title: The relationship between time spent communicating and communication outcomes on a hospital medicine service.
abstract: BACKGROUND
  Quality care depends on effective communication between caregivers, but it is unknown whether time spent communicating is associated with communication outcomes.
  
  
  OBJECTIVE
  To assess the association between time spent communicating, agreement on plan of care, and patient satisfaction.
  
  
  METHODS
  Time-motion study with cross-sectional survey.
  
  
  METHODS
  Academic medical center.
  
  
  METHODS
  Physicians, patients, and nurses on a hospital medicine service.
  
  
  METHODS
  Hospitalists' forms of communication were timed with a stopwatch. Physician-nurse agreement on the plan of care and patient satisfaction with physician communication were assessed via survey.
  
  
  RESULTS
  Eighteen hospitalists were observed caring for 379 patients. On average, physicians spent more time per patient on written than verbal communication (median: 9.2 min. vs. 6.3 min, p<0.001). Verbal communication was greatest with patients (mean time 5.3 min, range 0-37 min), then other physicians (1.4 min), families (1.1 min), nurses (1.1 min), and case managers (0.4 min). There was no verbal communication with nurses in 30% of cases. Nurses and physicians agreed most about planned procedures (87%), principal diagnosis (74%), tests ordered (73%), anticipated discharge date (69%) and least regarding medication changes (59%). There was no association between time spent communicating and agreement on plan of care. Among 123 patients who completed surveys (response rate 32%), time physicians spent talking to patients was not correlated with patients' satisfaction with physician communication (Pearson correlation coefficient = 0.09, p=0.30).
  
  
  CONCLUSIONS
  Hospitalists vary in the amount of time they spend communicating, but we found no association between time spent and either patient satisfaction or nurse-physician agreement on plan of care.
authors.affiliation: Center for Quality of Care Research, Springfield, MA, USA. Michael.Rothberg@bhs.org
authors.forename: Michael B
authors.initials: MB
authors.lastname: Rothberg
authors.forename: John R
authors.initials: JR
authors.lastname: Steele
authors.forename: John
authors.initials: J
authors.lastname: Wheeler
authors.forename: Ashish
authors.initials: A
authors.lastname: Arora
authors.forename: Aruna
authors.initials: A
authors.lastname: Priya
authors.forename: Peter K
authors.initials: PK
authors.lastname: Lindenauer
mesh_terms: D003142:Communication; D003266:Continuity of Patient Care / Q000592:standards*; D003430:Cross-Sectional Studies; D020445:Hospitalists / Q000379:methods / Q000592:standards*; D006801:Humans; D010348:Patient Care Team / Q000592:standards*; D017060:Patient Satisfaction; D010817:Physician-Patient Relations; D013996:Time and Motion Studies; D016896:Treatment Outcome