Zishan Siddiqui1, Rehan Qayyum2, Amanda Bertram3, Nowella Durkin1, Sosena Kebede4, Lucia Ponor5, Ibironke Oduyebo6, Lisa Allen7, Daniel J Brotman1. 1. Hospitalist Program, Division of General Internal Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland. 2. Department of Internal Medicine, University of Tennessee College of Medicine at Chattanooga, Chattanooga, Tennessee. 3. Division of General Internal Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland. 4. Hospitalist Program, Division of General Internal Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland; Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland. 5. Division of Hospital Medicine, Johns Hopkins Bayview Medical Center, Baltimore, Maryland. 6. Division of Gastrointestinal Diseases, Mayo Clinic, Rochester, Minnesota. 7. Service Excellence Department, Johns Hopkins School of Medicine, Baltimore, Maryland.
Abstract
BACKGROUND: There is a glaring lack of published evidence-based strategies to improve the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) patient experience scores on the physician domain. Strategies that have been used are resource intensive and difficult to sustain. OBJECTIVE: We hypothesized that prompting providers to assess their own etiquette-based practices every 2 weeks over the course of 1 year would improve patient experience on the physician domain. DESIGN: Randomized controlled trial. SETTING: 4 acute care hospitals. PARTICIPANTS: Hospitalists. INTERVENTION: Hospitalists were randomized to the study or the control arm. The study arm was prompted every 2 weeks for 12 months to report how frequently they engaged in 7 best-practice bedside etiquette behaviors. Control arm participants received similarly worded questions on quality improvement behaviors. MEASUREMENT: Provider experience scores were calculated from the physician HCAHPS and Press Ganey survey provider items. RESULTS: Physicians reported high rates of etiquette-based behavior at baseline, and this changed modestly over the study period. Self-reported etiquette behaviors were not associated with experience scores. The difference in difference analysis of the baseline and postintervention physician experience scores between the intervention arm and the control arm was not statistically significant (P = 0.71). CONCLUSION: In this 12-month study, biweekly reflection and reporting of best-practice bedside etiquette behaviors did not result in significant improvement on physician domain experience scores. It is likely that hospitalists' self-assessment of their bedside etiquette may not reflect patient perception of these behaviors. Furthermore, hospitalists may be resistant to improvement in this area since they rate themselves highly at baseline. Journal of Hospital Medicine 2017;12:402-406.
RCT Entities:
BACKGROUND: There is a glaring lack of published evidence-based strategies to improve the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) patient experience scores on the physician domain. Strategies that have been used are resource intensive and difficult to sustain. OBJECTIVE: We hypothesized that prompting providers to assess their own etiquette-based practices every 2 weeks over the course of 1 year would improve patient experience on the physician domain. DESIGN: Randomized controlled trial. SETTING: 4 acute care hospitals. PARTICIPANTS: Hospitalists. INTERVENTION: Hospitalists were randomized to the study or the control arm. The study arm was prompted every 2 weeks for 12 months to report how frequently they engaged in 7 best-practice bedside etiquette behaviors. Control arm participants received similarly worded questions on quality improvement behaviors. MEASUREMENT: Provider experience scores were calculated from the physician HCAHPS and Press Ganey survey provider items. RESULTS: Physicians reported high rates of etiquette-based behavior at baseline, and this changed modestly over the study period. Self-reported etiquette behaviors were not associated with experience scores. The difference in difference analysis of the baseline and postintervention physician experience scores between the intervention arm and the control arm was not statistically significant (P = 0.71). CONCLUSION: In this 12-month study, biweekly reflection and reporting of best-practice bedside etiquette behaviors did not result in significant improvement on physician domain experience scores. It is likely that hospitalists' self-assessment of their bedside etiquette may not reflect patient perception of these behaviors. Furthermore, hospitalists may be resistant to improvement in this area since they rate themselves highly at baseline. Journal of Hospital Medicine 2017;12:402-406.
Authors: Blair P Golden; Sean Tackett; Kimiyoshi Kobayashi; Terry Nelson; Alison Agrawal; Nicole Pritchett; Kaley Tilton; Geron Mills; Ting-Jia Lorigiano; Meron Hirpa; Jessica Lin; Sarah Disney; Matt Lautzenheiser; Shanshan Huang; Stephen A Berry Journal: J Gen Intern Med Date: 2022-01-10 Impact factor: 6.473