbalize their fears and concerns. Avoid outright generalization. This is because each patient has a unique temperament. Understanding this, makes navigating their fears an easy ride.

Take the time to explore any fears or concerns the patient may have. Ask open-ended questions and listen without judgment. Understanding their apprehensions can help you address them more effectively.

To advocate effectively for a patient, it’s essential to understand the fears and obstacles that might keep them from expressing their preferences. Some may worry about being seen as difficult or feel hesitant to question healthcare professionals’ expertise. Others might feel intimidated by medical jargon or hold cultural reasons for their reluctance to speak up. Recognizing these concerns enables you to adjust your approach and offer the support they need to overcome these barriers.

Fear often times presents as anger so sometimes sometimes just sitting with a patient who is expressing frustration and anger, and trying to understand what is driving that can be key to allowing them to express what is the true undercurrent. Fear. One example I’ve used is a mother who was in a patient’s room when the patient was having a 20 week fetal loss. The mother was shouting and screaming at the nurses. She and I sat down and I said what’s happening, what are you afraid of and she explained that it was breaking her heart that her baby was losing a baby and she had no power to control that loss. She wanted to be there for her daughter, but didn’t know how. She went on to be a true support for her daughter.

One thing I find helpful is to review the patients understanding of what information has already been given. I find sometimes not understanding often leads to fear and overwhelm. Also, understanding their overall goals and reviewing them frequently can assist in working through fear.

The time to ask questions is before, during, and after an appointment. I agree with the suggestion to encourage patients to write down any concerns before the appointment, then during the provider should ask multiple times for questions, then after provide an additional window for questions.

It is important to ask the right questions and ensure they understand their diagnosis and what are the right questions should entail.

Encourage patients to ask questions by reminding them that there are no "silly or dumb" questions. I also agree with having patients write questions down in advance so they have time to prepare and to prevent them from forgetting them when the opportunity to ask questions as an appointment/visit presents. Also, when feasible, I like to encourage patients to feel free to ask questions as they come up (i.e. via the EMR portal, etc). Often, new questions arise after a patient has had time to process information after the visit.

Dejar claro que las preguntas tontas no existen, que para una correcta intervención de las condiciones que se viven, es necesario dejar claro el porqué de las cosas

"White coat syndrome", the implied feeling by the patient that they are inferior, false intimidation belief. This is often when in personal contact. Allow and encourage patients raise their concerns via email, in writing, direct messenger. Offer them an alternate contact with a perceived trusted title, a nurse. Nurses are perceived as more trustworthy, easier to talk too, more empathetic to needs. A tea room, pastel green in colour and is private, may be more relaxing for patients by removing the stifling sterilised consolidating room. These are but a few "calming" approaches that can be implemented.

A patient can only make informed health decisions if they have the literacy skills pertaining to their health. These resources vary from written materials (flyers/internet) to even access to support groups. One can only be confident enough to ask question if they are knowledged in the discussion at hand. As a parent to children with rare diseases, I found myself researching on the kids condition and collecting these resources and sharing them with the HCP. Resources can be shared both ways and this enhances trust and encourages questions.

This usually happens due to past experiences of having their requests dismissed or receiving negative feedback. In my practice focused on patient-centered care, I prioritize understanding their concerns without making assumptions. Speak to the patient 1-on-1 to understand their apprehension about expressing their needs. Next, I would validate their concerns and explain how things will be handled differently this time to ensure their needs are met. Outlining the new and improved process will encourage them to share their requests, fostering hope that they will be heard & acted upon. Also, offering options for how they can express their needs respects their autonomy and empowers them to choose the method that feels most comfortable for them.

A patient advocate can empower the patient to articulate their preferences to make better and well-informed decisions about their health by providing resources. Patients who are aware and better educated on their health needs, condition, medications and procedures can make sound decisions with potentially better outcomes. Even providing the patients with pamphlets explaining their condition is a fantastic channel. Never underestimate how educational connections can help patients!

Everything is typed down to the last detail of what was agreed upon. Specific Instructions on what to do when. Any tests or referrals and supplies and the name/ number of who will deliver. Referrals/ tests are always provided with diagnosis codes and a note of what I am looking for or an eval and treat if I need someone to address a specific issue

Mantener un material gráfico sencillo pero acertivo y claro que pacientes de todo estrato lo pueda entender, crear material para reforzar el motivo de la consulta y del cuidado

Más que defensa, debemos verlo como herramienta de. Ayuda. Como puedo hacer que el paciente se comprometa más con su autocuidado y se interese por entender que sucede

There should be a more personal conversation with individuals and insurance representatives. I feel there is a lack of communication for patients and the insurance companies. Individuals don't always know what type of insurance they have, what it covers, what it doesn't cover and even what additional benefits the insurance companies offer. This is especially for older patients that don't know about additional aspects of their insurance. Some additional benefits are gym membership coverage, food delivery after a hospital stay while they are healing, a fall safe button that they can receive for free and even a free blood pressure monitor to encourage heart health.

If you have a gut feeling that a patient may need more attention than only what you’re in the room to provide, you’re probably right. Shyness, and particularly reluctance to come to the hospital for treatment at all are cues that you should be aware that their needs could likely exceed beyond your initial encounter. When a therapy session comes to an end, before wrapping up with them ask them if their needs have been met and remind them of any “as needed” features to the order and that they would never be out of line to request an extra treatment when the need arises.

Following up is crucial in ensuring that a patient’s preferences are not only heard but also acted upon. After discussions with healthcare providers, check in with the patient to see if they feel their concerns were addressed. This step shows that you are committed to seeing their needs met and are available to provide further assistance if necessary. Based on my experience with the PREFER qualification opinion from the European Medicines Agency, I’ve seen firsthand how structured follow-ups can significantly enhance patient satisfaction and trust. Ensuring patient involvement in decision-making processes is key to delivering patient-centered care and improving health outcomes.

At every visit. Once I know the appt day I follow up… only 3 weeks, I’m looking forward to getting their report so we can be sure you are on track

Following up with the patient ensures that you are committed to seeing their needs met. This also allows you to continue to establish a trusting relationship, because the patient can now see through actions, not just words that you are committed to their care which may encourage them to open up further to you. Even if the patient denies any further needs, it should be made clear that they can always have you come back to the room if something else comes up.