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J Gen Intern Med. 2012 Feb;27(2):185-9. doi: 10.1007/s11606-011-1857-8. Epub 2011 Sep 16.

The relationship between time spent communicating and communication outcomes on a hospital medicine service.

Author information

  • 1Center for Quality of Care Research, Springfield, MA, USA. Michael.Rothberg@bhs.org

Abstract

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 - indexed for MEDLINE]
PMCID:
PMC3270236
Free PMC Article

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