• Blair P Golden, Sean Tackett, Kimiyoshi Kobayashi, Terry S Nelson, Alison M Agrawal, Jerry Zhang, Nicole A Jackson, Geron Mills, Ting-Jia Lorigiano, Meron Hirpa, Jessica S Lin, Trent Johnson, Aparna Sajja, Sarah Disney, Shanshan Huang, Juhi Nayak, Matthew Lautzenheiser, and Stephen A Berry.
• Department of Medicine, University of Wisconsin-Madison School of Medicine and Public Health, Madison, Wisconsin, USA.
• J Hosp Med. 2024 May 1; 19 (5): 356367356-367.

BackgroundSitting at the bedside may improve patient-clinician communication; however, many clinicians do not regularly sit during inpatient encounters.ObjectiveTo determine the impact of adding wall-mounted folding chairs inside patient rooms, beyond any impact from a resident education campaign, on the patient-reported frequency of sitting at the bedside by internal medicine resident physicians.Design, Setting, And ParticipantsProspective, controlled pre-post trial between 2019 and 2022 (data collection paused 2020-2021 due to COVID-19) at an academic hospital in Baltimore, Maryland. Folding chairs were installed in two of four internal medicine units and educational activities were delivered equally across all units.Main Outcome And MeasuresPatient-reported frequency of sitting at bedside, assessed as means on Likert-type items with 1 being "never" and 5 being "every single time." We also examined the frequency of other patient-reported communication behaviors.ResultsTwo hundred fifty six and 206 patients enrolled in the pre and post-intervention periods, respectively. The mean frequency of patient-reported sitting by resident physicians increased from 1.8 (SD 1.2) to 2.3 (1.2) on education-only units (absolute difference 0.48 [95% CI: 0.21-0.75]) and from 2.0 (1.3) to 3.2 (1.4) on units receiving chairs (1.16, [0.87-1.45]). Comparing differences between groups using ordered logistic regression adjusting for clustering within residents, units with added chairs had greater increases in sitting (odds ratio 2.05 [1.10-3.82]), spending enough time at the bedside (2.43 [1.32-4.49]), and checking for understanding (3.04 [1.44-6.39]). Improvements in sitting and other behaviors were sustained on both types of units.ConclusionsAdding wall-mounted folding chairs may help promote effective patient-clinician communication.© 2024 The Authors. Journal of Hospital Medicine published by Wiley Periodicals LLC on behalf of Society of Hospital Medicine.

26 keywords...

hide…