Does physician-patient communication that aims at empowering patients improve clinical outcome? A case study.
OBJECTIVE
A case study at the department for heart surgery of an Austrian University Hospital in 2001, examined the outcome of improved communication aimed at empowering patients to be more effective co-producers of recuperation after surgery.


METHODS
Evaluated were the effects of a training program for developing communication skills of health professionals (physicians, physiotherapists, and nurses) along with a reorganization of patient information schemes. The clinical outcomes after four types of surgery (bypass, stent, artificial valve insertion and combination of these) were observed in 100 patients without (control group) and 99 with the intervention administered (intervention group). Two objective and two subjective health outcome parameters were selected for analysis: care level adjusted length of stay in hospital, frequency of post-surgery complications, subjective health, subjective satisfaction with care received. Self-administered breathing exercises were measured as an intermediary outcome parameter.


RESULTS
In the intervention group length of hospital stay was shorter (by 1 day), incidence of post-surgery tachyarrhythmia was reduced (by 15%), transfer to less intensive care levels was faster and patient ratings for communicative quality of care by doctors and nurses were improved.


CONCLUSIONS
Professional communication aimed at empowering patients to act as co producers can indeed have an effect on clinical outcome.


CONCLUSIONS
Staff training and reorganization of communication schemes can be an effective intervention in hospital care.
Trummer
Ursula F
UF
Ludwig Boltzmann Institute for Sociology of Health and Medicine, WHO, Collaborating Center for Health Promotion in Hospitals and Health Care, Vienna, Austria. uschi.trummer@univie.ac.at
Mueller
Ulrich O
UO
Nowak
Peter
P
Stidl
Thomas
T
Pelikan
Jürgen M
JM
D000328:Adult; D000368:Aged; D001145:Arrhythmias, Cardiac / Q000453:epidemiology / Q000209:etiology; D001317:Austria / Q000453:epidemiology; D006348:Cardiac Surgical Procedures / Q000009:adverse effects / Q000193:education / Q000523:psychology*; D002983:Clinical Competence / Q000592:standards; D003142:Communication; D005260:Female; D006801:Humans; D015994:Incidence; D007318:Inservice Training / Q000458:organization & administration; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008505:Medical Staff, Hospital / Q000193:education / Q000523:psychology; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D010353:Patient Education as Topic / Q000458:organization & administration*; D010358:Patient Participation / Q000379:methods / Q000523:psychology; D017060:Patient Satisfaction; D010360:Patient Transfer / Q000706:statistics & numerical data; D010817:Physician-Patient Relations; D011182:Postoperative Care / Q000193:education / Q000523:psychology; D011209:Power, Psychological; D015397:Program Evaluation