Siddiqui Zishan, Qayyum Rehan, Bertram Amanda, Durkin Nowella, Kebede Sosena, Ponor Lucia, Oduyebo Ibironke, Allen Lisa, Brotman Daniel J
Hospitalist Program, Division of General Internal Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland.
Department of Internal Medicine, University of Tennessee College of Medicine at Chattanooga, Chattanooga, Tennessee.
J Hosp Med. 2017 Jun;12(6):402-406. doi: 10.12788/jhm.2744.
There is a glaring lack of published evidence-based strategies to improve the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) patient experience scores on the physician domain. Strategies that have been used are resource intensive and difficult to sustain.
We hypothesized that prompting providers to assess their own etiquette-based practices every 2 weeks over the course of 1 year would improve patient experience on the physician domain.
Randomized controlled trial.
4 acute care hospitals.
Hospitalists.
Hospitalists were randomized to the study or the control arm. The study arm was prompted every 2 weeks for 12 months to report how frequently they engaged in 7 best-practice bedside etiquette behaviors. Control arm participants received similarly worded questions on quality improvement behaviors.
Provider experience scores were calculated from the physician HCAHPS and Press Ganey survey provider items.
Physicians reported high rates of etiquette-based behavior at baseline, and this changed modestly over the study period. Self-reported etiquette behaviors were not associated with experience scores. The difference in difference analysis of the baseline and postintervention physician experience scores between the intervention arm and the control arm was not statistically significant (P = 0.71).
In this 12-month study, biweekly reflection and reporting of best-practice bedside etiquette behaviors did not result in significant improvement on physician domain experience scores. It is likely that hospitalists' self-assessment of their bedside etiquette may not reflect patient perception of these behaviors. Furthermore, hospitalists may be resistant to improvement in this area since they rate themselves highly at baseline. Journal of Hospital Medicine 2017;12:402-406.
目前明显缺乏已发表的基于证据的策略来提高医疗服务提供者和系统的医院消费者评估（HCAHPS）中医生领域的患者体验得分。已采用的策略资源密集且难以持续。
我们假设在1年的时间里，每2周促使医疗服务提供者评估他们基于礼仪的行为，这将改善医生领域的患者体验。
随机对照试验。
4家急症护理医院。
住院医师。
住院医师被随机分配到研究组或对照组。研究组在12个月内每2周被促使报告他们进行7种最佳实践床边礼仪行为的频率。对照组参与者收到关于质量改进行为的措辞相似的问题。
根据医生HCAHPS和Press Ganey调查的提供者项目计算提供者体验得分。
医生在基线时报告基于礼仪行为的发生率很高，并且在研究期间变化不大。自我报告的礼仪行为与体验得分无关。干预组和对照组之间基线和干预后医生体验得分的差异分析无统计学意义（P = 0.71）。
在这项为期12个月的研究中，每两周对最佳实践床边礼仪行为进行反思和报告并未使医生领域的体验得分有显著改善。住院医师对其床边礼仪的自我评估可能无法反映患者对这些行为的看法。此外，住院医师可能在这方面抵制改进，因为他们在基线时对自己评价很高。《医院医学杂志》2017年；12：402 - 406。
