Most client histories begin before a person realizes they have a hearing loss and extend long after their final visit to a hearing care professional. By understanding the journey people with hearing loss go through on their path to rehabilitation, professionals can better address their clients’ experiences and collaborate with them for better outcomes.
A Patient Journey assists hearing care professionals in understanding their client’s point of view and recognizing where they are on their journey. It supports students and clinicians in mapping the rehabilitation journey and can be used as a starting point for understanding the complex phases and numerous milestones of hearing loss.
A Patient Journey is based on the Transtheoretical Model — also known as the Stages of Change. The model has six stages (Pre-contemplation, Contemplation, Preparation, Action, Maintenance, and Relapse) and intervention strategies for each to help people move to the next stage. The model was developed in the 1970s through studies examining people who were able to quit smoking on their own versus those who required further treatment to change their behavior.
The term “patient journey” has been used extensively in the medical field to describe the touchpoints between patients, medical professionals, and stakeholders. The emphasis is usually on how patients proceed through a care system such as a hospital or clinic.
A Patient Journey maps the internal stages of change a person goes through from the realization of hearing loss to successful rehabilitation and management of their hearing loss. Understanding how a typical patient journey may look creates a richer context for the interaction between the client and professional and allows the professional to provide the most appropriate support at the right time.
Traditional medical model
Patient journeys are typically part of the treatment protocol in the medical model. In this model, the approach to gathering information is physician-centered and focuses on problems and symptoms. Clients are not encouraged to share their stories. In the medical model, the professional is the expert and is responsible for what takes place during the appointment. They diagnose the problem, determine a solution, and advise how to proceed with treatment.
In the medical model, the patient intake interview is an exchange of information about the patient's specific illness. Clinicians see and define the journey from the medical point of view. When did the problem start? What are the symptoms? What the medical model does not take into account is that people come into the appointment with unique experiences, social environments, communication needs, and cultural backgrounds.
Toward a person-centered model
One of the most important characteristics of the person-centered approach is that the interaction between the clinician and client is perceived as a partnership. In this case, the hearing care professional is the expert in the field of audiology and the client is the expert in their own experience with hearing loss. In this more responsive model, professionals engage the client in a dialogue that respects their point of view.
According to Miller and Rollnick, motivational interviewing can facilitate behavior change by helping clients to explore and resolve their ambivalence about adopting or ceasing a behavior.
A Patient Journey provides a basis for understanding the client's story and incorporating motivational interviewing in the appointment to empower clients to become joint decision-makers in their treatment plans.
Benefits of a person-centered approach
Abdel-Tawab and Roter found that person-centered consultations took only one minute longer than physician-centered consultations but resulted in a threefold increase in client satisfaction and greater adherence to treatment. The quality of client outcomes is inextricably tied to the ability of the hearing care professional to listen to the client's perspective and to explore their readiness and motivation for treatment — in other words, to provide person-centered care based on an understanding of the client’s individual patient journey.