Background:

Patient experience scores are now widely accepted as a measure of healthcare quality and contribute to Medicare’s value-based purchasing quality reimbursement program. In order to enhance the patient’s experience, we must first seek to understand their perspective of the care received. A previous study suggested that patients’ perception of the amount of time that their physician spent during an ambulatory visit positively impacted their satisfaction. A second study of post-operative patients demonstrated that when providers sat down (as opposed to standing) at the bedside, patients’ perceived that more time was spent with them.  Evidence of the impact of provider posture on the inpatient experience is lacking.  The aim of this study was  to assess whether provider sitting behavior during a hospital encounter impacted patient or family reported satisfaction.

Methods:

This study was conducted at an urban, tertiary care teaching hospital.  A 12-item survey instrument was designed with input from members of our hospital’s Patient and Family Advisory Council. The survey included items related to sitting behavior as well as questions assessing whether the patient perceived that their providers kept them informed, spent enough time with them, listened to them, and were caring and polite. Surveys were administered for six months to a convenience sample of patients or their family members on a medical unit and a surgical unit at time of discharge.

Results:

We surveyed a total of 305 inpatients with 149 (48.9%) patients surveyed on a hospital medicine unit and 156 (51.1%) patients surveyed on a surgical unit. Sixty-four percent of medical patients and 80% of surgical patients reported that at least one provider sat down at some point during their hospitalization. Overall, patients who reported that at least one provider sat down while caring for them were more likely to feel that their provider spent appropriate time with them (p=0.004) and that their provider kept them well informed (p=0.03).  There was no significant difference in patient’s report of their healthcare provider being polite to them (p=0.86), caring about them (p=0.31) and listening to them (p=0.63) if a provider sat down compared to if no provider sat down. When a physician sat down (as opposed to any other healthcare provider), patients were more likely to report that their provider kept them well informed (p=0.003) and spent appropriate time with them (p=0.009). However, all other satisfaction measures were not statistically significant.

Conclusions:

Sitting down at a patient’s bedside improves aspects of patient and families’ experience of their hospital care.  Efforts to improve the patient experience in the hospital setting should include an emphasis on sitting down at the bedside.