Improving Communication Between Physicians and Dietitians:: Results of Physician Survey on Charting Methods

Abstract

Hospital chart notes are a major route of communication between physicians and dietitians. Too often, however, there is a discrepancy between what dietitians provide in their notes and what physicians actually require. Lengthy notes with redundant information may result in the failure of recommendations to be implemented. To assess the charting methods at our institution, we designed a survey to directly ask physicians what they expect and prefer from the dietitians’ chart notes. Surveys were distributed to 135 physicians in various specialties throughout the medical center; 112 were returned (83%). Among the results, 47% of the respondents felt that chart notes were too long, and, of these, 93% said that this hindered them from reading the notes more often. Physicians identified recommendations (95%), estimated nutritional needs (61%), and nutritional assessment (60%) as the most helpful parts of the notes. Subjective comments (49%) and lists of laboratory values/medications (44%) were parts that respondents did not find useful and felt could be omitted. The majority of physicians (71%) preferred to be notified of dietitians’ recommendations through the chart note. These results will be used in our institution to restructure the nutrition information and recommendations provided to physicians. In this era of outcome-based health care, it is essential that dietitians continually take steps to increase the likelihood that recommendations are carried out and that patients ultimately benefit from the intervention.