Improving Discharge Communication in the Emergency Department Through Information Structuring

Study Overview
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Brief Summary
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The goal of the proposed study is to assess the potential of information structuring for improving discharge communication. Specifically, the investigators aim to examine the advantages of an information-structuring skills training for physicians (compared to an empathy skills training) on discharge communication and associated patient outcomes, such as patients' information recall and adherence to physician recommendations. The investigators hypothesize that patients receiving structured discharge information from their trained physicians will be able to recall more information and show higher adherence to recommendations relative to controls (i.e., patients receiving discharge information from doctors trained in empathy skills).

Official Title
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Improving Discharge Communication in the Emergency Department Through Information Structuring: A Cluster Randomized Controlled Trial

Conditions
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Information Structuring Skills, Empathy Skills

Intervention / Treatment
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* Behavioral: Communication skills training empathy skills
* Behavioral: Communication skills training information structuring skills


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Outpatients with chest pain Outpatients with abdominal pain Exclusion criteria: Patients younger than 18 years of age (limited ability to provide informed consent) Patients with limited ability to communicate in German, the default language at the hospital (confounder related to language proficiency) Patients with dementia (confounder arising from pathological memory deficits)

Ages Eligible for Study
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Minimum Age: 18 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: Health Services Research
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Information structuring skills training<br>Physicians received a communication skills training focusing on information structuring with the so-called book metaphor for a structured discharge communication with the patient. | Behavioral: Communication skills training information structuring skills<br> <br> |
| Active Comparator: Empathy skills training<br>Physicians received a communication skills training focusing on empathy skills with the acronym NURSE for an empathetic discharge communication with the patient. | Behavioral: Communication skills training empathy skills<br> <br> |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Patients' recall of the information provided during discharge communication |  | 3 times: immediately after discharge, one week after discharge, one month after discharge | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Adherence to recommendations |  | 2 times: one week and one month after discharge | 
| Patient satisfaction in four dimensions | (1) comprehension, (2) structuredness (3) recommendation of the physician to family and friends (4) informativeness | Immediately after discharge | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Recall, Discharge communication, Satisfaction, Adherence, Information structuring, Empathy skills