scholarly journals What is the impact of physician communication and patient understanding in the management of headache?

2008 ◽  
Vol Volume 3 ◽  
pp. 893-897
Author(s):  
Greg Samsa
Keyword(s):  
Physician Communication ◽  
Patient Understanding ◽  
The Impact

Communication Between Physicians and Older Women With Localized Breast Cancer: Implications for Treatment and Patient Satisfaction

2002 ◽  
Vol 20 (4) ◽  
pp. 1008-1016 ◽  
Author(s):  
Wenchi Liang ◽  
Caroline B. Burnett ◽  
Julia H. Rowland ◽  
Neal J. Meropol ◽  
Lynne Eggert ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Cancer Care ◽  
Treatment Options ◽  
Treatment Choice ◽  
Satisfaction With Care ◽  
Physician Communication ◽  
Breast Cancer Patients ◽  
Actual Treatment ◽  
The Impact

PURPOSE: To identify factors associated with patient-physician communication and to examine the impact of communication on patients’ perception of having a treatment choice, actual treatment received, and satisfaction with care among older breast cancer patients. MATERIALS AND METHODS: Data were collected from 613 pairs of surgeons and their older (≥ 67 years) patients diagnosed with localized breast cancer. Measures of patients’ self-reported communication included physician- and patient-initiated communication and the number of treatment options discussed. Logistic regression analyses were conducted to examine the relationships between communication and outcomes. RESULTS: Patients who reported that their surgeons mentioned more treatment options were 2.21 times (95% confidence interval [CI], 1.62 to 3.01) more likely to report being given a treatment choice, and 1.33 times (95% CI, 1.02 to 1.73) more likely to get breast-conserving surgery with radiation than other types of treatment. Surgeons who were trained in surgical oncology, or who treated a high volume of breast cancer patients (≥ 75% of practice), were more likely to initiate communication with patients (odds ratio [OR] = 1.62; 95% CI, 1.02 to 2.56; and OR = 1.68; 95% CI, 1.01 to 2.76, respectively). A high degree of physician-initiated communication, in turn, was associated with patients’ perception of having a treatment choice (OR = 2.46; 95% CI, 1.29 to 4.70), and satisfaction with breast cancer care (OR = 2.13; 95% CI, 1.17 to 3.85) in the 3 to 6 months after surgery. CONCLUSION: Greater patient-physician communication was associated with a sense of choice, actual treatment, and satisfaction with care. Technical information and caring components of communication impacted outcomes differently. Thus, the quality of cancer care for older breast cancer patients may be improved through interventions that improve communication within the physician-patient dyad.

scholarly journals A Novel Survey to Examine the Relationship between Health IT Adoption and Nurse-Physician Communication

2016 ◽  
Vol 07 (04) ◽  
pp. 1182-1201 ◽  
Author(s):  
Eric Pfeifer ◽  
Milisa Manojlovich ◽  
Julia Adler-Milstein ◽  
A Holmgren
Keyword(s):  
Physician Communication ◽  
Full Potential ◽  
It Adoption ◽  
Health It ◽  
Secure Messaging ◽  
Software Adoption ◽  
Wide Range ◽  
Communication Practices ◽  
The Impact ◽  
The Relationship

SummaryBackground As EHR adoption in US hospitals becomes ubiquitous, a wide range of IT options are theoretically available to facilitate physician-nurse communication, but we know little about the adoption rate of specific technologies or the impact of their use.Objectives To measure adoption of hardware, software, and telephony relevant to nurse-physician communication in US hospitals. To assess the relationship between non-IT communication practices and hardware, software, and telephony adoption. To identify hospital characteristics associated with greater adoption of hardware, software, telephony, and non-IT communication practices.Methods We conducted a survey of 105 hospitals in the National Nursing Practice Network. The survey captured adoption of hardware, software, and telephony to support nurse-physician communication, along with non-IT communication practices. We calculated descriptive statistics and then created four indices, one for each category, by scoring degree of adoption of technologies or practices within each category. Next, we examined correlations between the three technology indices and the non-IT communication practices index. We used multivariate OLS regression to assess whether certain types of hospitals had higher index scores.Results The majority of hospitals surveyed have a range of hardware, software, and telephony tools available to support nurse-physician communication; we found substantial heterogeneity across hospitals in non-IT communication practices. More intensive non-IT communication was associated with greater adoption of software (r=0.31, p=0.01), but was not correlated with hardware or telephony. Medium-sized hospitals had lower adoption of software (r =−1.14,p=0.04) in comparison to small hospitals, while federally-owned hospitals had lower software (r=−2.57, p=0.02) and hardware adoption (r=−1.63, p=0.01).Conclusions The positive relationship between non-IT communication and level of software adoption suggests that there is a complementary, rather than substitutive, relationship. Our results suggest that some technologies with the potential to further enhance communication, such as CPOE and secure messaging, are not being utilized to their full potential in many hospitals.Citation: Holmgren AJ, Pfeifer E, Manojlovich M, Adler-Milstein J. A novel survey to examine the relationship between health IT adoption and nurse-physician communication.

Patient-physician communication about code status preferences: A randomized controlled trial.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. 9049-9049 ◽  
Author(s):  
Wadih Rhondali ◽  
Pedro Emilio Perez-Cruz ◽  
David Hui ◽  
Gary B. Chisholm ◽  
Shalini Dalal ◽  
...  
Keyword(s):  
Controlled Trial ◽  
Physician Communication ◽  
Do Not Resuscitate ◽  
Care Clinic ◽  
White Ethnicity ◽  
Code Status ◽  
Randomized Controlled ◽  
Physician Patient ◽  
The Impact ◽  
Very High

9049 Background: Code status discussions are important in cancer care. The best modality for such discussions has not been established. Our objective was to determine the impact of a physician ending a code status discussion with a question (autonomy approach) versus a recommendation (beneficence approach) on patients’ do-not-resuscitate (DNR) preference. Methods: Patients in a supportive care clinic watched two videos showing a physician-patient discussion regarding code status. Both videos were identical except for the ending: one ended with the physician asking for the patient’s code status preference and the other with the physician recommending DNR. Patients were randomly assigned to watch the videos in different sequences. The main outcome was the proportion of patients choosing DNR for the video patient. Results: 78 patients completed the study. 74% chose DNR after the question video, 73% after the recommendation video (p=NS). Median physician compassion score was very high and not different for both videos (p=0.73). 30/30 patients who had chosen DNR for themselves and 30/48 patients who had not chosen DNR for themselves chose DNR for the video patient (100% v/s 62%, p<0.001). Age (OR=1.1/year, p=0.01) and white ethnicity (OR=9.43, p=0.004) predicted DNR choice for the video patient. Conclusions: Ending DNR discussions with a question or a recommendation did not impact DNR choice or perception of physician compassion. Therefore, both approaches are clinically appropriate. All patients who chose DNR for themselves and most patients who did not choose DNR for themselves chose DNR for the video patient. Age and race predicted DNR choice.

scholarly journals Geographically Localized Medicine House-Staff Teams and Patient Satisfaction

2018 ◽  
Vol 6 (1) ◽  
pp. 46-52
Author(s):  
Zishan Siddiqui ◽  
Amanda Bertram ◽  
Stephen Berry ◽  
Timothy Niessen ◽  
Lisa Allen ◽  
...  
Keyword(s):  
Patient Satisfaction ◽  
Patient Experience ◽  
Discharge Planning ◽  
Chief Resident ◽  
House Staff ◽  
Direct Care ◽  
Physician Communication ◽  
Inpatient Service ◽  
Team Members ◽  
The Impact

Background: Geographically localized care teams may demonstrate improved communication between team members and patients, potentially enhancing coordination of care. However, the impact of geographically localized team on patient experience scores is not well understood. Objective: To compare experience scores of patients on resident teams home clinical units with patients assigned to them off of their home units over a 10-year period. Participants: Patients admitted to any of the 4 chief resident staffed internal medicine inpatient service were included. Patients admitted to the house-staff teams’ home clinical unit comprised the exposure group and their patients off of their home units comprised the control patients. Measurement: Top-box experience scores calculated from the physician Hospital Consumer Assessment of Healthcare and Provider Systems (HCAHPS) and Press Ganey patient satisfaction surveys. Results: There were 3012 patients included in the study. There were no significant differences in experience scores with physician communication, nursing communication, pain, or discharge planning between the 2 groups. Patients did not report satisfaction more often with the time physicians spent with them on localized teams (48.6% vs 47.5%; P = .54) or that staff were better at working together (63.2% vs 61.3%; P = .29). This did not change during a 45-month period when the proportion of patients on home units exceeded 75% and multidisciplinary rounds were started. Conclusion: Patients cared for by geographically localized teams did not have better patient experience. Other factors such as physician communication skills or limited time spent in direct care may overshadow the impact of having localized teams. Further research is needed to better understand organizational, team, and individual factors impacting patient experience.

THUR 075 Evaluating a personal information pack in epilepsy

2018 ◽  
Vol 89 (10) ◽  
pp. A8.3-A8
Author(s):  
Edmond Evan ◽  
Mehta Arpan ◽  
Taylor Alison ◽  
Jacob John
Keyword(s):  
Personal Information ◽  
Low Cost ◽  
Educational Interventions ◽  
Teaching Methodology ◽  
Service Utilisation ◽  
Specialist Nurse ◽  
Patient Understanding ◽  
Patient Rating ◽  
Information Pack ◽  
The Impact

A mainstay of epilepsy management is patient education and engagement. Previous educational interventions have varied greatly in number of sessions, teaching methodology and cost. This study assessed the impact of a low-cost intervention consisting of a personal information pack.MethodsForty-six consecutive patients with an existing epilepsy diagnosis attending clinic at MKUH NHS Trust were enrolled and pack provided. A baseline questionnaire assessed patient understanding and service utilisation (GP, A and E, specialist nurse). The questionnaire was repeated 3 months later. Patient engagement with the pack was assessed (completeness of information in pack, patient rating of usefulness).ResultsFourteen patients were lost to follow-up - thirty-two completed the second interview. There was a trend towards reduced service utilisation. Specialist nurse visits were significantly reduced (2.75 visits/year pre-intervention vs 1.11 post-intervention, p=0.01). Patient understanding was not significantly changed. Patient rating of usefulness was positive (2.4/3 on Likert scale). Two thirds of patients had not filled out the pack or added basic details only.DiscussionThis simple, low cost intervention may reduce some types of service utilisation and be found helpful by patients. A planned redesign involves the provision of a low-effort pre-filled information card together with the larger pack.

The Impact of Computerized Decision Support on the Ability to Supervise Resident Physician Sign-Outs

2014 ◽  
Vol 3 (1) ◽  
pp. 178-185
Author(s):  
Austin F. Mount-Campbell ◽  
Chad A. Weiss ◽  
Nicole Andonian ◽  
Andrew Duchon ◽  
James O’Brien ◽  
...  
Keyword(s):  
Decision Support ◽  
Best Practices ◽  
Communication Strategies ◽  
Resident Physician ◽  
Physician Communication ◽  
Computerized Decision Support ◽  
Resident Physicians ◽  
Study Participants ◽  
Attending Physicians ◽  
The Impact

Attending physicians need to supervise resident physician sign-outs in order to ensure patient safety. In one survey study, 59% of resident physicians reported at least one case of harm to one of their patients due to communication issues during sign-outs in their last rotation. In prior research, we identified ‘best practices’ for sign-outs used by attending physicians. For the outgoing physician, communication strategies improve the informativeness, structure, and coverage of the information. For the incoming physician, communication strategies focus on minimizing interruptions, active listening, and assertively questioning the accuracy of contentious decisions. These may include diagnoses, treatment plans, and prognoses. Real-time monitoring of four teams of resident physicians conducting sign-outs simultaneously is extremely difficult for attending physicians without computerized decision support. In this study, we examined the impact of providing automated highlights of sign-out transcripts on the ability to judge the quality of the sign-out. A between-subject design was employed to compare performance with a system displaying four transcripts of sign-outs simultaneously vs. one with the automated highlights on the transcripts. Study participants were 16 fourth-year medical students. Hypothesized benefits of the computerized support on performance and efficiency were not detected. One explanation is that the participants did not understand or agree with the best practice communication strategies, which were used in the design of the highlighted information. Nevertheless, study participants without the computerized support were more likely to judge the supervisory task as not able to be performed safely (p<0.05). All study participants reported that they would be more comfortable performing the task if they were already familiar with the patients (p<0.05). Implications of the study findings include design revisions to the computerized support and the need to provide training on best practices for software assisted sign-outs.

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