Communication Tool Effect on ED Patients' Comprehension and Satisfaction of Care

2.50
Hdl Handle:
http://hdl.handle.net/10755/324177
Category:
Abstract
Type:
Presentation
Title:
Communication Tool Effect on ED Patients' Comprehension and Satisfaction of Care
Author(s):
Dilts Skaggs, Mary Kate
Author Details:
Mary Kate Dilts Skaggs, MSN, RN, NE-BC, email: skaggsmk@somc.org
Abstract:
Research Abstract Purpose: Patient-physician communication in the Emergency Department (ED) has repeatedly been shown to be deficient, and many strategies have been proposed to improve knowledge transfer. A communication tool can be utilized by patients and care providers to facilitate communication. The hypothesis was that this structured communication tool, would increase patient comprehension of and satisfaction with care. Patient Satisfaction is important as ED –CAHPS, Emergency Department Consumer Assessment of Healthcare Providers & Systems is on the horizon. Design: Utilizing a quasi-experimental, before (317 patients) and after (326 patients received the communication instrument, titled “My InformER”. ) study design, patients were surveyed on comprehension of and satisfaction with care. Setting: The study was conducted at four hospitals in Michigan and Ohio, with annual census ranging from 42,000-90,000 patient visits . The hospitals included a large tertiary care academic institution in a small city, two mid-sized hospitals in Detroit, and a rural 232 bed acute care, nonprofit, teaching hospital in southern Ohio. Participants/Subjects: Staff Nurse (Research associates) enrolled patients from noon to 8pm, 7 days per week, who met inclusion (ESI Triage Category 2 & 3, age 18 years & older with English as their first language) and exclusion criteria (ESI Triage category 1, 4, & 5, age less than 18 years, prisoners, not primary English speaking, under custodianship or prior participation in the pilot study). All eligible patients presenting during the enrollment periods were approached for inclusion in the study after triage. Data was collected in CY 2012. Methods: My InformER instrument included areas to write ED plan details such as wait time, labs, studies, PO status, patient questions or notes. Physicians, nurses, techs, the patient and their families were able to use this instrument Comprehension was assessed based on patient reported answers compared to a nursing chart review. Linear mixed models were used to limit other differences between the groups to offset the before and after design. Satisfaction with communication was measured via the Communication Assessment Tool-Team (CAT-T) instrument, which is a validated instrument to assess patient satisfaction with communication. Results: Patients were found to have frequent knowledge deficits about discharge instructions, including diagnosis (48%), follow up instructions (49%) and reasons to return (62%), but also about the nature of care received including whether medication (12.4%), imaging (18.5%) or laboratory tests (7.3%) were performed. The intervention had no significant effect on eliminating knowledge deficits about emergency care. Elderly patients and extremely elderly patients in both control and intervention groups were found to have 1.1 (p<0.01) and 1.7 (p<0.01) more knowledge gaps respectively than patients aged 25-44. There was no significant effect of the communication guide on patient satisfaction. Implications: Patients frequently misunderstand medical care in the Emergency Department and their post care instructions. Comprehension does seem to decrease with increasing age. A standardized communication instrument, guiding the patient and provider to discuss the medical care does not improve patient satisfaction with communication or patient understanding of the care received.
Keywords:
Patient-Physician Communication Tool
Repository Posting Date:
4-Aug-2014
Date of Publication:
4-Aug-2014
Conference Date:
2014
Conference Name:
2014 ENA Leadership Conference
Conference Host:
Emergency Nurses Association
Conference Location:
Phoenix, Arizona USA
Description:
2014 ENA Leadership Conference Theme: Safe Practice, Safe Care. Held at the Phoenix Convention Center
Note:
This is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.

Full metadata record

DC FieldValue Language
dc.language.isoen_USen_GB
dc.type.categoryAbstracten_GB
dc.typePresentationen_GB
dc.titleCommunication Tool Effect on ED Patients' Comprehension and Satisfaction of Careen_GB
dc.contributor.authorDilts Skaggs, Mary Kateen_GB
dc.author.detailsMary Kate Dilts Skaggs, MSN, RN, NE-BC, email: skaggsmk@somc.orgen_GB
dc.identifier.urihttp://hdl.handle.net/10755/324177-
dc.description.abstractResearch Abstract Purpose: Patient-physician communication in the Emergency Department (ED) has repeatedly been shown to be deficient, and many strategies have been proposed to improve knowledge transfer. A communication tool can be utilized by patients and care providers to facilitate communication. The hypothesis was that this structured communication tool, would increase patient comprehension of and satisfaction with care. Patient Satisfaction is important as ED –CAHPS, Emergency Department Consumer Assessment of Healthcare Providers & Systems is on the horizon. Design: Utilizing a quasi-experimental, before (317 patients) and after (326 patients received the communication instrument, titled “My InformER”. ) study design, patients were surveyed on comprehension of and satisfaction with care. Setting: The study was conducted at four hospitals in Michigan and Ohio, with annual census ranging from 42,000-90,000 patient visits . The hospitals included a large tertiary care academic institution in a small city, two mid-sized hospitals in Detroit, and a rural 232 bed acute care, nonprofit, teaching hospital in southern Ohio. Participants/Subjects: Staff Nurse (Research associates) enrolled patients from noon to 8pm, 7 days per week, who met inclusion (ESI Triage Category 2 & 3, age 18 years & older with English as their first language) and exclusion criteria (ESI Triage category 1, 4, & 5, age less than 18 years, prisoners, not primary English speaking, under custodianship or prior participation in the pilot study). All eligible patients presenting during the enrollment periods were approached for inclusion in the study after triage. Data was collected in CY 2012. Methods: My InformER instrument included areas to write ED plan details such as wait time, labs, studies, PO status, patient questions or notes. Physicians, nurses, techs, the patient and their families were able to use this instrument Comprehension was assessed based on patient reported answers compared to a nursing chart review. Linear mixed models were used to limit other differences between the groups to offset the before and after design. Satisfaction with communication was measured via the Communication Assessment Tool-Team (CAT-T) instrument, which is a validated instrument to assess patient satisfaction with communication. Results: Patients were found to have frequent knowledge deficits about discharge instructions, including diagnosis (48%), follow up instructions (49%) and reasons to return (62%), but also about the nature of care received including whether medication (12.4%), imaging (18.5%) or laboratory tests (7.3%) were performed. The intervention had no significant effect on eliminating knowledge deficits about emergency care. Elderly patients and extremely elderly patients in both control and intervention groups were found to have 1.1 (p<0.01) and 1.7 (p<0.01) more knowledge gaps respectively than patients aged 25-44. There was no significant effect of the communication guide on patient satisfaction. Implications: Patients frequently misunderstand medical care in the Emergency Department and their post care instructions. Comprehension does seem to decrease with increasing age. A standardized communication instrument, guiding the patient and provider to discuss the medical care does not improve patient satisfaction with communication or patient understanding of the care received.en_GB
dc.subjectPatient-Physician Communication Toolen_GB
dc.date.available2014-08-04T13:28:53Z-
dc.date.issued2014-08-04-
dc.date.accessioned2014-08-04T13:28:53Z-
dc.conference.date2014en_GB
dc.conference.name2014 ENA Leadership Conferenceen_GB
dc.conference.hostEmergency Nurses Associationen_GB
dc.conference.locationPhoenix, Arizona USAen_GB
dc.description2014 ENA Leadership Conference Theme: Safe Practice, Safe Care. Held at the Phoenix Convention Centeren_GB
dc.description.noteThis is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.en_GB
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