Wild Dorothea M G, Kwon Nancy, Dutta Suparna, Tessier-Sherman Baylah, Woddor Navitha, Sipsma Heather L, Rizzo Tara, Bradley Elizabeth H
Griffin Hospital, Derby, Connecticut, USA.
Jt Comm J Qual Patient Saf. 2011 Oct;37(10):461-8. doi: 10.1016/s1553-7250(11)37059-6.
The Hospital Consumer Assessment of Health Care Providers and Systems (HCAHPS) survey asks patients how frequently their physicians treated them with courtesy and respect, listened carefully, and explained things in a way they could understand. Such summary reports may obscure differences among the types of physicians involved. A study was conducted to examine the association between ratings for different physician types and the overall HCAHPS rating of physicians.
A mixed-methods study included closed-ended surveys and in-depth interviews of patients on a hospitalist teaching service. The three HCAHPS physician communication items were used to interview patients about their communication experiences with emergency medicine (EM) physicians, hospitalists, and specialists. The association between the overall score and the scores of each physician type was examined using Spearman correlation coefficients and linear regression. Qualitative data from additional in-depth interviews were analyzed using the constant comparative method to identify recurrent themes.
Ninety-six patients were recruited for the survey, and additional in-depth interviews were conducted with the first 30 patients. Hospitalist and specialist scores were significantly associated (p values < .05) with overall scores. Recurrent themes regarding determinants of patients' ratings were categorized in three broad domains: individual physician behavior, team communication, and system issues. The influence of each domain differed across physician types.
Physician communication scores may be most strongly influenced by patient experiences with hospitalists and specialists rather than with EM physicians. Several team communication and system issues represent opportunities for improving physician communication.
医疗服务提供者与系统消费者评估（HCAHPS）调查询问患者，其医生以礼貌和尊重的态度对待他们、认真倾听并以易懂的方式解释事情的频率如何。此类总结报告可能会掩盖不同类型医生之间的差异。开展了一项研究，以检验不同类型医生的评分与医生总体HCAHPS评分之间的关联。
一项混合方法研究包括对医院教学服务中的患者进行封闭式调查和深入访谈。使用HCAHPS的三项医生沟通项目，就患者与急诊医学（EM）医生、住院医生和专科医生的沟通经历对患者进行访谈。使用斯皮尔曼相关系数和线性回归检验总体得分与每种医生类型得分之间的关联。使用持续比较法分析来自额外深入访谈的定性数据，以识别反复出现的主题。
招募了96名患者参与调查，并对前30名患者进行了额外的深入访谈。住院医生和专科医生的得分与总体得分显著相关（p值<0.05）。关于患者评分决定因素的反复出现的主题分为三个广泛领域：个体医生行为、团队沟通和系统问题。每个领域的影响因医生类型而异。
医生沟通得分可能受患者与住院医生和专科医生而非EM医生的经历影响最大。几个团队沟通和系统问题代表了改善医生沟通的机会。
