The Relationship Between Time Spent Communicating and Communication Outcomes on a Hospital Medicine Service.
J Gen Intern Med. 2011 Sep 16;
Authors: Rothberg MB, Steele JR, Wheeler J, Arora A, Priya A, Lindenauer PK
BACKGROUND: Quality care depends on effective communication between caregivers, but it is unknown whether time spent communicating is associated with communication outcomes. OBJECTIVE: To assess the association between time spent communicating, agreement on plan of care, and patient satisfaction. DESIGN: Time-motion study with cross-sectional survey. SETTING: Academic medical center. PARTICIPANTS: Physicians, patients, and nurses on a hospital medicine service. MEASUREMENTS: Hospitalists' forms of communication were timed with a stopwatch. Physician-nurse agreement on the plan of care and patient satisfaction with physician communication were assessed via survey. RESULTS: Eighteen hospitalists were observed caring for 379 patients. On average, physicians spent more time per patient on written than verbal communication (median: 9.2 min. vs. 6.3 min, p?<?0.001). Verbal communication was greatest with patients (mean time 5.3 min, range 0-37 min), then other physicians (1.4 min), families (1.1 min), nurses (1.1 min), and case managers (0.4 min). There was no verbal communication with nurses in 30% of cases. Nurses and physicians agreed most about planned procedures (87%), principal diagnosis (74%), tests ordered (73%), anticipated discharge date (69%) and least regarding medication changes (59%). There was no association between time spent communicating and agreement on plan of care. Among 123 patients who completed surveys (response rate 32%), time physicians spent talking to patients was not correlated with patients' satisfaction with physician communication (Pearson correlation coefficient = 0.09, p?=?0.30). CONCLUSIONS: Hospitalists vary in the amount of time they spend communicating, but we found no association between time spent and either patient satisfaction or nurse-physician agreement on plan of care.
PMID: 21922161 [PubMed - as supplied by publisher]