School of Medicine and Health Sciences Poster Presentations

Title

What's the Plan? Improving Physician Patient Communication in the Hospital

Document Type

Poster

Keywords

Patient Care Plan; Patient Satisfaction; Quality Improvement; Physician Cross Covering

Publication Date

Spring 2017

Abstract

Objective/Background:
For hospitalized inpatients, the medical plan of care often changes throughout the day based on the results of lab work, imaging, and consultant recommendations. What is presented as the plan of care to the patient by the medical team at the start of the day may differ by the end of the day. These changes, while expected, may be perceived as miscommunication and serve as a source of anxiety and confusion for patients and their families. In addition, duty hour regulations create additional handoffs of patient care between day and night teams, further emphasizing the need for proper and consistent communication.

Aim Statement:
To reduce the number of overnight cross cover team phone calls regarding patient plans of care by 50% by June 15, 2017.

Methods:
Plan-do-Study-Act (PDSA) cycles were completed using pre-printed templates, referred to as plans of care (PC) that included spaces to fill in patient-specific plans that were the most pertinent sources of overnight questions by the patient, nursing staff, and families. PDSA cycle 1 consisted of the complete plan of care distributed to one patient on one day. PDSA cycle 2 consisted of this PC being handed to family members present during rounds on four separate occasions. PDSA cycle 3 involved adjusting the time of handing out the PC as well as adjusting how the PC was distributed. Ultimately the PC was posted to the patients' rooms for PDSA cycle 4.

Results:
Initially handing the PC to the patient was unsuccessful; however on incorporating the PC onto the patient room wall, families that knew about the update were overall more satisfied with the care provided. Families stated "this is very helpful," patient's expressed gratitude, and both responded to the PC being easily visible at all times with quotes such as "thank you for leaving this here" and "will look at that when I forget everything you just said."

Conclusions:
Communicating with patients and their families with reinforcement of a document that outlines major points in the plan of care for the day leads to less anxiety, concern, and overall increased satisfaction of care in the hospital. Analysis will next include assessing the numbers of times cross cover teams are contacted overnight by patients and/or families about their plans of care. Subsequently, we hope to evaluate patient satisfaction through a post hospital discharge survey to patients and a family member.

Creative Commons License

Creative Commons License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License.

Open Access

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Comments

Poster to be presented at GW Annual Research Days 2017.

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What's the Plan? Improving Physician Patient Communication in the Hospital

Objective/Background:
For hospitalized inpatients, the medical plan of care often changes throughout the day based on the results of lab work, imaging, and consultant recommendations. What is presented as the plan of care to the patient by the medical team at the start of the day may differ by the end of the day. These changes, while expected, may be perceived as miscommunication and serve as a source of anxiety and confusion for patients and their families. In addition, duty hour regulations create additional handoffs of patient care between day and night teams, further emphasizing the need for proper and consistent communication.

Aim Statement:
To reduce the number of overnight cross cover team phone calls regarding patient plans of care by 50% by June 15, 2017.

Methods:
Plan-do-Study-Act (PDSA) cycles were completed using pre-printed templates, referred to as plans of care (PC) that included spaces to fill in patient-specific plans that were the most pertinent sources of overnight questions by the patient, nursing staff, and families. PDSA cycle 1 consisted of the complete plan of care distributed to one patient on one day. PDSA cycle 2 consisted of this PC being handed to family members present during rounds on four separate occasions. PDSA cycle 3 involved adjusting the time of handing out the PC as well as adjusting how the PC was distributed. Ultimately the PC was posted to the patients' rooms for PDSA cycle 4.

Results:
Initially handing the PC to the patient was unsuccessful; however on incorporating the PC onto the patient room wall, families that knew about the update were overall more satisfied with the care provided. Families stated "this is very helpful," patient's expressed gratitude, and both responded to the PC being easily visible at all times with quotes such as "thank you for leaving this here" and "will look at that when I forget everything you just said."

Conclusions:
Communicating with patients and their families with reinforcement of a document that outlines major points in the plan of care for the day leads to less anxiety, concern, and overall increased satisfaction of care in the hospital. Analysis will next include assessing the numbers of times cross cover teams are contacted overnight by patients and/or families about their plans of care. Subsequently, we hope to evaluate patient satisfaction through a post hospital discharge survey to patients and a family member.