Effective communication and interpersonal skills are essential for delivering quality patient care and have been identified as a core competency for physicians. The Communication Assessment Tool (CAT) is a psychometrically validated instrument for patient assessment of physician communication skills. Most patients (both inpatient and outpatient) sampled during CAT development had multiple interactions with their physician and rated their health status as “good” or “very good.” In contrast, hospitalists' patients usually lack previous exposure to the hospitalist and are likely have poorer health status. We examined the feasibility of using the CAT to assess patients' perception of communication with hospitalists.
We sampled hospitalized patients on the general medicine inpatient units at an urban, academic hospital. Patients admitted to the hospital medicine or teaching service were eligible once assigned to a hospitalist physician for 2–3 days. Exclusion criteria included patient confusion, physiological instability, non‐English speaking, and patient in isolation status. Research assistants were trained to verbally administer the 14 core items of the CAT instrument. The 15th item, “The doctor's staff treated me with respect,” was dropped, as it focused on an outpatient office setting. Items were answered on a 5‐point Likert scale (poor, fair, good, very good, excellent). Results for each physician are reported as the percentage of “excellent” responses.
A total of 500 patients (20 patients for each of 25 hospitalists) were surveyed. Of these, 53% were female. Ages were categorized as 44 and younger (24.3%), 45–65 (38.7%), and 65 and older (37.0%). The hospitalists ranged in age from 30 to 39 years, 52% were female, and years of experienced ranged from 1 to 9 years, with an average of 4.1 years practicing as a hospitalist. The proportion of excellent ratings for each hospitalist varied from 48.0% to 84.4%, with an average of 67.5% (SD = 9.99). For the group as a whole, highest ratings on individual CAT items were for treating the patient with respect (74% excellent), letting the patient talk without interruptions (74%), and talking in terms the patient can understand (72%). Lowest ratings were for giving the patient as much information as he or she wanted (58%), encouraging the patient to ask questions (62%), and involving the patient in decisions as much as he or she wanted (62%). Overall scale reliability was high (Cronbach's alpha = 0.98).
Our study demonstrates that the CAT is a feasible means of gauging a hospitalist's communication skills. Overall, patients at our institution rate hospitalists' communication skills as good, but a significant proportion may benefit from targeted training to improve these skills, particularly in the areas of encouraging questions and involving patients in decision‐making.
D. Ferranti, none; G. Makoul, none; V. Forth, none; J. Rauworth, none; C. Lawes, none; M. Williams, Society of Hospital Medicine, Editor.
To cite this abstract:Ferranti D, Makoul G, Forth V, Rauworth J, Lawes C, Williams M. How Well Do Hospitalists Communicate? The Patient's Perspective. Abstract published at Hospital Medicine 2009, May 14-17, Chicago, Ill. Abstract 35. Journal of Hospital Medicine. 2009; 4 (suppl 1). https://www.shmabstracts.com/abstract/how-well-do-hospitalists-communicate-the-patients-perspective/. Accessed May 26, 2019.