Communication Coaching to Improve Patient and Clinician Satisfaction in Cardiology Encounters

Study Overview
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Brief Summary
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The purpose of this study is to determine the effect of a clinician communication coaching intervention versus control on an objective measure of the quality of communication (primary outcome) and patients' perceptions of the quality of patient-centered care (secondary outcome), both overall and within Black and White patients.

Detailed Description
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The investigators propose a two-arm cluster randomized controlled design, in which the unit of randomization is the clinician. Up to fifty cardiology clinicians will be randomly assigned to either the coaching intervention or to a control condition. The investigators will recruit up to 50 clinicians to ensure that we have at least 40 clinicians with complete pre- and post-intervention measures. Although the unit of randomization is the clinician, the unit of evaluation is the patient: 10 patients per clinician who get cardiology care from the enrolled clinicians will consent to audio-recording of their encounters and to completing the surveys. Clinicians randomized to the intervention will obtain verbal consent from additional patients to audio-record the encounter for coaching. The intervention will be delivered in the clinic or via video-conference (Skype or Facetime), providing individual coaching and professional feedback on the communication behaviors encounters. The investigators will also measure Press Ganey scores by clinician pre- and post-intervention.

Official Title
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Communication Coaching to Improve Patient and Clinician Satisfaction in Cardiology Encounters

Conditions
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Improved Communication Between Clinician and Patient

Intervention / Treatment
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* Behavioral: Communication Intervention


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patients must be 18 years or older Must be able to read Must speak English Capable of providing informed consent Must be receiving continuity care from and enrolled clinician Exclusion Criteria: Currently hospitalized Awaiting heart transplant

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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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Other
Allocation: Randomized
Intervention Model: Parallel Assignment
Interventional Model Description: Interventional: To determine the effect of a clinician communication coaching intervention versus control on an objective measure of the quality of communication (primary outcome) and patients' perceptions of the quality of patient-centered care (secondary outcome), both overall and within Black and White patients.
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| No Intervention: Standard of Care<br>Investigator will compare patients randomized into the intervention group to those who receive standard of care. | |
| Experimental: Communication Intervention<br>The intervention will contain elements of Motivational Interviewing coaching but also will teach providers how to address patient emotion and increase the efficiency of their visits. Clinicians randomized to the intervention will receive a tailored communication coaching intervention that includes didactic elements, audio recording encounters and providing feedback, and role-playing. | Behavioral: Communication Intervention<br>* . The intervention will contain elements of Motivational Interviewing coaching but also will teach providers how to address patient emotion and increase the efficiency of their visits. Clinicians randomized to the intervention will receive a tailored communication coaching intervention that includes didactic elements, audio recording encounters and providing feedback, and role-playing.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in quality of communication with black patients as measured by a summary of clinician-encounter counts derived from audio recordings | Determine the effect of a clinician communication coaching intervention versus control on racial disparities in objective measures of communication quality | Baseline, 7 months | 
| Change in quality of communication with white patients by continuous measure using a linear mixed-effects model. | Determine the effect of a clinician communication coaching intervention versus control on racial disparities in objective measures of communication quality | Baseline, 7 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in quality of patient-centered care as measured by a linear mixed-effects model via SAS PROC MIXED | Determine the effect of a clinician communication coaching intervention versus control on racial disparities in objective measures of communication quality and in the quality of patient-centered care | Baseline, 7 months |