Horton Devin J, Yarbrough Peter M, Wanner Nathan, Murphy Ryan D, Kukhareva Polina V, Kawamoto Kensaku
1 University of Utah, Salt Lake City, UT.
2 George E. Wahlen Veteran Affairs Medical Center, Salt Lake City, UT.
Am J Med Qual. 2017 Nov/Dec;32(6):617-624. doi: 10.1177/1062860616689592. Epub 2017 Feb 1.
Physicians often fail to communicate well with patients. The objective of this retrospective controlled interrupted time series study was to evaluate the impact of a standardized communication intervention to improve physician communication. All patients ages 18 years or older (N = 7739 visits) admitted to University of Utah Health Care in Salt Lake City, Utah, from July 1, 2012, to June 31, 2014, were included. Obstetrics, rehabilitation, and psychiatric patients were excluded. The primary outcome was the percentage of patients who answered "Always" to all HCAHPS questions regarding physician-patient communication. Among the intervention group, the primary outcome increased from 56% to 63% ( P = .014, N = 1021) while remaining stable for the control group (65% to 66%, P = .6, N = 6718). The downward trend reversed after the intervention (-0.6% to +1.7% per month, P < .001). Standardized communication was associated with improvement in physician communication HCAHPS scores.
医生常常无法与患者进行良好的沟通。这项回顾性对照间断时间序列研究的目的是评估标准化沟通干预对改善医生沟通的影响。纳入了2012年7月1日至2014年6月31日期间在犹他州盐湖城的犹他大学医疗保健中心就诊的所有18岁及以上患者(N = 7739次就诊)。产科、康复科和精神科患者被排除在外。主要结局是在所有关于医患沟通的医疗保健消费者评估与医疗服务报告系统(HCAHPS)问题中回答“总是”的患者百分比。在干预组中,主要结局从56%提高到了63%(P = 0.014,N = 1021),而对照组保持稳定(65%至66%,P = 0.6,N = 6718)。干预后下降趋势逆转(每月从-0.6%变为+1.7%,P < 0.001)。标准化沟通与医生沟通的HCAHPS评分改善相关。