Improving Patient‐Centered Care among House Staff through Observed Rounds

1Mount Sinai School of Medicine, New York, NY
2Mount Sinai School of Medicine, New York, NY
3Mount Sinai School of Medicine, New York, NY
4Mount Sinai School of Medicine, New York, NY
5Mount Sinai School of Medicine, New York, NY

Meeting: Hospital Medicine 2010, April 8-11, Washington, D.C.

Abstract number: 195

Background:

In most internal medicine residency programs, house staff round on their patients each morning. This practice provides residents with the opportunity To review with patients the hospital course, results from previously completed tests, changes lo The Treatment plan, and the anticipated length of slay in the hospital House staff can also assess a patient's physical discomfort and address any questions. Executing these communication tasks skillfully improves patient satisfaction. Unfortunately, proficiency in patient‐centered rounds is not currently emphasized in medical school curricula or residency training. In an effort to overcome this gap in education and improve patient satisfaction, mandatory training and evaluation of physician communication skills have become program requirements.

Purpose:

We implemented a formal process using observation and feedback of residents during work rounds to evaluate and improve communication skills.

Description:

In Mount Sinai Hospital's internal medicine residency, resident‐led health care teams are required to round on a patient at least once daily. In ar effort to assess clinical judgment, communication skills, and teaching ability, the chief residents regularty observe residents and provide feedback on their performance. To standardize the evaluation of the residents, the investigators developed a behavioral checklist —the rounding log —to monitor and evaluate patient centeredness. teaching, and compliance (Table 1). To date. 62 observations for 48 residents have been recorded over a 20‐week period. Preliminary results from these observations demonstrate that house staff members have room for improvement on their communication behavior (Table 2). Although most house staffers are friendly and courteous, fewer than half introduce new members of the team to the patents, and fewer than a quarter consistently inquire about patients' pain. In interactions with patients, < 25% always provide anticipatory guidance to their patients, and few residents always actively include the medical students. Although these data demonstrate communication weaknesses, resident performance improved overtime: resident observations from weeks 16 to 20 showed improved performance as compared with weeks 1‐8. This improvement likely reflects a cultural shift toward greater patient‐centeredness.

Conclusions:

Internal medicine house staffers at an urban academic hospital have substantial deficits in communication behaviors. A formal and structured observation program during morning rounds can improve resident performance.

Author Disclosure:

K. Smith, none; D. O'Connor, none; L Razzouk, none; D. Marin, none; M. Babyatsky, none.

To cite this abstract:

Smith K, O'Connor D, Razzouk L, Marin D, Babyatsky M. Improving Patient‐Centered Care among House Staff through Observed Rounds. Abstract published at Hospital Medicine 2010, April 8-11, Washington, D.C. Abstract 195. Journal of Hospital Medicine. 2010; 5 (suppl 1). https://www.shmabstracts.com/abstract/improving-patientcentered-care-among-house-staff-through-observed-rounds/. Accessed November 13, 2019.

« Back to Hospital Medicine 2010, April 8-11, Washington, D.C.