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Patient Interactive Rating: An Original Communication Assessment Tool For Health Care Providers and Patient Encounters.ã

A semi quantitative, personal, and momentary measurement of the level of communicative interaction achieved with a particular patient at a particular point in time in health or disease.

Level

Description of Communication

0

Patient does not seem to respond either with body language or verbal language to the presence, gestures or stimuli of health care provider.

1

Patient seems to be responding to some stimuli but NOT necessarily to stimuli provided by the heath care provider.

2

Patient is addressing the health care provider but either the gestures and/or the verbal language are not comprehensible.

3

This is standard communication between two parties. Patient and health care provider interchange gestures and language with nearly full understanding of the messages interchanged.

4

This is the same as in 3 above but with the addition that there is a witness, a family member, a nurse, a fire rescue paramedic or someone who can attest and validate certain elements of the medical history.

Explanatory Notes:

An encounter where there is evidence of a waxing and waning level of communication may be documented by two levels; For example: 1®2 for encounters where the patient – in the first instance seemed to be wildly behaving but then began to attempt to direct his communication towards the health care provider. Or in another example, 2®3 to denote an encounter where the patient began trying to communicate but not being understood and later he made himself or herself understood.

Note these encounters. If a patient has PIR of 1 and a relative comes in and provides information regarding his medical history, specifically the present illness, that should be designated 1®4.

If a patient cannot verbally communicate with you because of a serious language barrier and a nurse who saw the patient come into the ER is there are translates the historical clinical data for you, that should be designated 2®4. The designation 3®4 is essentially 4 by definition.