Becker's Clinical Quality & Infection Control

10 PATIENT EXPERIENCE Physician viewpoint: We must stop blaming patients for unhealthy lifestyle choices By Mackenzie Bean P hysicians must abandon the mindset that pa- tients who practice unhealthy behaviors, such as smoking, are to blame for their illnesses or cancer, Monica Bhargava, MD, an Oakland, Calif.-based pulmo- nary and critical care physician, wrote in an op-ed for The Washington Post. "Our culture's tendency to frame certain illnesses as character defects, as opposed to complex phenom- ena with genetic and psychosocial components, is widespread and carries serious consequences," Dr. Bhargava wrote. She said smokers are "shamed more vocally" for having lung cancer than other patients who develop diseases strongly linked to patient behavior or lifestyle. Dr. Bhar- gava also said she's witnessed how this stigma alters the care pulmonary patients receive at her practice. Physicians have a responsibility to promote healthy behaviors and should offer to help patients quit harmful habits, she acknowledged. "But if our patients receive a cancer diagnosis, we need to care for them with a spirit of unconditional empathy and advocacy," Dr. Bhargava concluded. "Our patients are more than what they have ingested or inhaled." n UChicago Medicine cuts inpatient sleep disruptions with EHR tool By Mackenzie Bean U niversity of Chicago Medicine successfully reduced nighttime disruptions for patients by inte- grating a sleep-friendly tool into its EHR. Researchers described the initiative and its outcomes in a study published in the Journal of Hospital Medicine. e study examined the outcomes of a UChicago initiative called Sleep for Inpa- tients: Empowering Staff To Act. As part of the SIESTA initiative, researchers imple- mented "nudges" in the hospital's EHR that encouraged physicians and nurses to avoid waking patients up for minimally valuable tasks, such as measuring vital signs. To assess the initiative's outcomes, research- ers looked at two 18-bed general medicine units where 1,083 patients were admitted between March 2015 and March 2016. Pa- tients were either admitted to a SIESTA-en- hanced unit or a normal hospital unit. Physicians trained to use the EHR nudges rotated between both units, but nurses in the SIESTA unit received additional coach- ing to advocate for patients' sleep. Researchers found sleep-friendly EHR orders increased on both units. However, decisions to skip nighttime vital sign checks increased from 4 percent to 34 percent on the SIESTA unit. Sleep-friendly timing of nighttime medication administration also increased from 15 percent to 42 percent during the study period, while total night- time room entries dropped 44 percent. "Efforts to improve patients' sleep are not new, but they do not oen stick because they rely on staff to remember to implement the changes," lead study author Vineet Arora, MD, professor of medicine at UChicago, said in a press release. "is illustrates the importance of engaging both nurses and physicians to create sleep-friendly environments in hospitals." n Half of young patients don't get private time with physicians, study finds By Mackenzie Bean O nly about half of adolescents and young adults in the U.S. get private time with their physicians, according to a study published in the Journal of Adolescent Health. For the study, researchers surveyed a nationally representa- tive group of 1,918 individuals ages 13-26 on their health- care experiences. Fifty-five percent of females and 49 percent of males reported ever having private time with their regular physician. In addition, 55 percent of females and 44 percent of males reported speaking to their physicians about confidentiality. Patients who did have private time with physicians were more likely to be older, have a higher household income and be the same gender as their provider, among other factors. These patients also demonstrated more positive attitudes about their physicians and were more willing to discuss sensitive topics. "Although confidentiality and private time are important to [adolescents and young adults], many are not experi- encing these components of care," researchers conclud- ed. "Providing private time and discussions of confiden- tiality can improve the delivery of healthcare for young people by enhancing positive youth attitudes about preventive care." n

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