Effect of Hospitalist – Advanced Practice Provider Teams on Patient Experience

1Medical College of Wisconsin, Milwaukee, WI
2Froedtert Hospital, Milwaukee, WI

Meeting: Hospital Medicine 2014, March 24-27, Las Vegas, Nev.

Abstract number: 73

Background:

Due to restrictions on resident duty hours, increasing numbers of patients at academic hospitals are being cared for by hospitalists paired with advanced practice providers (H‐APP teams). Hospitals are held accountable for their patient’s experiences by pay for performance programs such as the Centers for Medicare and Medicaid Services value based purchasing program, yet there is limited research investigating the impact of H‐APP teams on patient experience.

Methods:

We conducted a retrospective cohort study examining the patient experience when care was provided by H‐APP teams versus care provided by Hospitalist – Resident teams (H‐RES) at a 500 bed academic medical center.

For a 3 year period from July 2010 to June 2013, we obtained top box scores (percentage of responses in the highest category) for the 3 items in the ‘doctor communication’ section of the Hospital Consumer Assessment of Healthcare Providers and Systems Survey and attributed these scores to the discharging hospitalist. We then matched the date of discharge for the survey respondent and name of hospitalist to the team block schedule to determine if the survey result reflected care provided by an H‐APP team or H‐RES team. Hospitalists spent different numbers of 2 week blocks staffing H‐APP versus H‐RES teams, so to create a group of hospitalists that provided sufficient care as part of both types of teams we only included survey results for those who provided > 30% of their care as part of both H‐APP and H‐RES teams during the study period. Our final data set comprised of survey results for 11 hospitalists with 427 and 364 survey responses reflecting care from H‐APP and H‐RES teams respectively. We then compared the composite patient experience scores with doctor communication as well as scores for each of the 3 items separately between care provided by H‐APP and H‐Res teams using the Chi‐squared test.

Results:

Care provided by H‐APP teams was associated with better patient experience with doctor communication. This difference was especially pronounced for patient experience reflected by the response to the question “How often did doctors explain things in a way you could understand?” (Table)

Conclusions:

The H‐APP team model of care may provide better patient experience with doctor communication as compared to H‐RES teams. This improvement in patient experience may be a result of APPs using less medical jargon when communicating with patients as compared to residents or features of the H‐APP model of care such as fewer handoffs of care.

Comparison of percent ‘top box’ patient experience scores between Hospitalist – Advanced Practice Provider teams (H‐APP) and Hospitalist – Resident teams (H‐RES). P value derived using Chi Squared test.



H‐APP H‐RES P value
Composite patient experience with communication with doctors 77.11 70.40 <0.001
How often did doctors treat you with courtesy and respect? 83.61 79.60 0.15
How often did doctors listen carefully to you? 75.89 69.51 0.05
How often did doctors explain things in a way you could understand? 71.78 62.10 0.004

To cite this abstract:

Singh S, Ahmed A, Dunn C, Rana V, Raaum J, Vrba M, DeLonge C, Skjervem K, Biblo L. Effect of Hospitalist – Advanced Practice Provider Teams on Patient Experience. Abstract published at Hospital Medicine 2014, March 24-27, Las Vegas, Nev. Abstract 73. Journal of Hospital Medicine. 2014; 9 (suppl 2). https://www.shmabstracts.com/abstract/effect-of-hospitalist-advanced-practice-provider-teams-on-patient-experience/. Accessed July 17, 2019.

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