Hospitalist Communication: To Whom Are They Talking and How Much?

1Northwestern University, Chicago, IL
2Northwestern University, Chicago, IL
3Northwestern University, Chicago, IL
4Northwestern University, Chicago, IL
5Northwestern University, Chicago, IL
6Northwestern University, Chicago, IL

Meeting: Hospital Medicine 2009, May 14-17, Chicago, Ill.

Abstract number: 65

Background:

Working without support from residents, hospitalists anecdotally spend a great deal of time and effort coordinating care planning among different physician specialties, nurses, ancillary staff, and other health care professionals. Ultimately responsible for the successful execution of the care plan, hospitalists also serve as the primary contact for both patients and their families during hospitalizations and as the liaison to the primary care physician who will subsequently care for patients once discharged. Only 1 study has analyzed with whom hospitalists communicate and how. The present study aimed to further that research with a larger data set and more granular evaluation.

Methods:

Trained observers shadowed each of 24 hospitalists for 2 full‐day shifts using Workstudy+® software installed on a handheld device, a Palm TX. The software allowed the observers to record the frequency and duration of all tasks performed by the hospitalist according to a predefined 3‐tiered hierarchy of activities. Specifically, the major category of communication was also identified by mode (e.g., phone, in person) and then by to whom it was directed.

Results:

Of the 496 total hours observed, the hospitaiists spent almost half their time communicating (44%; 95% Cl: 42%‐46%), more than half of which was with other health care professionals (57%; 95% Cl: 54%‐60%), and the remainder was with patients and/or families. Communication with other professionals was distributed among other physicians (50%; 95% Cl: 47%–53%) and nurses (19%; 95% Cl: 17%–21%), with the remainder among other members of the care team (31%; 95% Cl: 28%–‐33%) including therapists, case managers, social workers, technologists, and pharmacists. On average (± SD), for a typical patient, hospitalists communicated for 8.9 ± 0.8 minutes with the patient, for 0.7 ± 0.2 minutes with the family, for 6.3 ± 0.6 minutes with other physicians, for 2.4 ± 0.3 minutes with nurses, and for 3.9 ± 0.6 minutes with the rest of the care team, for a total of 22.2 ± 5 minutes per patient. During a typical day shift, hospitalists spent 91 minutes on the phone (95% Cl: 82–101 minutes), 49 minutes talking face to face (95% Cl: 43–55 minutes), and 24 minutes sending, receiving, and reviewing pages (95% Cl: 22‐26 minutes), which included an average of 41 ± 11 pages received per shift,

Conclusions:

As the central figure in a hospitalized patient's care, a hospitalist interact with numerous diverse health care professionals but predominantly interacts with other physicians, communicating more than twice as much time as with nurses. If hospitalists move toward a more team‐based approach to care that increasingly involves nurses and more time with patients and families, this will affect their communication with other physicians caring for their patients.

Author Disclosure:

D. Malkenson, none; D. Magill, none; M. Tipping, none; V. Forth, none; K. Englert, none; M. Williams, Society of Hospital Medicine, Editor.

To cite this abstract:

Malkenson D, Magill D, Tipping M, Forth V, Englert K, Williams M. Hospitalist Communication: To Whom Are They Talking and How Much?. Abstract published at Hospital Medicine 2009, May 14-17, Chicago, Ill. Abstract 65. Journal of Hospital Medicine. 2009; 4 (suppl 1). https://www.shmabstracts.com/abstract/hospitalist-communication-to-whom-are-they-talking-and-how-much/. Accessed May 27, 2019.

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