The impact of business cards on physician recognition after general anesthesia

Doctor Who? A Quality Improvement Project to Assess and Improve Patients' Knowledge of Their Inpatient Physicians

Background Patient-physician communication is an integral part of high-quality patient care and an expectation of the Clinical Learning Environment Review program. Objective This quality improvement initiative evaluated the impact of an educational audit and feedback intervention on the frequency of use of 2 tools-business cards and white boards-to improve provider identification. Methods This before-after study utilized patient surveys to determine the ability of those patients to name and recognize their physicians. The before phase began in July 2013. From September 2013 to May 2014, physicians received education on business card and white board use. Results We surveyed 378 patients. Our intervention improved white board utilization (72.2% postintervention versus 54.5% preintervention, P < .01) and slightly improved business card use (44.4% versus 33.7%, P = .07), but did not improve physician recognition. Only 20.3% (14 of 69) of patients could name their physician without use of the business card or white board. Data from all study phases showed the use of both tools improved patients' ability to name physicians (OR = 1.72 and OR = 2.12, respectively; OR = 3.68 for both; P < .05 for all), but had no effect on photograph recognition. Conclusions Our educational intervention improved white board use, but did not result in improved patient ability to recognize physicians. Pooled data of business cards and white boards, alone or combined, improved name recognition, suggesting better use of these tools may increase identification. Future initiatives should target other barriers to usage of these types of tools.

Patient satisfaction in the emergency department and the use of business cards by physicians

BACKGROUND

Emergency departments (EDs) across the country become increasingly crowded. Methods to improve patient satisfaction are becoming increasingly important.

OBJECTIVE

To determine if the use of business cards by emergency physicians improves patient satisfaction.

METHODS

A prospective, convenience sample of ED patients were surveyed in a tertiary care, suburban teaching hospital. Inclusion criteria were limited to an understanding of written and spoken English. Excluded patients included those with altered mental status or too ill to complete a survey. Patients were assigned to receive a business card on alternate days in the ED from the treating physician(s) during their patient introductions. The business cards listed the physician's name and position (resident or attending physician) and the institution name and phone number. Before hospital admission or discharge, a research assistant asked patients to complete a questionnaire regarding their ED visit to determine patient satisfaction.

RESULTS

Three hundred-twenty patients were approached to complete the questionnaire and 259 patients (81%) completed it. Patient demographics were similar in both the business card and non-business-card groups. There were no statistically significant differences for patient responses to any of the study questions whether or not they received a business card during the physician introduction.

CONCLUSION

The use of business cards during physician introduction in the ED does not improve patient satisfaction.

Informed Consent for Anaesthesia in Australia and New Zealand

The legal and ethical requirements related to an anaesthetist's communication with patients in preparing them for anaesthesia, assisting them in making appropriate decisions and obtaining consent in a formal sense are complex. Doing these things well takes time, skill and sensitivity. The primary focus should be to adequately prepare patients for surgery and to ensure that they are sufficiently well informed to make the choices that best meet their own needs. This is just an affirmation of the importance of patient-centred care.

Predicting orthopedic surgeons' preferences for peripheral nerve blocks for their patients

BACKGROUND

A 2002 survey of 468 Canadian orthopedic surgeons found that the "two principal reasons regional anesthesia is not favored" are "delays in operating rooms" and "unpredictable success." We reanalyzed the data from the study to evaluate whether these concerns were the best predictors of an individual surgeon's willingness to use peripheral nerve blocks for their patients.

METHODS

Of the five procedures included in the survey, three had relevant questions for our reanalysis of the results: arthroscopic shoulder surgery, arthroscopic anterior cruciate ligament reconstruction, and total knee replacement.

RESULTS

A surgeon's preference for peripheral nerve block for him or herself strongly predicted his or her anesthetic preference for patients (all P < 0.001). Concordance rates were 89% for arthroscopic shoulder surgery, 87% for anterior cruciate ligament reconstruction, and 93% for total knee replacement. There was almost no incremental predictive value for the surgeon's preference for patients from the surgeon's perception of the times to perform a block (P > or = 0.27) or perception of block success rate (P > or = 0.30). There was also almost no direct predictive value for the surgeon's preference for patients from the surgeon's perception of the times to perform a block (Kendall's tau < or = 0.04, P > or = 0.28) or perception of block success rate (Kendall's tau < or = 0.02, P > or = 0.24). An economically important percentage of surgeons (37%, 95% confidence interval: 32%-41%) would choose a peripheral nerve block for their own surgery for some, but not all, of the procedures (i.e., for 1 or 2 versus 0 or 3).

CONCLUSIONS

A surgeon's preference for peripheral nerve blocks for his or her own surgery predicted a surgeon's preference for his or her patients. Perceptions of delays and success rate did not add sufficient incremental information to the surgeon's preferences to be of economic importance. These results are important to better forecast the net economic impact on an anesthesia group of a regional block team.

Communication with patients before anesthesia and obtention of preanesthetic consent

Communication in medicine deserves greater attention than it usually receives. The physician's obligation to obtain informed consent for clinical care and research forces the issue out into the open. Recognition that communication can have legal and economic impacts suggests communication skills should be cultivated as a medical art. This review places communication issues in anesthesia practice, especially those related to informed consent, in an historical, and when possible, scientific context.

Significance of working conditions on burnout in anesthetists

BACKGROUND

The influence of working conditions on the development of burnout syndrome was assessed in anesthetists working at a university hospital.

METHODS

Self-reporting questionnaires were used to assess physical health and emotional well-being (Health and Stress Profile), burnout syndrome (Maslach Burnout Inventory) and working conditions (Instrument for Stress-Oriented Task Analysis) in anesthetists.

RESULTS

Twenty-three anesthetists (25.8%) appeared to be at risk for burnout, and three anesthetists (3.4%) had already developed full-blown burnout syndrome. Anesthetists at risk for burnout more frequently suffered from limited complexity of work (P=0.001), lacking individual time control (P=0.004), lack of participation possibilities (P=0.012), and had more physical complaints (P=0.017) and greater job dissatisfaction (P=0.002) than did their colleagues with no burnout symptoms.

CONCLUSION

Job conditions providing little opportunity to influence work pace and participation contribute to the development of burnout syndrome. Communication and contact with colleagues appear to be an important preventive regulative.