Podcasts about what matters avoiding contextual errors

This episode features a conversation between Kedar Mate, MD, President and CEO of the Institute for Healthcare Improvement and Saul Weiner, MD, Professor of Medicine, Pediatrics and Medical Education, Director of the Clinical Leaders and Academic Scholars Fellowship at the University of Illinois at Chicago, and Deputy Director of the Center of Innovation for Complex Chronic Health Care at the Veterans Health Administration. This session is the third of four talks focused on health care sector efforts to Adjust clinical care based on information about patients' social circumstances. In this conversation, Kedar and Saul explore the intersection of social care adjustment and the practice of contextualizing care and raise questions about both potential benefits and unintended consequences of implementing contextualized care.Recommended references:  https://www.contextualizingcare.org/  Weiner SJ. Contextualizing care: An essential and measurable clinical competency. Patient Educ Couns. 2021.  Weiner SJ, Schwartz A, Altman L et al. Evaluation of a Patient-Collected Audio Audit and Feedback Quality Improvement Program on Clinician Attention to Patient Life Context and Health Care Costs in the Veterans Affairs Health Care System. JAMA Netw Open. 2020.  Weiner SJ, Schwartz A. Listening for What Matters: Avoiding Contextual Errors in Health Care. Oxford Univ Press. 2016. Weiner SJ. On Becoming a Healer: The Journey from Patient Care to Caring about Your Patients. Johns Hopkins Univ Press. 2020. Gawande A. “Personal Best”. The New Yorker. 2011.

Kathryn Tristan is a Research Scientist and Assistant Professor of Medicine on the faculty of Washington University School of Medicine. She studies our biological immune system and its diseases. She also is interested in the “psychological immune system” that represents our constellation of thoughts and feelings meant to protect us. www.whyworrybook.comSaul J. Weiner, MD is a professor of medicine, pediatrics, and medical education at the University of Illinois at Chicago,  the deputy director of the Veterans Health Administration's Center of Innovation for Complex Chronic Healthcare, and the cofounder of the Institute for Practice and Provider Performance Improvement (I3PI). He is the coauthor of Listening for What Matters: Avoiding Contextual Errors in Health Care. http://www.contextualizingcare.org

Conversations about death during hospitalization are among the most difficult imaginable: the moral weight of a human life is suspended by stressful conversations in which medical knowledge and personal context must be negotiated. In Through the Valley of Shadows: Living Wills, Intensive Care, and Making Medicine Human (Oxford University Press, 2016), Samuel Morris Brown approaches the problem of end-of-life care with a clinician’s eye and a scholar of religion’s touch. The book places advance directives in the clinic in their historical context while unpacking their ethical and legal nature, describes the psychological aspects of medical decision-making and how moral distress clouds judgment, and provides recommendations on how to heal the process of healing in the Intensive Care Unit (ICU). An ICU physician himself, Brown’s account is interwoven with powerful stories that render his argument for humanistic care particularly salient. As such, Through the Valley of Shadows offers as much to dyed-in-the-wool humanists as it does to those focused on measuring and improving outcomes. This is the second of a pair of interviews on communication in health care, preceded by Listening for What Matters: Avoiding Contextual Errors in Health Care, by Saul Weiner and Alan Schwartz. Learn more about your ad choices. Visit megaphone.fm/adchoices

Conversations about death during hospitalization are among the most difficult imaginable: the moral weight of a human life is suspended by stressful conversations in which medical knowledge and personal context must be negotiated. In Through the Valley of Shadows: Living Wills, Intensive Care, and Making Medicine Human (Oxford University Press, 2016), Samuel Morris Brown approaches the problem of end-of-life care with a clinician's eye and a scholar of religion's touch. The book places advance directives in the clinic in their historical context while unpacking their ethical and legal nature, describes the psychological aspects of medical decision-making and how moral distress clouds judgment, and provides recommendations on how to heal the process of healing in the Intensive Care Unit (ICU). An ICU physician himself, Brown's account is interwoven with powerful stories that render his argument for humanistic care particularly salient. As such, Through the Valley of Shadows offers as much to dyed-in-the-wool humanists as it does to those focused on measuring and improving outcomes. This is the second of a pair of interviews on communication in health care, preceded by Listening for What Matters: Avoiding Contextual Errors in Health Care, by Saul Weiner and Alan Schwartz. Learn more about your ad choices. Visit megaphone.fm/adchoices Support our show by becoming a premium member! https://newbooksnetwork.supportingcast.fm/medicine

Conversations about death during hospitalization are among the most difficult imaginable: the moral weight of a human life is suspended by stressful conversations in which medical knowledge and personal context must be negotiated. In Through the Valley of Shadows: Living Wills, Intensive Care, and Making Medicine Human (Oxford University Press, 2016), Samuel Morris Brown approaches the problem of end-of-life care with a clinician's eye and a scholar of religion's touch. The book places advance directives in the clinic in their historical context while unpacking their ethical and legal nature, describes the psychological aspects of medical decision-making and how moral distress clouds judgment, and provides recommendations on how to heal the process of healing in the Intensive Care Unit (ICU). An ICU physician himself, Brown's account is interwoven with powerful stories that render his argument for humanistic care particularly salient. As such, Through the Valley of Shadows offers as much to dyed-in-the-wool humanists as it does to those focused on measuring and improving outcomes. This is the second of a pair of interviews on communication in health care, preceded by Listening for What Matters: Avoiding Contextual Errors in Health Care, by Saul Weiner and Alan Schwartz. Learn more about your ad choices. Visit megaphone.fm/adchoices Support our show by becoming a premium member! https://newbooksnetwork.supportingcast.fm/psychology

Conversations about death during hospitalization are among the most difficult imaginable: the moral weight of a human life is suspended by stressful conversations in which medical knowledge and personal context must be negotiated. In Through the Valley of Shadows: Living Wills, Intensive Care, and Making Medicine Human (Oxford University Press, 2016), Samuel Morris Brown approaches the problem of end-of-life care with a clinician’s eye and a scholar of religion’s touch. The book places advance directives in the clinic in their historical context while unpacking their ethical and legal nature, describes the psychological aspects of medical decision-making and how moral distress clouds judgment, and provides recommendations on how to heal the process of healing in the Intensive Care Unit (ICU). An ICU physician himself, Brown’s account is interwoven with powerful stories that render his argument for humanistic care particularly salient. As such, Through the Valley of Shadows offers as much to dyed-in-the-wool humanists as it does to those focused on measuring and improving outcomes. This is the second of a pair of interviews on communication in health care, preceded by Listening for What Matters: Avoiding Contextual Errors in Health Care, by Saul Weiner and Alan Schwartz. Learn more about your ad choices. Visit megaphone.fm/adchoices

When clinicians listen to patients, what do they hear? In Listening for What Matters: Avoiding Contextual Errors in Health Care (Oxford UP, 2016), Saul Weiner and Alan Schwartz provide a riveting account of a decade of research on improving outcomes by incorporating patients’ individual life contexts into planning of care. Their groundbreaking studies showed that physicians, while getting the biological details largely correct, frequently disregard personal circumstances that lead to medical errors. Such an assertion might appear intractable or unfit for empirical study, but Listening for What Matters describes a series of creative experiments that strongly support it. From placing fake patients into real clinical contexts to measure the appropriateness of recommendations, to recording interactions between real patients and doctors (for which they developed a system, Content Coding for Contextualization of Care), and finally training groups of medical students to ask about individual context, Weiner and Schwartz build a case for the existence of a widespread problem while simultaneously offering compelling solutions. This is the first of a pair of interviews on communication in health care, to be followed by Samuel Morris Brown’s Through the Valley of Shadows: Living Wills, Intensive Care, and Making Medicine Human. Learn more about your ad choices. Visit megaphone.fm/adchoices

When clinicians listen to patients, what do they hear? In Listening for What Matters: Avoiding Contextual Errors in Health Care (Oxford UP, 2016), Saul Weiner and Alan Schwartz provide a riveting account of a decade of research on improving outcomes by incorporating patients' individual life contexts into planning of care. Their groundbreaking studies showed that physicians, while getting the biological details largely correct, frequently disregard personal circumstances that lead to medical errors. Such an assertion might appear intractable or unfit for empirical study, but Listening for What Matters describes a series of creative experiments that strongly support it. From placing fake patients into real clinical contexts to measure the appropriateness of recommendations, to recording interactions between real patients and doctors (for which they developed a system, Content Coding for Contextualization of Care), and finally training groups of medical students to ask about individual context, Weiner and Schwartz build a case for the existence of a widespread problem while simultaneously offering compelling solutions. This is the first of a pair of interviews on communication in health care, to be followed by Samuel Morris Brown's Through the Valley of Shadows: Living Wills, Intensive Care, and Making Medicine Human. Learn more about your ad choices. Visit megaphone.fm/adchoices Support our show by becoming a premium member! https://newbooksnetwork.supportingcast.fm/medicine

When clinicians listen to patients, what do they hear? In Listening for What Matters: Avoiding Contextual Errors in Health Care (Oxford UP, 2016), Saul Weiner and Alan Schwartz provide a riveting account of a decade of research on improving outcomes by incorporating patients' individual life contexts into planning of care. Their groundbreaking studies showed that physicians, while getting the biological details largely correct, frequently disregard personal circumstances that lead to medical errors. Such an assertion might appear intractable or unfit for empirical study, but Listening for What Matters describes a series of creative experiments that strongly support it. From placing fake patients into real clinical contexts to measure the appropriateness of recommendations, to recording interactions between real patients and doctors (for which they developed a system, Content Coding for Contextualization of Care), and finally training groups of medical students to ask about individual context, Weiner and Schwartz build a case for the existence of a widespread problem while simultaneously offering compelling solutions. This is the first of a pair of interviews on communication in health care, to be followed by Samuel Morris Brown's Through the Valley of Shadows: Living Wills, Intensive Care, and Making Medicine Human. Learn more about your ad choices. Visit megaphone.fm/adchoices Support our show by becoming a premium member! https://newbooksnetwork.supportingcast.fm/psychology

When clinicians listen to patients, what do they hear? In Listening for What Matters: Avoiding Contextual Errors in Health Care (Oxford UP, 2016), Saul Weiner and Alan Schwartz provide a riveting account of a decade of research on improving outcomes by incorporating patients’ individual life contexts into planning of care. Their groundbreaking studies showed that physicians, while getting the biological details largely correct, frequently disregard personal circumstances that lead to medical errors. Such an assertion might appear intractable or unfit for empirical study, but Listening for What Matters describes a series of creative experiments that strongly support it. From placing fake patients into real clinical contexts to measure the appropriateness of recommendations, to recording interactions between real patients and doctors (for which they developed a system, Content Coding for Contextualization of Care), and finally training groups of medical students to ask about individual context, Weiner and Schwartz build a case for the existence of a widespread problem while simultaneously offering compelling solutions. This is the first of a pair of interviews on communication in health care, to be followed by Samuel Morris Brown’s Through the Valley of Shadows: Living Wills, Intensive Care, and Making Medicine Human. Learn more about your ad choices. Visit megaphone.fm/adchoices

With all the technology around today, doctors still often fail to make the right diagnosis.  Usually not due to any failure of knowledge or smarts, but because diagnostics is often as much art as science. As such, it requires an almost intuitive and/or subtle understanding of the patient, his or her circumstances and sometimes it’s as much about what is not said by the patient, as that which is voiced. Drs. Saul Weiner and Alan Schwartz have taken these ideas to the next step in their research about art of context and diagnostics.  Their work is revealed in Listening for What Matters: Avoiding Contextual Errors in Health Care. My conversation with Dr. Saul Weiner and Dr. Alan Schwartz

Saul J. Weiner, M.D., and Alan Schwartz, PH.D., join Mark Alyn to talk about their new book, Listening for What Matters: Avoiding Contextual Errors in Health Care. The book is based on 10 years of groundbreaking research conducted by the authors and explains how and why doctors commonly fail when diagnosing and treating patients. With federal grants, Weiner and Schwartz conducted studies, which first sent actors, called Unannounced Standardized Patients (“USPs”) and then real patients, to hundreds of doctor's visits with hidden audio-recording devices so that the research team could listen and analyze the results of the visits. This is their story.The focus behind the experiments was to find out how often doctors picked up on “contextual red flags” alluded to by the patients. These are clues that something is going on in a patient’s life that needs to be addressed for a care plan to be effective. So, if a patient drops clues that he is unable to afford an expensive brand name medication after losing health insurance coverage, then Weiner and Schwartz would observe whether the doctor picks up on the clues and prescribes a lower-cost generic medicine. The studies document that physicians are frequently overlooking crucial clues about patients’ individual life circumstances and making medical errors as a result. These mistakes by doctors are costly and pervasive and can be prevented. Weiner and Schwartz explain how doctors and other health-care professionals can learn to listen better, ask the right questions, and get better results.In their interview with Mark, Saul and Alan will discuss:- Some of the most surprising things they learned while conducting these experiments—stories from the trenches revealed by the actors and patients that went into the doctors’ offices undercover.- Why doctors so frequently miss patient clues that they are struggling – termed “contextual red flags” - even when these red flags seem obvious to the reader.- What our medical schools can do to better train health care professionals to listen and engage with patients on an individual level so that patients’ health care outcomes are better.- Why contextualized care is more cost effective and why it doesn't have to take any more time out of a busy doctor's day than the current way care is delivered.- What patients can do to better their, or a loved one's, care if they don't feel their health-care professionals are listening to them.The book is available from Oxford University Press and can be bought online via Amazon, Oxford, or another retailer.

Saul J. Weiner, M.D., and Alan Schwartz, PH.D., join Mark Alyn to talk about their new book, Listening for What Matters: Avoiding Contextual Errors in Health Care. The book is based on 10 years of groundbreaking research conducted by the authors and explains how and why doctors commonly fail when diagnosing and treating patients. With federal grants, Weiner and Schwartz conducted studies, which first sent actors, called Unannounced Standardized Patients (“USPs”) and then real patients, to hundreds of doctor's visits with hidden audio-recording devices so that the research team could listen and analyze the results of the visits. This is their story.The focus behind the experiments was to find out how often doctors picked up on “contextual red flags” alluded to by the patients. These are clues that something is going on in a patient’s life that needs to be addressed for a care plan to be effective. So, if a patient drops clues that he is unable to afford an expensive brand name medication after losing health insurance coverage, then Weiner and Schwartz would observe whether the doctor picks up on the clues and prescribes a lower-cost generic medicine. The studies document that physicians are frequently overlooking crucial clues about patients’ individual life circumstances and making medical errors as a result. These mistakes by doctors are costly and pervasive and can be prevented. Weiner and Schwartz explain how doctors and other health-care professionals can learn to listen better, ask the right questions, and get better results.In their interview with Mark, Saul and Alan will discuss:- Some of the most surprising things they learned while conducting these experiments—stories from the trenches revealed by the actors and patients that went into the doctors’ offices undercover.- Why doctors so frequently miss patient clues that they are struggling – termed “contextual red flags” - even when these red flags seem obvious to the reader.- What our medical schools can do to better train health care professionals to listen and engage with patients on an individual level so that patients’ health care outcomes are better.- Why contextualized care is more cost effective and why it doesn't have to take any more time out of a busy doctor's day than the current way care is delivered.- What patients can do to better their, or a loved one's, care if they don't feel their health-care professionals are listening to them.The book is available from Oxford University Press and can be bought online via Amazon, Oxford, or another retailer.

Saul J. Weiner, M.D., and Alan Schwartz, PH.D., join Mark Alyn to talk about their new book, Listening for What Matters: Avoiding Contextual Errors in Health Care. The book is based on 10 years of groundbreaking research conducted by the authors and explains how and why doctors commonly fail when diagnosing and treating patients. With federal grants, Weiner and Schwartz conducted studies, which first sent actors, called Unannounced Standardized Patients (“USPs”) and then real patients, to hundreds of doctor's visits with hidden audio-recording devices so that the research team could listen and analyze the results of the visits. This is their story. The focus behind the experiments was to find out how often doctors picked up on “contextual red flags” alluded to by the patients. These are clues that something is going on in a patient’s life that needs to be addressed for a care plan to be effective. So, if a patient drops clues that he is unable to afford an expensive brand name medication after losing health insurance coverage, then Weiner and Schwartz would observe whether the doctor picks up on the clues and prescribes a lower-cost generic medicine. The studies document that physicians are frequently overlooking crucial clues about patients’ individual life circumstances and making medical errors as a result. These mistakes by doctors are costly and pervasive and can be prevented. Weiner and Schwartz explain how doctors and other health-care professionals can learn to listen better, ask the right questions, and get better results. In their interview with Mark, Saul and Alan will discuss: - Some of the most surprising things they learned while conducting these experiments—stories from the trenches revealed by the actors and patients that went into the doctors’ offices undercover. - Why doctors so frequently miss patient clues that they are struggling – termed “contextual red flags” - even when these red flags seem obvious to the reader. - What our medical schools can do to better train health care professionals to listen and engage with patients on an individual level so that patients’ health care outcomes are better. - Why contextualized care is more cost effective and why it doesn't have to take any more time out of a busy doctor's day than the current way care is delivered. - What patients can do to better their, or a loved one's, care if they don't feel their health-care professionals are listening to them. The book is available from Oxford University Press and can be bought online via Amazon, Oxford, or another retailer.

Saul J. Weiner, M.D., and Alan Schwartz, PH.D., join Mark Alyn to talk about their new book, Listening for What Matters: Avoiding Contextual Errors in Health Care. The book is based on 10 years of groundbreaking research conducted by the authors and explains how and why doctors commonly fail when diagnosing and treating patients. With federal grants, Weiner and Schwartz conducted studies, which first sent actors, called Unannounced Standardized Patients (“USPs”) and then real patients, to hundreds of doctor's visits with hidden audio-recording devices so that the research team could listen and analyze the results of the visits. This is their story. The focus behind the experiments was to find out how often doctors picked up on “contextual red flags” alluded to by the patients. These are clues that something is going on in a patient’s life that needs to be addressed for a care plan to be effective. So, if a patient drops clues that he is unable to afford an expensive brand name medication after losing health insurance coverage, then Weiner and Schwartz would observe whether the doctor picks up on the clues and prescribes a lower-cost generic medicine. The studies document that physicians are frequently overlooking crucial clues about patients’ individual life circumstances and making medical errors as a result. These mistakes by doctors are costly and pervasive and can be prevented. Weiner and Schwartz explain how doctors and other health-care professionals can learn to listen better, ask the right questions, and get better results. In their interview with Mark, Saul and Alan will discuss: - Some of the most surprising things they learned while conducting these experiments—stories from the trenches revealed by the actors and patients that went into the doctors’ offices undercover. - Why doctors so frequently miss patient clues that they are struggling – termed “contextual red flags” - even when these red flags seem obvious to the reader. - What our medical schools can do to better train health care professionals to listen and engage with patients on an individual level so that patients’ health care outcomes are better. - Why contextualized care is more cost effective and why it doesn't have to take any more time out of a busy doctor's day than the current way care is delivered. - What patients can do to better their, or a loved one's, care if they don't feel their health-care professionals are listening to them. The book is available from Oxford University Press and can be bought online via Amazon, Oxford, or another retailer.