The four steps encompass a “physician communication bundle” developed by a group of VHA hospitals. Physicians from several VHA member hospitals met and examined research on physician communication to identify and then test communication behaviors that eventually became part of the bundle.
The four steps – referred to as “GSWW” – are as follows:
1. Enter with a Warm greeting. Knock on the door, introduce yourself and your role, and give your business card to the patient, explained Ms. DeMotte.
2. Sit down. Ensure you are on the same level as the patient.
3. Ask a Worry question. Don’t ask patients if they have any questions. Rather, ask: “What are your concerns and worries?”
4. Write the care plan on a whiteboard in the patient room. This ensures that it is always available to the patient.
Ms. DeMotte also recommended a fifth step of asking the patient to teach back what you have told him or her. For example, you might ask a patient to tell you what he plans to tell his wife about his diagnosis.
