S. R. DiBrito1, R. Craig-Schapiro1, H. Overton1, J. Taylor1, M. Bowring1, E. Haut1, B. C. Sacks1 1Johns Hopkins University School Of Medicine,Baltimore, MD, USA
Introduction: Patients often have an incomplete understanding of the roles of surgical providers and their level of training. Misunderstandings about who comprises the "surgical team" can lead to patient confusion, frustration, and dissatisfaction, thus making it difficult for the patient and surgeon to establish a trusting relationship.
Methods: As an ACGME-required residency quality improvement initiative, we conducted a prospective pre-intervention discharge survey of gastrointestinal surgery inpatients from 10/2016-01/2017 to evaluate patient opinions regarding the "surgical team" and other measures of patient satisfaction. The survey consisted of 8 questions on a 5-point Likert scale (1=strongly disagree to 5=strongly agree) in addition to patient demographics. We then introduced a "facesheet", containing team member photos, level of training, and roles [Figure]. We distributed sheets to all surgical inpatients from 02/2017-05/2017. We surveyed these post-intervention patients using the same survey tool. We compared the pre-and post-intervention scores with Mann-Whitney tests and Chi-squared tests after creating binary variables.
Results: We evaluated 153 pre- and 100 post-intervention patients. The two groups did not differ significantly in age, gender, or race. Pre-intervention patients reported median scores of 4 for 5 domains and median of 5 for 3 domains. Post-intervention, median scores were 4 in 3 domains and 5 in 5 domains. The percent of patients answering "Agreed (4) or Strongly Agreed (5)" overall rose from 83% to 88% (p=0.5). Scores for patients agreeing that they knew the "roles" of their providers increased from 72 to 83% (p=0.05) for intervention, and that it was "important" to know who surgical team members were increased from 85 to 94% (p=0.04). Interestingly, there was a trend towards significance in patients feeling more "confident" in their team overall following facesheet distribution (89 to 95%, p=0.09).
Conclusion: Distribution of facesheets increased patients’ knowledge of the roles of their surgical team members, and the feeling that it was important to know their teams. This intervention is simple, inexpensive, easy to implement, and delivers improvement in the patient experience during surgical admissions. A patient's improved understanding of their inpatient surgical team may be reflected in improved satisfaction scores, and may help foster a stronger patient-physician relationship.
