Physician Attire and Appreciation of Physician Communication in Postpartum Women

Study Overview
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Brief Summary
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Wearing white coat during hospital rounds has been associated with increased risk of colonization and transmission of resistant pathogens. On the other hand, studies have shown that physicians' attire affects patients' confidence in their physician and the patient-physician relationship. The results of these studies were highly dependent on the practice setting, with no data in postpartum patients. The objective is to test the hypothesis that not wearing a white coat during physician postpartum rounds impact patient-physician communication scores.

Detailed Description
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Patient satisfaction is an important measure of quality of care. One of the most important variables in patients satisfaction scores is the physician communication skills. There have been several studies evaluating different strategies to improve the patient perceptions of patient - physician communication including delayed physician rounds, improvement of handoff strategies, and family centered rounds. Additionally, research has shown that patients develop a first impression of their physician based on the physician's verbal and nonverbal communication, including the clothing and cleanliness. Patient - physician communication scores not only have an impact on patient care, but are also now linked to Medicare reimbursements. White coats have been widely used in the medical profession, however some physicians believe that this can be a nonverbal barrier to patient's interaction. Prior studies on the impact of physician attire have reported conflicting results. In a survey published by Cha et al, obstetric and gynecologic patients seen in the outpatient clinic preferred that the resident use white coats. Another study showed that patients favor the use of white coat in the Internal Medicine outpatient clinic which may favorably influence trust and confidence in the medical encounter. No randomized controlled trial has been published on the impact of the use of white coat on patient - physician communication scores in the postpartum patients. This trial's primary outcome is to evaluate the impact of physician attire (specifically wearing white coat) during postpartum rounds on patient - physician communication scores. This study is a randomized controlled trial performed in postpartum patients to evaluate the impact of not wearing white coat during rounds on patient - physician communication scores.

Official Title
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Physician Attire and Appreciation of Physician Communication in Postpartum Women

Conditions
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Patient Satisfaction

Intervention / Treatment
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* Other: non White coat


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Maternal age ≥ 18 years and <50 years Patient admitted to postpartum floor at University of Texas Medical Branch (UTMB) Patient care managed by obstetric physicians during the postpartum period. Exclusion Criteria: Patient admitted to ICU Delivery resulting in stillbirth Patient not fluent in Spanish and/or English

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 50 Years

Sexes Eligible for Study
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Female

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: Women are randomly assigned to having their postpartum physician team wear a white coat (WC) or not (no-WC) during rounds.
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: non white coat rounding<br>The postpartum physician rounding in this group will be performed wearing white coat. | Other: non White coat<br>* Postpartum patients are randomized to either arm of the study (white coat or standard scrub suit only) by location. All the obstetric physicians associated with patient's postpartum care should use or not use white coat in every single encounter with patient.<br>|
| Placebo Comparator: White coat rounding<br>The postpartum physician rounding in this group will be performed not wearing white coat. | Other: non White coat<br>* Postpartum patients are randomized to either arm of the study (white coat or standard scrub suit only) by location. All the obstetric physicians associated with patient's postpartum care should use or not use white coat in every single encounter with patient.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Patient - physician communication score | Obtained from the three Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) questions. | 24 to 120 hours | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Hospital rating scores | Obtained from one question of the HCAHPS survey | 24 to 120 hours | 
| Recommending the hospital to friends and family | Obtained from one question of the HCAHPS survey | 24 to 120 hours | 
| Physician attire rating score | Rated from 1 to 4 | 24 to 120 hours | 
| White coat use | Patient answer if she remember or not if their physician were using white coat. | 24 to 120 hours | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Attire, White coat, Patient physician communication