TY - JOUR
T1 - Comportment and communication patterns among hospitalist physicians
T2 - Insight gleaned through observation
AU - Kotwal, Susrutha
AU - Torok, Haruka
AU - Khaliq, Waseem
AU - Landis, Regina
AU - Howell, Eric
AU - Wright, Scott
N1 - Publisher Copyright:
© 2015 by The Southern Medical Association.
PY - 2015/8/5
Y1 - 2015/8/5
N2 - Objectives By 2014, there were more than 40,000 hospitalists delivering the majority of inpatient care in US hospitals. No empiric research has characterized hospitalist comportment and communication patterns as they care for patients. Methods The chiefs of hospital medicine at five different hospitals were asked to identify their best hospitalists. These hospitalists were watched during their routine clinical care of patients. An observation tool was developed that focused on elements believed to be associated with excellent comportment and communication. One observer watched the physicians, taking detailed quantitative and qualitative field notes. Results A total of 26 hospitalists were shadowed. The mean age of the physicians was 38 years, and their average experience in hospital medicine was 6 years. The hospitalists were observed for a mean of 5 hours, during which time they saw an average of 7 patients (patient encounters observed N = 181). Physicians spent an average of 11 minutes with each patient. There was large variation in the extent to which desirable behaviors were performed. For example, most physicians (76%) started encounters with an open-ended question, and relatively few (30%) attempted to integrate nonmedical content into conversation with patients. Conclusions This study represents a first step in trying to characterize comportment and communication in hospital medicine. Because hospitalists spend only a small proportion of their clinical time in direct patient care, it is imperative that excellent comportment and communication are clearly defined and established as a goal for every encounter.
AB - Objectives By 2014, there were more than 40,000 hospitalists delivering the majority of inpatient care in US hospitals. No empiric research has characterized hospitalist comportment and communication patterns as they care for patients. Methods The chiefs of hospital medicine at five different hospitals were asked to identify their best hospitalists. These hospitalists were watched during their routine clinical care of patients. An observation tool was developed that focused on elements believed to be associated with excellent comportment and communication. One observer watched the physicians, taking detailed quantitative and qualitative field notes. Results A total of 26 hospitalists were shadowed. The mean age of the physicians was 38 years, and their average experience in hospital medicine was 6 years. The hospitalists were observed for a mean of 5 hours, during which time they saw an average of 7 patients (patient encounters observed N = 181). Physicians spent an average of 11 minutes with each patient. There was large variation in the extent to which desirable behaviors were performed. For example, most physicians (76%) started encounters with an open-ended question, and relatively few (30%) attempted to integrate nonmedical content into conversation with patients. Conclusions This study represents a first step in trying to characterize comportment and communication in hospital medicine. Because hospitalists spend only a small proportion of their clinical time in direct patient care, it is imperative that excellent comportment and communication are clearly defined and established as a goal for every encounter.
KW - communication and comportment skills
KW - hospitalists
KW - patient safety
KW - patient-centered care
KW - professionalism
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U2 - 10.14423/SMJ.0000000000000328
DO - 10.14423/SMJ.0000000000000328
M3 - Article
C2 - 26280779
AN - SCOPUS:84938576763
SN - 0038-4348
VL - 108
SP - 496
EP - 501
JO - Southern Medical Journal
JF - Southern Medical Journal
IS - 8
ER -