03.05 Identification of Clinical Risk Factors Affecting Patient-Physician Communication

S. Khedr1, A. Santos1, A. Torices Dardon1, K. Khariton1, C. Chen1, M. Kopp1  1NewYork-Presbyterian Queens, Surgery, Flushing, NEW YORK, USA

Introduction: Patient satisfaction is an important indicator of quality in healthcare and is linked to clinical outcomes, hospital rankings, patient retention, hospital reimbursement, malpractice claims, personal and professional satisfaction. Efficient physician-patient communication is essential to providing high-quality healthcare and improving patient satisfaction. Patients admitted to the hospital from the Emergency Department may not understand their diagnosis, reason for admission or plan of care, which can adversely impact their hospital experience and in turn reflect poorly in the Hospital Consumer Assessment of Healthcare Providers and Systems scores. We aim to identify risk factors that contribute to poor patient-physician communication.

Methods: From November 2020 to April 2021, patients admitted to the surgical floor were surveyed within 24 hours of admission. They were surveyed by either a Registered Nurse, Research Assistant, or Surgical Resident. They were asked “Do you know why you are in the hospital?”, “Do you know what your diagnosis is?”, “Do you understand your diagnosis?” and “Do you know what your treatment plan is?” A chart review was then performed recording patient demographics, preferred language, time of admission, health insurance, dependence in activities of daily living, dwelling, hearing impairment, pain level at time of admission, and number of chronic medical problems. Patients were excluded if they were < 18 years of age, had a history of neurocognitive disorders, had altered mental status defined as GCS < 15, required admission to the Intensive Care Unit or Step-Down Unit. Residents and attendings were debriefed regarding improving physician-patient communication at the end of January 2021 in order to raise awareness of the issue. Surveys answered before and after the brief intervention were compared.

Results: 131 patients that were admitted to the surgical floor were surveyed. Nineteen did not know their diagnoses (14%), 29 could not explain their diagnoses (22%), and 28 did not know their treatment plans (21%). A total of 29% of patients answered “no” to at least one question. Trauma patients (p = 0.027), patients with pain score > 4 at time of admission (p = 0.035), age > 65 (p = 0.044), and patients with >3 comorbidities (p = 0.035) were more likely to answer “no” to at least one of the questions. Limited English proficiency, insurance status, gender, and time of admission were not statistically significant barriers to effective communication. After raising awareness regarding improving physician-patient communication, we saw an 11% reduction in number of patients answering “no” to 24% from 35%.

Conclusion: Trauma patients, patients with poor pain control, the elderly and those with multiple comorbidities are more likely to experience poor patient-physician communication. Additionally, we found that raising awareness of the importance of this matter resulted in an improvement in communication.