1
|
Golden BP, Tackett S, Kobayashi K, Nelson T, Agrawal A, Pritchett N, Tilton K, Mills G, Lorigiano TJ, Hirpa M, Lin J, Disney S, Lautzenheiser M, Huang S, Berry SA. Sitting at the Bedside: Patient and Internal Medicine Trainee Perceptions. J Gen Intern Med 2022; 37:3038-3044. [PMID: 35013927 PMCID: PMC8744572 DOI: 10.1007/s11606-021-07231-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Accepted: 10/19/2021] [Indexed: 11/24/2022]
Abstract
BACKGROUND Sitting at the bedside may strengthen physician-patient communication and improve patient experience. Yet despite the potential benefits of sitting, hospital physicians, including resident physicians, may not regularly sit down while speaking with patients. OBJECTIVE To examine the frequency of sitting by internal medicine residents (including first post-graduate year [PGY-1] and supervising [PGY-2/3] residents) during inpatient encounters and to assess the association between patient-reported sitting at the bedside and patients' perceptions of other physician communication behaviors. We also assessed residents' attitudes towards sitting. DESIGN In-person survey of patients and email survey of internal medicine residents between August 2019 and January 2020. PARTICIPANTS Patients admitted to general medicine teaching services and internal medicine residents at The Johns Hopkins Hospital. MAIN MEASURES Patient-reported frequency of sitting at the bedside, patients' perceptions of other communication behaviors (e.g., checking for understanding); residents' attitudes regarding sitting. KEY RESULTS Of 334 eligible patients, 256 (76%) completed a survey. Among these 256 respondents, 198 (77%) and 166 (65%) reported recognizing the PGY-1 and PGY-2/3 on their care team, respectively, for a total of 364 completed surveys. On most surveys (203/364, 56%), patients responded that residents "never" sat. Frequent sitting at the bedside ("every single time" or "most of the time," together 48/364, 13%) was correlated with other positive behaviors, including spending enough time at the bedside, checking for understanding, and not seeming to be in a rush (p < 0.01 for all). Of 151 residents, 77 (51%) completed the resident survey; 28 of the 77 (36%) reported sitting frequently. The most commonly cited barrier to sitting was that chairs were not available (38 respondents, 49%). CONCLUSIONS Patients perceived that residents sit infrequently. However, sitting was associated with other positive communication behaviors; this is compatible with the hypothesis that promoting sitting could improve overall patient perceptions of provider communication.
Collapse
Affiliation(s)
- Blair P Golden
- Department of Medicine, University of Wisconsin-Madison School of Medicine and Public Health, K4/463 CSC, 600 Highland Avenue Madison, Madison, WI, 53792, USA.
| | - Sean Tackett
- Department of Medicine, Division of General Internal Medicine, Johns Hopkins Bayview Medical Center, Johns Hopkins University School of Medicine, Baltimore, MD, USA.,Biostatistics, Epidemiology, and Data Management Core, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Kimiyoshi Kobayashi
- Department of Medicine, University of Massachusetts Memorial Medical Center, Worcester, MA, USA
| | - Terry Nelson
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Alison Agrawal
- Central Billing Office, University of Maryland Medical System, Hunt Valley, Baltimore, MD, USA
| | - Nicole Pritchett
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Kaley Tilton
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Geron Mills
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Ting-Jia Lorigiano
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Meron Hirpa
- Cincinnati Health Department, Cincinnati, OH, USA
| | - Jessica Lin
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Sarah Disney
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Matt Lautzenheiser
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Shanshan Huang
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Stephen A Berry
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| |
Collapse
|