Optimizing Hospitalist-Patient Communication: An Observation Study of Medical Encounter Quality

Abstract

Optimizing patient-hospitalist interactions heightens patient satisfaction, improves patient health outcomes, and improves hospitalist job satisfaction. A study was conducted to recognize hospitalist communication that enhance encounters, identify hospitalist behaviors for improvement interventions, and explore the association of time and gender with communication quality. Researchers observed encounters between 36 hospitalists and 206 adult patients. All but 1 of the hospitalists was observed at a 410-bed, general medical and surgical facility in the Midwest. On the adapted Kalamazoo Essential Elements of Communication Checklist (KEECC), hospitalists scored highest on the Builds a Relationship, Shares Information, and Gathers Information dimensions. Participants were seen using multiple, effective verbal and nonverbal techniques to show care and concern, as well as create relational rapport, often while successfully sharing and obtaining clinical information. Hospitalists scored lowest on the Understands the Patient Perspective and Reaches Agreement dimensions. Hospitalists were observed infrequently and inconsistently empathizing with patients and rarely attempting to gain shared understanding and agreement from patients. Significant difference was found in sharing information (t [194] = 2.47; p = 0.01), with male hospitalists (mean [M] = 4.14; standard deviation [SD] = 1.01) more highly rated than female hospitalists (M = 3.78; SD = 0.90). Hospitalist and patient gender match revealed significant difference in sharing information (F [3,192] = 2.60; p = 0.05). Male hospitalists were rated higher interacting with female patients than female hospitalists interacting with male patients. Results identify specific hospitalist communication techniques that may ultimately contribute to better-quality medical encounters. Communication interventions are recommended.