I am sure many colleague primary care providers are familiar with the soaring feeling of frustration when at the end of a visit, hand on the doorknob and ready to move on to the next patient, you are unexpectedly halted by your patient’s one last question. Often the one last question — aka the “doorknob” question — is in fact so important to your patient’s health and one you wish you’d been asked earlier in the encounter.
Many of us have adopted a daily team huddle into our practice, scanning through patient charts ahead of the visit in an effort to anticipate patients’ needs and delegating tasks to our team in planning for a smooth encounter. Yet I have found myself surprised that no matter how thoroughly I huddle with my team, it is often still not enough to meet my patients’ agenda of the day.
Unless, that is, I can screen for their needs prior to the encounter and count on the team to coordinate their requests.
This is exactly what inspired me a few years ago to create a previsit screening checklist tailored around my patient population’s most frequent health needs, to prompt structured team communication and actions and to improve delivery of care during a visit. We conducted an interventional quality improvement initiative and published the results in Clinical Pediatrics.
Sophie Allende-Richter, MD is a primary care pediatrician at Boston Children’s Hospital, an instructor in pediatrics at Harvard Medical School and a physician consultant at Groton School. Most of her work focuses on improving health care delivery for undeserved adolescents and young adults.