• J Gen Intern Med · Nov 2009

    Comparative Study

    Impact of localizing physicians to hospital units on nurse-physician communication and agreement on the plan of care.

    • Kevin J O'Leary, Diane B Wayne, Matthew P Landler, Nita Kulkarni, Corinne Haviley, Katherine J Hahn, Jiyeon Jeon, Katherine M Englert, and Mark V Williams.
    • Division of Hospital Medicine, Northwestern University Feinberg School of Medicine, 259 E. Erie Street, Chicago, IL 60611, USA. keoleary@nmh.org
    • J Gen Intern Med. 2009 Nov 1; 24 (11): 122312271223-7.

    BackgroundA significant barrier to communication among patient care providers in hospitals is the geographic dispersion of team members.ObjectiveTo determine whether localizing physicians to specific patient care units improves nurse-physician communication and agreement on patients' plans of care.MethodsWe conducted structured interviews of a cross-sectional sample of nurses and physicians before and after an intervention to localize physicians to specific patient care units. Interviews characterized patterns of nurse-physician communication and assessed understanding of patients' plans of care. Two internists reviewed responses and rated nurse-physician agreement on six aspects of the plan of care as none, partial, or complete agreement.ResultsThree hundred eleven of 342 (91%) and 291 of 294 (99%) patients' nurses and 301 of 342 (88%) and 285 of 294 (97%) physicians completed the interview during the pre- and post-localization periods. Two hundred nine of 285 (73%) patients were localized to physicians' designated patient care units in the post-localization period. After localization, a higher percentage of patients' nurses and physicians was able to correctly identify one another (93% vs. 71%; p < 0.001 and 58% vs. 36%; p < 0.001, respectively). Nurses and physicians reported more frequent communication after localization (68% vs. 50%; p < 0.001 and 74% vs. 61%; p < 0.001, respectively). Nurse-physician agreement was significantly improved for two aspects of the plan of care: planned tests and anticipated length of stay.ConclusionsAlthough nurses and physicians were able to identify one another and communicated more frequently after localizing physicians to specific patient care units, there was little impact on nurse-physician agreement on the plan of care.

      Pubmed     Copy Citation     Plaintext  

      Add institutional full text...

    Notes

     
    Knowledge, pearl, summary or comment to share?
    300 characters remaining
    help        
    You can also include formatting, links, images and footnotes in your notes
    • Simple formatting can be added to notes, such as *italics*, _underline_ or **bold**.
    • Superscript can be denoted by <sup>text</sup> and subscript <sub>text</sub>.
    • Numbered or bulleted lists can be created using either numbered lines 1. 2. 3., hyphens - or asterisks *.
    • Links can be included with: [my link to pubmed](http://pubmed.com)
    • Images can be included with: ![alt text](https://bestmedicaljournal.com/study_graph.jpg "Image Title Text")
    • For footnotes use [^1](This is a footnote.) inline.
    • Or use an inline reference [^1] to refer to a longer footnote elseweher in the document [^1]: This is a long footnote..

    hide…