The Impact Of Physician Communication On Family Inpatient Experience

Study Overview
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Brief Summary
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Patient satisfaction is affected by physician communication styles and communication at the bedside. The investigators are conducting a randomized controlled trial involving both providers and families to determine if providers sitting down while talking with families, will improve one aspect of quality care delivered during an inpatient stay as measured by patient/family satisfaction. The investigators will additionally study the affects of the intervention on the following outcomes: family assessment of provider communication, readmission rates, and length of stay.

Official Title
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The Impact Of Physician Communication On Family Inpatient Experience

Conditions
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Parental/Patient Satisfaction

Intervention / Treatment
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* Behavioral: Sitting
* Behavioral: Standing


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Providers: all attendings, residents, and medical students involved in the care of patients on the pediatric inpatient wards during the study period. Families (Parents or legal guardians and children): (1) inpatient admissions to the pediatrics medical service at Boston Medical Center (2) whose parents or guardian have agreed to participate in family centered walk rounds (3) patients age 17 or younger who have family members present at the bedside each morning of hospitalization (4) English speaking. Exclusion Criteria: (1) All patients/families that as part of admission justification involves social assessment and concern by the patient care team, including patients with neonatal abstinence syndrome, child maltreatment, and concern for neglect. (2) All patients transferred to or from PICU as part of their inpatient care (3) All patients transferred from an outside institution to the inpatient ward for further care secondary to progression of disease.

Ages Eligible for Study
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Maximum Age: 17 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Supportive Care
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Provider sitting<br>Providers seated during communication through hospitalization | Behavioral: Sitting<br>* Providers will sit during inpatient family-centered walk rounds throughout the communication during rounds. The participating members of the care team (attending physician, resident and medical student) will remain seated while communicating with the patient and caregiver.<br>|
| Experimental: Provider standing (control)<br>Providers standing during communication through hospitalization | Behavioral: Standing<br>* Providers will stand during inpatient family-centered walk rounds throughout the communication during rounds. The participating members of the care team (attending physician, resident and medical student) will remain standing while communicating with the patient and caregiver.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Patient/family satisfaction | Questionnaire obtains basic provider information | 4mo | 
| Patient/family Satisfaction | Caregiver questionnaire obtains baseline information on caregiver and patients | 4 mo | 
| Patient/family satisfaction | PSQ-18: Assesses parental satisfaction with medical care | 4 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Length of stay | Chart review of length of inpatient hospitalization during intervention | 4 months | 
| Readmission rate | Chart review and parental contact regarding readmission for same reason of initial hospitalization | 5 mo | 
| Family discharge preparedness | Brief PREPARED instrument | 4 mo | 
| Follow-up appointment attendance | Chart review and communication with caregivers regarding keeping follow-up appointment | 5 mo | 
| Family assessment of doctor-patient communication skills | Crossley Communication Questionnaire | 4 mo |