1. © 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

2. © 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

3. © PCC Institute, 2015 Scope and Scale of Health Communication Research Interdisciplinary Priorities Measuring health communication effectiveness Communication education in healthcare Designing and testing communication interventions

4. © 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

5. © 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

6. © 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

7. © 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

8. © 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

9. © 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 IdentifyDesignDeliver Scale Measure

10. © 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