Effective communication between attending physicians (AP) and residents is crucial to patient care. As Pediatric Hospitalists we recognize this need further when supervising residents on general inpatient pediatric teams. To date there have been no studies attempting to overcome barriers to communication between AP and residents in the field of Pediatric Hospitalist medicine.
We implemented a list of reasons to call the AP and a mandatory set check out time by phone. The interventions were evaluated by administering a survey to the APs and residents pre and post implementation. The survey used a likert scale to assess residents’ feelings of imposing on the AP or looking incompetent if they called the AP. The residents and APs were asked to estimate the number of instances of miscommunication and adverse events in patient care due to poor communication pre and post implementation.
Baseline surveys were sent to residents with a return rate of 37% (34/92). Baseline surveys were sent to AP with a return rate of 76% (19/25). Post intervention: Residents had a return rate of 82% (18/ 22) and the AP had a return rate of 90% (28/31). Following the intervention, residents estimated the instances of miscommunication decreased (from 13 to 0, P = 0.047) but the number of adverse events due to miscommunication did not change (P = 0.0959). When looking at the resident’s feelings about calling, the proportion that felt it was an imposition decreased from 41.2 to 11.1% (P = 0.03), but the proportion that felt incompetent was unchanged (14.7% vs 11.1%, P = 0.72). AP estimated that the number of instances of miscommunication and adverse events decreased (from 13 to 0, P = 0.02, P < 0.01 respectively). The percent of AP who agreed that residents felt it was an imposition to call went from 50 to 21.4% (P = 0.04) and the percent who agreed that residents felt it looked incompetent to call went from 27.8% to 3.6% (P = 0.02).
The intervention of a call list and set check out time improves communication by decreasing barriers and resulting in the perception of improved patient care.
To cite this abstract:Sherman A, Kesterson J, Queen M, Riss R. Reducing Barriers in Comunication and Adverse Outcomes in Patient Care: Improving Communication Between Supervising Attendings and Nighttime Residents. Abstract published at Hospital Medicine 2012, April 1-4, San Diego, Calif. Abstract 97604. Journal of Hospital Medicine. 2012; 7 (suppl 2). https://www.shmabstracts.com/abstract/reducing-barriers-in-comunication-and-adverse-outcomes-in-patient-care-improving-communication-between-supervising-attendings-and-nighttime-residents/. Accessed March 28, 2020.