The History of the PAC-CARD

During the summer of 2007, whilst on holiday in Spain I broke my ankle, badly. This accident led to me having surgery with a five-day stay in a hospital in Spain. And then on the way home through France, I was looked after by various medical practitioners. During the next year, back in Amsterdam where I live, I had to make numerous visits to Dutch hospitals.

Over this whole period I had many meetings with different doctors, nurses and health specialists. The wide variety of these peoples’ communication skills was remarkable. I was grateful to those who listened well and were informed. I was all too often distressed, angered and confused by the miscommunications.

Almost every friend, colleague or acquaintance that I talked with, had similar stories; the hospital or country made little difference. The recurring problem seemed to be how helpless, frightened and unintelligent we, the patients, would become, when faced with our ailing health combined with having to communicate with (all too often inarticulate) professional practitioners in Hospitals and Health Centers.

It became clear to me that to attempt to improve individual doctors and healthworkers’ communication skills, as well as hospital communication protocol was ‘mission impossible’.

But what I could do was create a card with a list of questions to support me and make me not only emotionally brave but also mentally clear enough to ask the best questions and find out the necessary information to guide my own journey back (hopefully) to health.

Over the next year, after many conversations plus the input of patient / friends and encouraged by a positive response from Dr. R. W. Poolman (my orthopedic surgeon), I collated the PAC-CARD (Patient’s Action Communication Card).

Dr. R.W. Poolman was particularly enthusiastic that this guide for effective patient / health-worker communication was instigated by a patient. He believed that in this way it would not contain any hospital, doctor or insurance company bias or subtext. In 2011/2012 a pilot clinical trial was set up at the OLVG Amsterdam by Jeanet Rooseman, Vanessa Scholtes and Dr. R. W. Poolman assessing the effectiveness of the PAC-CARD, the following was concluded:

"The primary analysis with regard to patient satisfaction in patient-caregiver communication showed that the **PAC-CARD** had a positive impact on two aspects of patient satisfaction in the intervention group. Patient satisfaction regarding quality of care and the way of communication improved significantly in the intervention group. To support patients in a more structured way of communicating the **PAC-CARD** is recommended to be used by patients. It helps patients communicate more effectively and patients are more satisfied with the quality of care and communication. When looking at implications for further research, it is important to carry out research in a larger study population. In conclusion, further investigation will be conducted within the OLVG.”

In 2012 I wrote the book The Patient’s Guide – THINK . ASK . KNOW This book is a concise explanation of why and how to use the PAC-CARD. It includes a copy of the PAC-CARD as well as space for you to write your own notes. Should either yourself, friends or family at any time need to talk with medical professionals then I hope the PAC-CARD and this book will support and guide you to successfully: think clearly, ask questions and know that people are listening to you. And in this way help you to make the best decisions along the way. The Patient’s Guide can be bought online world-wide through Amazon, Lulu and many other platforms.

June 2013 a Dutch version of this book was published by Kosmos Uigevers under the title ‘Zo praat je met je arts’ Now available in book shops in the Netherlands as well as on line.

Please feel free to contact me with any feedback and ideas.