Jason M Satterfield1, Sylvia Bereknyei, Joan F Hilton, Alyssa L Bogetz, Rebecca Blankenburg, Sara M Buckelew, H Carrie Chen, Bradley Monash, Jacqueline S Ramos, Stephanie Rennke, Clarence H Braddock. 1. Dr. Satterfield is professor of clinical medicine, Division of General Internal Medicine, University of California, San Francisco, San Francisco, California. Dr. Bereknyei is a research scholar, Stanford Center for Medical Education Research and Innovation, Stanford University, Stanford, California. Dr. Hilton is professor, Division of Biostatistics, University of California, San Francisco, San Francisco, California. Ms. Bogetz is project coordinator, Division of General Internal Medicine, University of California, San Francisco, San Francisco, California. Dr. Blankenburg is clinical assistant professor, General Pediatrics, Stanford University, Stanford, California. Dr. Buckelew is associate clinical professor, Department of Pediatrics, University of California, San Francisco, San Francisco, California. Dr. Chen is professor, Department of Pediatrics, University of California, San Francisco, San Francisco, California. Dr. Monash is assistant professor, Division of Hospital Medicine, University of California, San Francisco, San Francisco, California. Ms. Ramos is program coordinator, Stanford Center for Medical Education Research and Innovation, Stanford University, Stanford, California. Dr. Rennke is assistant professor, Division of Hospital Medicine, University of California, San Francisco, San Francisco, California. Dr. Braddock is vice dean for medical education, University of California, Los Angeles, Los Angeles, California.
Abstract
PURPOSE: To quantify the prevalence of social and behavioral sciences (SBS) topics during patient care and to rate team response to these topics once introduced. METHOD: This cross-sectional study used five independent raters to observe 80 inpatient ward teams on internal medicine and pediatric services during attending rounds at two academic hospitals over a five-month period. Patient-level primary outcomes-prevalence of SBS topic discussions and rate of positive responses to discussions-were captured using an observational tool and summarized at the team level using hierarchical models. Teams were scored on patient- and learner-centered behaviors. RESULTS: Observations were made of 80 attendings, 83 residents, 75 interns, 78 medical students, and 113 allied health providers. Teams saw a median of 8.0 patients per round (collectively, 622 patients), and 97.1% had at least one SBS topic arise (mean = 5.3 topics per patient). Common topics were pain (62%), nutrition (53%), social support (52%), and resources (39%). After adjusting for team characteristics, the number of discussion topics raised varied significantly among the four services and was associated with greater patient-centeredness. When topics were raised, 38% of teams' responses were positive. Services varied with respect to learner- and patient-centeredness, with most services above average for learner-centered, and below average for patient-centered behaviors. CONCLUSIONS: Of 30 SBS topics tracked, some were addressed commonly and others rarely. Multivariable analyses suggest that medium-sized teams can address SBS concerns by increasing time per patient and consistently adopting patient-centered behaviors.
PURPOSE: To quantify the prevalence of social and behavioral sciences (SBS) topics during patient care and to rate team response to these topics once introduced. METHOD: This cross-sectional study used five independent raters to observe 80 inpatient ward teams on internal medicine and pediatric services during attending rounds at two academic hospitals over a five-month period. Patient-level primary outcomes-prevalence of SBS topic discussions and rate of positive responses to discussions-were captured using an observational tool and summarized at the team level using hierarchical models. Teams were scored on patient- and learner-centered behaviors. RESULTS: Observations were made of 80 attendings, 83 residents, 75 interns, 78 medical students, and 113 allied health providers. Teams saw a median of 8.0 patients per round (collectively, 622 patients), and 97.1% had at least one SBS topic arise (mean = 5.3 topics per patient). Common topics were pain (62%), nutrition (53%), social support (52%), and resources (39%). After adjusting for team characteristics, the number of discussion topics raised varied significantly among the four services and was associated with greater patient-centeredness. When topics were raised, 38% of teams' responses were positive. Services varied with respect to learner- and patient-centeredness, with most services above average for learner-centered, and below average for patient-centered behaviors. CONCLUSIONS: Of 30 SBS topics tracked, some were addressed commonly and others rarely. Multivariable analyses suggest that medium-sized teams can address SBS concerns by increasing time per patient and consistently adopting patient-centered behaviors.
Authors: Rebecca Blankenburg; Joan F Hilton; Patrick Yuan; Stephanie Rennke; Brad Monash; Stephanie M Harman; Debbie S Sakai; Poonam Hosamani; Adeena Khan; Ian Chua; Eric Huynh; Lisa Shieh; Lijia Xie Journal: J Hosp Med Date: 2018-02-05 Impact factor: 2.960
Authors: Stephanie M Harman; Rebecca Blankenburg; Jason M Satterfield; Brad Monash; Stephanie Rennke; Patrick Yuan; Debbie S Sakai; Eric Huynh; Ian Chua; Joan F Hilton Journal: Acad Med Date: 2019-07 Impact factor: 6.893
Authors: Corrie E McDaniel; Andrew A White; Miranda C Bradford; Carolyn D Sy; Tiffany Chen; Doug Brock; Jeffrey Foti; Jimmy B Beck Journal: Acad Med Date: 2018-02 Impact factor: 6.893
Authors: John T Ratelle; Michelle Herberts; Donna Miller; Ashok Kumbamu; Donna Lawson; Eric Polley; Thomas J Beckman Journal: J Patient Exp Date: 2021-04-08