Velez Vicente J, Kaw Roop, Hu Bo, Frankel Richard M, Windover Amy K, Bokar Dan, Rish Julie M, Rothberg Michael B
Department of Hospital Medicine, Medicine Institute, Center for Excellence in Healthcare Communication, Office of Patient Experience, Cleveland Clinic, Cleveland, Ohio.
Department of Hospital Medicine, Medicine Institute, Department of Outcomes Research, Anesthesiology Institute, Cleveland Clinic, Cleveland, Ohio.
J Hosp Med. 2017 Jun;12(6):421-427. doi: 10.12788/jhm.2743.
Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) scores measure patient satisfaction with hospital care. It is not known if these reflect the communication skills of the attending physician on record. The Four Habits Coding Scheme (4HCS) is a validated instrument that measures bedside physician communication skills according to 4 habits, namely: investing in the beginning, eliciting the patient's perspective, demonstrating empathy, and investing in the end.
To investigate whether the 4HCS correlates with provider HCAHPS scores.
Using a cross-sectional design, consenting hospitalist physicians (n = 28), were observed on inpatient rounds during 3 separate encounters. We compared hospitalists' 4HCS scores with their doctor communication HCAHPS scores to assess the degree to which these correlated with inpatient physician communication skills. We performed sensitivity analysis excluding scores returned by patients cared for by more than 1 hospitalist.
A total of 1003 HCAHPS survey responses were available. Pearson correlation between 4HCS and doctor communication scores was not significant, at 0.098 (-0.285, 0.455; P = 0.619). Also, no significant correlations were found between each habit and HCAHPS. When including only scores attributable to 1 hospitalist, Pearson correlation between the empathy habit and the HCAHPS respect score was 0.515 (0.176, 0.745; P = 0.005). Between empathy and overall doctor communication, it was 0.442 (0.082, 0.7; P = 0.019).
Attending-of-record HCAHPS scores do not correlate with 4HCS. After excluding patients cared for by more than 1 hospitalist, demonstrating empathy did correlate with the doctor communication and respect HCAHPS scores. Journal of Hospital Medicine 2017;12:421-427.
医院医疗服务提供者及系统消费者评估（HCAHPS）评分用于衡量患者对医院护理的满意度。目前尚不清楚这些评分是否反映了记录在案的主治医生的沟通技巧。四习惯编码方案（4HCS）是一种经过验证的工具，可根据四个习惯来衡量床边医生的沟通技巧，这四个习惯分别是：在沟通开始时投入、引出患者的观点、表达同理心以及在沟通结束时投入。
研究4HCS与医疗服务提供者HCAHPS评分之间是否相关。
采用横断面设计，在3次不同的查房过程中观察了同意参与的住院医生（n = 28）。我们将住院医生的4HCS评分与其医生沟通HCAHPS评分进行比较，以评估这些评分与住院医生沟通技巧的相关程度。我们进行了敏感性分析，排除了由多名住院医生护理的患者返回的评分。
共获得1003份HCAHPS调查回复。4HCS与医生沟通评分之间的Pearson相关性不显著，为0.098（-0.285，0.455；P = 0.619）。此外，每个习惯与HCAHPS之间均未发现显著相关性。仅纳入由一名住院医生护理的患者的评分时，同理心习惯与HCAHPS尊重评分之间的Pearson相关性为0.515（0.176，0.745；P = 0.005）。同理心与医生总体沟通之间的相关性为0.442（0.082，0.7；P = 0.019）。
记录在案的主治医生的HCAHPS评分与4HCS不相关。在排除由多名住院医生护理的患者后，表达同理心与医生沟通及HCAHPS尊重评分确实相关。《医院医学杂志》2017年；12：421 - 427。
