Clinical trial NCT03403660: Physician Attire and Appreciation of Physician Communication in Postpartum Women
Official title: Physician Attire and Appreciation of Physician Communication in Postpartum Women
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Patient Satisfaction
Keywords: Attire
White coat
Patient physician communication
Lead sponsor: The University of Texas Medical Branch, Galveston
Sponsor class: OTHER
First posted: 2018-01-18
Enrollment: 178
Sex: FEMALE
Minimum age (years): 18
Maximum age (years): 50
Standard ages: ADULT
Accepts healthy volunteers: yes
Allocation: RANDOMIZED
Intervention model: PARALLEL
Intervention model description: Women are randomly assigned to having their postpartum physician team wear a white coat (WC) or not (no-WC) during rounds.
Primary purpose: OTHER

Brief summary: 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: 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.

Eligibility criteria: 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

Primary outcomes:
measure: Patient - physician communication score
timeFrame: 24 to 120 hours
Secondary outcomes:
measure: Hospital rating scores
timeFrame: 24 to 120 hours
measure: Recommending the hospital to friends and family
timeFrame: 24 to 120 hours
measure: Physician attire rating score
timeFrame: 24 to 120 hours
measure: White coat use
timeFrame: 24 to 120 hours
Other outcomes:
Locations:
city: Galveston
country: United States
facility: Universty of Texas Medical Branch
state: Texas
Study officials:
affiliation: University of Texas
name: Mauricio La Rosa, MD
role: STUDY_DIRECTOR
References: