Studying physician-patient communication in the acute care setting: the hospitalist rapport study.
OBJECTIVE
To assess the feasibility of studying physician-patient communication in the acute care setting.


METHODS
We recruited hospitalist physicians and patients from two hospitals within a university system and audio-recorded their first encounter. Recruitment, data collection, and challenges encountered were tracked.


RESULTS
Thirty-two physicians consented (rate 91%). Between August 2008 and March 2009, 441 patients were referred, 210 (48%) were screened, and 119 (66% of 179 eligible) consented. We audio-recorded encounters of 80 patients with 27 physicians. Physicians' primary concern about participation was interference with their workflow. Addressing their concerns and building the protocol around their schedules facilitated participation. Challenges unique to the acute care setting were: (1) extremely limited time for patient identification, screening, and enrollment during which patients were ill and busy with clinical care activities and (2) little advance knowledge of when physician-patient encounters would occur. Employing a full-time study coordinator mitigated these challenges.


CONCLUSIONS
Physician concerns for participating in communication studies are similar in ambulatory and acute care settings. The acute care setting presents novel challenges for patient recruitment and data collection.


CONCLUSIONS
These methods should be used to study provider-patient communication in acute care settings. Future work should test strategies to increase patient enrollment.
Anderson
Wendy G
WG
Division of Hospital Medicine, Department of Medicine, University of California, San Francisco, CA 94143-0903, USA. anderson.wg@gmail.com
Winters
Kathryn
K
Arnold
Robert M
RM
Puntillo
Kathleen A
KA
White
Douglas B
DB
Auerbach
Andrew D
AD
D000208:Acute Disease; D000328:Adult; D003142:Communication; D003430:Cross-Sectional Studies; D005240:Feasibility Studies; D005260:Female; D020445:Hospitalists; D006801:Humans; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D010817:Physician-Patient Relations; D013637:Tape Recording
J Gen Intern Med. 1995 Aug;10(8):436-42
7472700
Patient Educ Couns. 2006 Oct;63(1-2):138-44
16242896
J Bone Joint Surg Am. 2008 Jul;90(7):1427-35
18594089
Crit Care Med. 2006 Jun;34(6):1679-85
16625131
Ann Intern Med. 1998 Sep 15;129(6):441-9
9735081
J Fam Pract. 1998 Sep;47(3):213-20
9752374
J Clin Oncol. 1999 Jan;17(1):371-9
10458256
Arch Intern Med. 2007 Mar 12;167(5):461-7
17353493
JAMA. 1997 Feb 26;277(8):678-82
9039890
Support Care Cancer. 2008 Sep;16(9):1049-57
18196288
Am J Respir Crit Care Med. 2005 May 1;171(9):987-94
15665319
Crit Care Med. 2007 Feb;35(2):442-8
17205000
JAMA. 2000 Aug 23-30;284(8):1021-7
10944650
Am J Respir Crit Care Med. 2005 Apr 15;171(8):844-9
15640361
J Gen Intern Med. 2007 Oct;22(10):1429-33
17674111
Health Care Manag (Frederick). 2004 Jul-Sep;23(3):238-56
15457841
Med Care. 1998 May;36(5):728-39
9596063
Support Care Cancer. 2002 May;10(4):314-21
12029431
Palliat Med. 2006 Dec;20(8):813-9
17148536
Patient Educ Couns. 2008 May;71(2):157-68
18356003
J Clin Oncol. 2007 Dec 20;25(36):5748-52
18089870
Psychooncology. 2005 Oct;14(10):812-28; discussion 829-30
16200512
J Gen Intern Med. 1997 Jun;12(6):339-45
9192250
J Fam Pract. 2007 Dec;56(12):1031-6
18053443
Patient Educ Couns. 2003 May;50(1):17-21
12767579
J Crit Care. 2002 Sep;17(3):147-60
12297990
Psychooncology. 2002 Jan-Feb;11(1):47-58
11835592