Quality Improvement in Health Care (한국의료질향상학회지)

Korean Society for Quality in Health Care (한국의료질향상학회)
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Analysis of Communication Content on Bedside Rounds in a Hospital - Implications for Patient Centered Communication

일개 병원의 입원환자 회진의 의사소통 내용 분석 - 환자 중심 의사소통을 위한 함의

  • Yeon-Hoon Jang (Office of eHealth Research and Businesses, Seoul National University Bundang Hospital) ;
  • Myoung-Soon You (Department of Public Health, Graduate School of Public Health, Seoul National University) ;
  • Gi-Beom Park (Graduate School of Convergence Science and Technology, Seoul National University) ;
  • Bong-Won Suh (Graduate School of Convergence Science and Technology, Seoul National University) ;
  • Chang-Eun Song (Department of Otolaryngology-Head & Neck Surgery, Myongji Hospital, Hanyang University College of Medicine)
  • 장연훈 (분당서울대학교병원 디지털헬스케어 연구사업부) ;
  • 유명순 (서울대학교 보건대학원) ;
  • 박기범 (서울대학교 융합과학기술대학원) ;
  • 서봉원 (서울대학교 융합과학기술대학원) ;
  • 송창은 (한양대학교 의과대학 명지병원 이비인후과)
  • Received : 2023.03.31
  • Accepted : 2023.06.16
  • Published : 2023.06.30
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Abstract

Purpose:Few studies on bedside rounds have focused on the principles of patient-centered communication (PCC). This study pursued three objectives. First, we investigated the verbal contents of bedside rounds from the PCC perspective. Next, we analyzed inpatient surveys concerning patients' experience of and perspective regarding bedside rounds. Finally, we identified which factors affect patient satisfaction levels. Methods: To evaluate doctor-patient communication, the contents of bedside rounds from 151 patients (88 in medical wards and 63 in surgical wards) were analyzed using the Roter Interaction Analysis System. An inpatient survey was also conducted to obtain further information about patient experience. Results: The average duration of bedside rounds was 71.3 seconds. The distribution of conversations between doctors and patients was significantly different, with doctors accounting for 62% and patients for 38% of the total (p<.001). Both doctors (44.7%) and patients (40.5%) considered provision of biomedical information as the most important aspect of communication. On the other hand, the proportion of psychological-social communication was relatively low in both groups, at 2.3% and 4.2%, respectively. In the inpatient survey, 40.8% of respondents reported being uninformed about the ward round in advance, while 44.7% stated that the rounds did not take place at the pre-informed time. While 66.7% of participants felt that the interaction during rounds was sufficient, those who felt that they had insufficient round time were the least satisfied. There was a positive correlation between sufficiency of the bedside round duration and overall satisfaction with bedside round (p<.01). Conclusion: The findings of this study indicate that neither the verbal contents of the bedside rounds nor the overall patient satisfaction adequately meet the conditions for patient centeredness.

Keywords

Acknowledgement

This research was supported by the faculty grant of Myongji Hospital (1902-09-25)

References

  1. Jayadevappa R, Chhatre S. Patient centered care-a conceptual model and review of the state of the art. The Open Health Services and Policy Journal. 2011;4(1):15-25. https://doi.org/10.2174/1874924001104010015
  2. Scholl I, Zill JM, Harter M, Dirmaier J. An integrative model of patient-centeredness-a systematic review and concept analysis. PloS one. 2014;9(9):e107828.
  3. Epstein RM, Street RL. Patient-centered communication in cancer care: promoting healing and reducing suffering. Washington DC, USA: National Cancer Institute; 2007.
  4. Ruben BD. Communication theory and health communication practice: the more things change, the more they stay the same. Health communication. 2016;31(1):1-11. https://doi.org/10.1080/10410236.2014.923086
  5. Health Insurance Review & Assessment Service. Patient experience assessment results (2019 2nd). Wonju, Korea: Health Insurance Review & Assessment Service; 2020.
  6. Korea Institute for Health and Social Affairs. 2017 Korea medical quality report. Sejong, Korea: Korea Institute for Health and Social Affairs; 2017.
  7. Patient experience + service design myongji hospital hipex 2016 [Internet]. Seoul, Korea: Welfare News; 2016 [cited 2023 Mar 31]. Available from: http://www.whosaeng.com/85378.
  8. Lee YJ. An exploratory study on effects of ptient-doctor communication factors to influence on medical outcome: applying RIAS [Master's thesis]. Seoul: Seoul university; 2017.
  9. Lee MJ. A study on patient-doctor communication during medical consultations in korea. Seoul: Seoul University; 2020.
  10. Torke AM, Monahan P, Callahan CM, Helft PR, Sachs GA, Wocial LD, et al. Validation of the family inpatient communication survey. Journal of Pain and Symptom Management. 2017; 53(1):96-108. https://doi.org/10.1016/j.jpainsymman.2016.08.010
  11. HCAHPS: Patients' Perspectives of Care Survey [internet]. Baltimore, USA: Centers for Medicare & Medicaid Services. available from: https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/HospitalQualityInits/Hospitalhcahps.
  12. Forsythe DE, Buchanan BG, Osheroff JA, Miller RA. Expanding the concept of medical information: an observational study of physicians' information needs. Computers and Biomedical Research. 1992;25(2):181-200. https://doi.org/10.1016/0010-4809(92)90020-B
  13. Lee M, Seo S, Choi S, Park JH, Kim S, Choe YJ, et al. Parental acceptance of COVID-19 vaccination for children and its association with information sufficiency and credibility in South Korea. JAMA Network Open. 2022:5(12):e2246624.
  14. Stiell A, Forster AJ, Stiell IG, Walraven C. Prevalence of information gaps in the emergency department and the effect on patient outcomes. Canadian Medical Association Journal. 2003;169(10):1023-8. https://doi.org/10.1197/aemj.10.5.512-b
  15. Roter, D., Larson, S. The Roter interaction analysis system(RIAS): utility and flexibility for analysis of medical interactions. Patient education and counseling. 2002;46(4):243-51. https://doi.org/10.1016/S0738-3991(02)00012-5
  16. Dijkstra H, Albada A, Cronauer CK, Ausems MG, van Dulmen S. Nonverbal communication and conversational contribution in breast cancer genetic counseling: are counselors' nonverbal communication and conversational contribution associated with counselees' satisfaction, needs fulfillment and state anxiety in breast cancer genetic counseling?. Patient education and counseling. 2013;93(2):216-23. https://doi.org/10.1016/j.pec.2013.05.014
  17. Roter DL, Hall JA, Kern DE, Barker LR, Cole KA, Roca RP. Improving physicians' interviewing skills and reducing patients' emotional distress: a randomized clinical trial. Archives of internal medicine, 1995;155(17):1877-84. https://doi.org/10.1001/archinte.1995.00430170071009
  18. Castro EM, Regenmortel TV, Vanhaecht, K, Sermeus W, Hecke AV. Patient empowerment, patient participation and patient-centeredness in hospital care: A concept analysis based on a literature review. Patient Education and Counseling. 2016;99(12):1923-39. https://doi.org/10.1016/j.pec.2016.07.026
  19. Ha JF, Longnecker N. Doctor-patient communication: a review. Ochsner Journal. 2010;10(1):38-43.
  20. Sisterhen LL, Blaszak RT, Woods MB, Smith CE. Defining family-centered rounds. Teaching and learning in medicine. 2007;19(3):319-22. https://doi.org/10.1080/10401330701366812
  21. Mulugeta H, Afenigus AD, Wagnew F, Haile D, Tadesse A, Kibret GD. The effect of hourly nursing rounds on patient satisfaction at Debre Markos Referral Hospital, Northwest Ethiopia: A non-randomized controlled clinical trial. International Journal of Africa Nursing Sciences. 2020;13:e100239.
  22. Negarandeh R, Bahabadi AH, Mamaghani JA. Impact of regular nursing rounds on patient satisfaction with nursing care. Asian Nursing Research. 2014;8(4):282-5. https://doi.org/10.1016/j.anr.2014.10.005
  23. Poole K, Moran N, Bell G, Solomon J, Kendall S, McCarthy M, et al. Patients' perspectives on services for epilepsy: a survey of patient satisfaction, preferences and information provision in 2394 people with epilepsy. Seizure. 2000;9(8):551-8. https://doi.org/10.1053/seiz.2000.0450
  24. Im M, Oh J. An integrative review on family-centered rounds for hospitalized children caring. Child Health Nursing Research. 2016;22(2):107-16. https://doi.org/10.4094/chnr.2016.22.2.107