Arora Vineet M, Schaninger Caitlin, D'Arcy Michael, Johnson Julie K, Humphrey Holly J, Woodruff James N, Meltzer David O
Department of Medicine, University of Chicago, Chicago, USA.
Jt Comm J Qual Patient Saf. 2009 Dec;35(12):613-9. doi: 10.1016/s1553-7250(09)35086-2.
Improving patients' ability to identify their inpatient physicians and understand their roles is vital to safe patient care. Picture cards were designed to facilitate physician introductions. The effect of Feedback Care and Evaluation (FACE) cards on patients' ability to correctly identify their inpatient physicians and on patients understanding of physicians roles was assessed.
In October 2006, team members introduced themselves with FACE cards, which included a photo and an explanation of their roles. During an inpatient interview, research assistants asked patients to name their inpatient physicians and trainees and to rate their understanding of their physicians' roles.
Of 2,100 eligible patients, 1,686 (80%) patients participated in the baseline period, and 857 (67%) of the 1,278 patients in the intervention period participated in the evaluation. With the FACE intervention, patients were significantly more likely to correctly identify at least one inpatient physician (attending, resident, or intern; baseline 12.5% versus intervention 21.1%; p < .001). Of the 181 patients who were able to correctly identify at least one inpatient physician in the intervention period, research assistants noted that 59% (107) had FACE cards visible in their rooms. Surprisingly, fewer patients rated their understanding of their physicians' roles as excellent or very good in the intervention period (45.6%) compared with the baseline period (55.3%; p < .001).
Although FACE cards improved patients ability to identify their inpatient physicians, many patients still could not identify their inpatient doctors. FACE cards may have served as a reminder to physicians to introduce themselves to their patients. The FACE cards also served to highlight patients' misunderstanding of their physicians' roles.
提高患者识别其住院医师并了解其职责的能力对于患者安全护理至关重要。设计了图片卡片以方便医师介绍。评估了反馈护理与评估(FACE)卡片对患者正确识别其住院医师能力以及对医师职责理解的影响。
2006年10月,团队成员使用FACE卡片进行自我介绍,卡片包含照片及其职责说明。在住院患者访谈期间,研究助理询问患者说出其住院医师和实习医生的姓名,并对他们对医师职责的理解进行评分。
在2100名符合条件的患者中,1686名(80%)患者参与了基线期,在干预期的1278名患者中有857名(67%)参与了评估。通过FACE干预,患者更有可能正确识别至少一名住院医师(主治医生、住院医生或实习医生;基线期为12.5%,干预期为21.1%;p<0.001)。在干预期能够正确识别至少一名住院医师的181名患者中,研究助理注意到59%(107名)患者房间里有FACE卡片。令人惊讶的是,与基线期(55.3%)相比,干预期将其对医师职责理解评为优秀或非常好的患者较少(45.6%;p<0.001)。
尽管FACE卡片提高了患者识别其住院医师的能力,但许多患者仍然无法识别其住院医生。FACE卡片可能起到了提醒医师向患者自我介绍的作用。FACE卡片还凸显了患者对医师职责的误解。