Implement a Communication Tool in 5 Steps

Debra Shute, February 1, 2018

A quick and easy communication technique borrowed from outpatient family medicine keeps hospital clinicians focused and patients happy.

This article first appeared in the January/February 2018 issue of HealthLeaders magazine.

BATHE—which stands for Background, Affect, Trouble, Handling, and Empathy/Exit—is a brief psychosocial intervention designed to reduce distress and strengthen the physician-patient relationship. 

At the University of Virginia Health System (UVA), residents training in family medicine under Claudia Allen, JD, PhD, UVA associate professor and clinical psychologist, discovered almost by accident that this tool, used routinely in outpatient settings, helped significantly improve patient satisfaction scores in the hospital.

Patients that received the BATHE technique daily as part of a randomized controlled trial at UVA gave their doctors an average score of 4.77 compared with an average score of 4.0 for patients receiving standard care.

Step 1: Obtain buy-in

The primary obstacle in getting hospital physicians to use the BATHE intervention is the concern that asking the questions will take too much time, says Allen.

So at first, Allen and her residents decided to informally try BATHE with patients on their inpatient family medicine service during morning rounds.

"Physicians who get some training in BATHE find it quite easy, and they say that it helps turn an unfocused conversation, where maybe a patient is distressed or complaining, into a more focused and productive one."

—Claudia Allen, JD, PhD, associate professor and clinical psychologist, University of Virginia Health System

Debra Shute

Debra Shute is the Senior Physicians Editor for HealthLeaders Media.


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