Patient Care

Case Studies in Improving Patient Care – “Missing the Beat on Patient Experience”


Presenter: Elizabeth Harry, MD

Summation: Dr. Harry structured her talk on Jonathan Sweller’s theory of Cognitive Load. Representing 3 components; Intrinsic Load (acute focused analysis and problem solving), Extrinsic load (external forces affecting our focus) and Germane Load (that which we have already learned and/or automated to minimize acute effort)

This theory applies very well to what we do as physicians. Focus on this model can make the days better for our colleges, our patients and us. It also greatly affects the patient experience. This has application both on an individual level and a system level.

Key Points:

Improve our germane load capability.

  • Develop automatic behaviors regarding patient interaction that help with patient ownership and engagement.
  • Develop clinical facility with standards of care, necessary studies and labs regarding the most frequent diagnosis we see
  • How can we use our IT systems and daily rounding schedules to help with germane load?

Minimize our extrinsic load.

  • Organized structure for communication between colleagues and staff
  • Make things automatic as part of our workflow during the day
  • Set up work areas and expectations that minimize interruptions

Focus effort on our intrinsic load.

  • Intrinsic load is the area where we make the most difference in clinical decisions.
  • Focusing on the information and wishes that are patients are conveying
  • Input from different members of our teams to coordinate care
  • Intrinsic load is also where we provide great value for our patient’s experience
  • Is the cognitive component that provides professional satisfaction for physicians

Negative interactions, short tempers and fatigue area main symptoms of cognitive overload

“The Watchman’s Rattle” By Rebecca D. Costa was a book Dr. Harry recommended

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