It's a catalyst for improvement

doi:10.1136/bmj.39156.553565.FA

BMJ 2007;334:599 (24 March), doi:10.1136/bmj.39156.553565.FA

Letters

Access to records

It's a catalyst for improvement

The first 150 words of the full text of this article appear below.

We must not lose sight of the potential of universal patientrecord access to fundamentally change the quality of consultations.¹The key step in any consultation is to reach a shared understandingof the problem with the patient: expectations, hopes, and fearsare identified and what can and cannot be done explicitly isdiscussed and acted on.² In a series of educational assessmentsof the consultation skills of volunteer experienced UK generalpractitioners, the most common recommendation for improvementwas identifying the patient's reasons for consulting (77% ofparticipants)³ and the fourth most common was collaboratingwith the patient in agreeing management plans (23% of participants;unpublished data), vividly demonstrating that the achievementof shared understanding can be improved.

When patients can assess the records we make of their consultations,the gap between their agendas and our actions will become explicitand a powerful catalyst for us to improve our . . . [Full text of this article]

Robert K McKinley, professor of academic general practice¹, Richard H Baker, professor of quality of health care²

¹ Keele University Medical School, Keele University, Staffordshire ST5 5BG, ² Department of Health Sciences, University of Leicester, Leicester LE1 6TP

r.k.mckinley@hfac.keele.ac.uk