Background: Effectively communicating information to a patient is the driving force for a successful physician-patient relationship. Patient outcomes depend on successful communication. As efficiency metrics and clinical productivity remain top priorities for most health systems, time spent with each patient gets affected hindering effective patient-physician communication. This in turn affects the HCAHPS (Hospital Consumer Assessment of Healthcare Providers and Systems) scores.
Purpose: To study the effect of the “Ask Them Three” card on patient-physician communication.
Description: To improve our patient-physician communication, the Division of Hospital Medicine and the Department of Patient and Family Centered Care decided to implement the use of the Insitute for Healthcare Improvement card titled “Ask Them Three.” This card would be piloted on a couple of units who struggled with their patient-physician communication scores. Once patients got to their rooms, the card would be at their bedside. The card lists 3 questions to be reviewed daily by the hospitalist, a blank space for patients to write down any questions that come up as well as a place for the hospitalist to write their name. The questions listed on the card addressed whether the patient’s plan of care was reviewed whether any pending tests were still needed and whether the hospitalists discussed the patient’s anticipated discharge date. This card would be included in the discharge paperwork for the patient to keep.We conducted surveys on the units we piloted asking patients whether they found it helpful, whether it enhances communication with the hospitalist and whether it helps them understand their plan of care. 76% found the card helpful, 73% found the card to enhance communication and 69% found the card helpful in understanding their plan of care.In comparing HCAHPS scores on those same units for patients discharged between 5/2021-10/2021 and 5/2022-10/2022, we noticed the “communication with doctors” domain score increased from 72% to 80%. As a result, the overall “recommend the hospital” score for those same units also increased during the same time period from 55% to 70%.
Conclusions: In its early pilot phases, the Ask Them Three card has been shown to help improve patient-physician communication. With the implementation of the Ask Them Three card, hospitalists are prompted to engage with their patients in a more consistent and thorough manner. Not only is their plan of care being reiterated and questions answered daily, but overall physician-patient communication is being highlighted and reinforced. As a result, we are seeing higher patient-physician communication HCAHPS scores, which is commonly used as an indicator for measuring quality in our health care system. We are hoping to expand this pilot throughout the hospital.