Take a Seat: An Innovation to Encourage Seated Dialogue on Physician Rounds

1UCSF, San Francisco, CA
2UCSF, San Francisco, CA
3UCSF, San Francisco, CA
4UCSF, San Francisco, CA

Meeting: Hospital Medicine 2013, May 16-19, National Harbor, Md.

Abstract number: 154

Background:

Patient satisfaction has been linked to improved compliance with medication instructions and physician recommendations, as well as enhanced clinical outcomes. Previous studies have shown that when physicians sit, patients perceive they spend 40% longer and patients have a more positive perception of their providers.

Purpose:

To facilitate seated conversations by educating providers about the impact of sitting and by providing folding chairs in patient rooms on a surgical and medical floor.

Description:

As part of an ongoing collaboration with Medical Center Patient Relations, we obtained medical center funding for 32 chairs on 1 medical and 1 surgical pilot unit. Nursing leadership, facilities, environmental safety, and infection control were engaged regarding the project timeline, chair safety, and space design. Inexpensive, lightweight folding chairs were placed on hooks mounted to the wall behind patients' doors. The project description and launch date were publicized through resident noon conferences, hospitalist staff meetings, and bimonthly e‐mails starting 1 month prior to the launch date. A brightly colored and laminated description of the project and rationale for chair use was placed on the doors of participating rooms. Leveraging a preexisting volunteer rounding program, volunteers questioned a random sample of patients before and after the intervention to assess communication and chair use on each of the units, and this feedback was provided to teams (Table 1). Patient responses on the medical unit improved significantly during the intervention period (88% vs. 100%, P = 0.005), whereas no significant difference was observed on the surgical unit. When asked for an explanation of the differences noted when providers sit, patients reported that when the physicians sat, they “seem more friendly,” “less rushed,” and “nicer.” They also reported that it “helps the conversation,” and it was “easier to ask questions.” Neutral responses said that “it made no difference” and they “neither liked or disliked the chair.” There were no negative comments. Next steps involve looking at postdischarge patient satisfaction surveys to determine differences in rooms with and without chairs.

Conclusions:

Including folding chairs in patient rooms is feasible and can potentially improve patient perceptions of communication. Both physician adoption and patient perceptions varied greatly between medical and surgical floors. On the medical service, staffed entirely by hospitalists, the lack of a longitudinal relationship with patients may increase importance of sitting in forming therapeutic rapport.

Responses to Pre- and Postintervention Patient Survey



PREintervention Medical (n = 118) Surgical (n = 110) P
Physicians listen to your questions and concerns 104 (88%) 104 (95%) 0.104
POSTintervention Medical (n = 56) Surgical (n = 58) P
Physicians listen to your questions and concerns 56 (100%) 56 (100%) 1.0
Members of your health care team sit down while talking with you 30 (54%) 11 (19%) <0.001
Sitting made a difference 29 (97%) 1 (9%) <0.001

To cite this abstract:

Mourad M, Alves‐Rankin S, Phillips J, Bekmezian A. Take a Seat: An Innovation to Encourage Seated Dialogue on Physician Rounds. Abstract published at Hospital Medicine 2013, May 16-19, National Harbor, Md. Abstract 154. Journal of Hospital Medicine. 2013; 8 (suppl 2). https://www.shmabstracts.com/abstract/take-a-seat-an-innovation-to-encourage-seated-dialogue-on-physician-rounds/. Accessed November 22, 2019.

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