Patient perspectives on communication with the medical team: pilot study using the Communication Assessment Tool-Team (CAT-T).
ABSTRACT Effective communication is an essential aspect of high-quality patient care and a core competency for physicians. To date, assessment of communication skills in team-based settings has not been well established. We sought to tailor a psychometrically validated instrument, the Communication Assessment Tool, for use in Team settings (CAT-T), and test the feasibility of collecting patient perspectives of communication with medical teams in the emergency department (ED).
A prospective, cross-sectional study in an academic, tertiary, urban, Level 1 trauma center using the CAT-T, a 15-item instrument. Items were answered via a 5-point scale, with 5 = excellent. All adult ED patients (> or = 18 y/o) were eligible if the following exclusion criteria did not apply: primary psychiatric issues, critically ill, physiologically unstable, non-English speaking, or under arrest.
81 patients were enrolled (mean age: 44, S.D. = 17; 44% male). Highest ratings were for treating the patient with respect (69% excellent), paying attention to the patient (69% excellent), and showing care and concern (69% excellent). Lowest ratings were for greeting the patient appropriately (54%), encouraging the patient to ask questions (54%), showing interest in the patient's ideas about his or her health (53% excellent), and involving the patient in decisions as much as he or she wanted (53% excellent).
Although this pilot study has several methodological limitations, it demonstrates a signal that patient assessment of communication with the medical team is feasible and offers important feedback. Results indicate the need to improve communication in the ED.
In the ED, focusing on the medical team rather then individual caregivers may more accurately reflect patients' experience.
Full-textDOI: · Available from: Michael A Gisondi, Aug 25, 2015
- SourceAvailable from: Deborah M Rooney
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- "This topic is of interest because improving clinical teamwork has been named as a priority area for improving the safety and quality of health care   . Also, while teams have been assessed by trained observers or team member self-report   , research suggests patients may be aware of and able to assess teamwork-related behaviors    . Whereas patients have most often been asked only about provider–patient communication, we propose that patients' perception of teamwork may be useful to improvement efforts and may relate to their satisfaction with care experiences   . "
ABSTRACT: Objective: To explore patient observations of teamwork-related behaviors such as inter-team communication through a newly designed survey. Methods: In this cross-sectional study, 101 patients (N = 86) and caregivers (N = 15) recruited from the emergency department (ED) of an urban, academic medical center (>85,000 visits/year) completed the 16-item Patients' Insights and Views Observing Teams (PIVOT) Survey. We evaluated validity evidence through descriptive statistics and analysis including a Many-facet Rasch model to determine associations between questionnaire items and sociodemographic characteristics. Results: Participant responses provided evidence survey items performed well and reflected patients' awareness of team behaviors such as inter-team communication, coordination, and keeping teammates informed. Also, participants responded about the consistency of information from team members and knowing what people's jobs were on the team. Rasch analysis largely supported that the PIVOT items reflected the intended content area and adequacy of ratings scales supporting evidence of response processes. High internal consistency (Cronbach alpha, r = .87) supported evidence of internal structure. As expected, response patterns differed by ED visit acuity level and length of stay. Conclusions: The PIVOT survey offered a means to collect patient and caregiver observations of health care teams. Practice implications: PIVOT survey responses may contribute to evaluation of teamwork behaviors.Patient Education and Counseling 06/2014; 96(3). DOI:10.1016/j.pec.2014.06.002 · 2.60 Impact Factor
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- "Furthermore, Crowe et al. (2002) pointed out that the interpersonal relationships between the patients and health care provider is the most important determinant of customer satisfaction (Gill and White, 2009). Similarly, the quality of the relationship between patients and doctors has a considerable impact on the patient satisfaction measure (Alhashem et al., 2011; Mercer et al., 2008; Moret et al., 2008). In this context, patient satisfaction is defined as the judgment made by patients on their expectations for care services that have been met or not in respect of both technical and interpersonal care (Campbell et al., 2000; Esch et al., 2008). "
ABSTRACT: Purpose ‐ The purpose of this study is to investigate hospital service quality and its effect on patient satisfaction and behavioural intention. Design/methodology/approach ‐ A convenience sampling technique was used in this study. A total of 350 questionnaires were distributed and 216 were returned (61.7 per cent response rate). Findings ‐ The results confirm that the five dimensions ‐ admission, medical service, overall service, discharge and social responsibility ‐ are a distinct construct for hospital service quality. Each dimension has a significant relationship with hospital service quality. The findings of this study indicate that the establishment of higher levels of hospital service quality will lead customers to have a high level of satisfaction and behavioural intention. Research limitations/implications ‐ This research examined the concept of hospital service quality, patient satisfaction and behavioural intention from the perspective of patients. However, this study did not explore the perspective of service providers. This is a limitation in as much as it only considers the patients' view, which might be different from the providers' view. Practical implications ‐ The results indicate that managers should use the perceived service quality and customer satisfaction as mechanisms for exit strategy that will increase loyalty among the present customers. Originality/value ‐ This study will enable hospitals to have a better understanding of the effects of service quality, which will lead to patient satisfaction and behavioural intention in order to build long-term relationships with their patients.Clinical Governance An International Journal 07/2013; 18(3). DOI:10.1108/CGIJ-05-2012-0016
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- "These problems, as well as the frequency of multitasking that occurs in the ED, impose cognitive loads on clinical staff that can negatively affect memory (Coiera et al., 2002; Woloshynowych et al., 2007). However, ''despite the acknowledged importance of communication, assessment of communication skills in team-based care settings has not been well-established'' (Mercer et al., 2008, p. 220). Physiotherapists have recently joined the multidisciplinary teams in many hospitals internationally, but their role in the ED has not yet been well-documented (Anaf and Sheppard , 2007). "
ABSTRACT: The aim of this study was to develop a systematic review using international research to describe the role of teamwork and communication in the emergency department, and its relevance to physiotherapy practice in the emergency department. Searches were conducted of CINAHL, Academic Search Premier, Scopus, Cochrane, PEDro, Medline, Embase, Amed and PubMed. Selection criteria included full-text English language research papers related to teamwork and/or communication based directly in the emergency department, involvement of any profession in the emergency department, publication in peer-reviewed journals, and related to adult emergency services. Studies were appraised using a validated critical appraisal tool. Fourteen eligible studies, all of mid-range quality, were identified. They demonstrated high levels of staff satisfaction with teamwork training interventions and positive staff attitudes towards the importance of teamwork and communication. There is moderate evidence that the introduction of multidisciplinary teams to the ED may be successful in reducing access block, and physiotherapists may play a role in this. The need for teamwork and communication in the ED is paramount, and their roles are closely linked, with the common significant purposes of improving patient safety, reducing clinical errors, and reducing waiting times.International emergency nursing 07/2010; 18(3):127-37. DOI:10.1016/j.ienj.2009.05.006 · 0.72 Impact Factor