Communication failure between patients and providers in hospital settings lead to patient dissatisfaction. Simple, low-cost interventions, (e.g., bedside whiteboards and face cards), have been used to enhance communication between patients, families and medical teams. However, the impact of these interventions on patient satisfaction is poorly understood. 


Medline, Embase, SCOPUS, Web of science, CINAHL and Cochrane, were searched from inception to April 2016. Studies that reported (a) ease of physician identification, (b) understanding of provider roles, (c) professional communication, and (d) patient satisfaction with visual tools (e.g., whiteboards, face-cards, note-pads etc.) in adult or pediatric (represented by family members or care givers) hospitalized patients were included. Risk of study bias was assessed using the Downs and Black scale.


Of 2148 citations retrieved, 66 articles were reviewed; 13 studies met eligibility criteria. Included studies used whiteboards (n=4); face cards (n=6); whiteboards and face cards (n=1); formatted note-pads (n=1); and electronic patient-portals (n=2) as interventions. Twelve studies reported quantitative outcome data, and one reported both quantitative and qualitative outcomes. Pictures of providers were most frequently used (n=6 studies). Most studies included adult medical patients (n=9). Overall, use of visual tools improved patients’ identification of their providers (n=11 studies). Visual tools had variable effect on understanding of providers’ roles: positive (n=7 studies); neutral (n=1 study); negative (n=1 study). In three studies, professional communication via use of whiteboards, notepads and patient portals improved. Satisfaction with use of pictures was positive (n=2 studies) or neutral (n=2 studies). Subgroup analysis suggests that variability in outcomes may relate to differences in the picture format (individual pictures of each provider vs. handouts with pictures of all providers), patient characteristics (adult vs. pediatric/patient vs. care givers) and study design.

Limitations: Only two of the thirteen studies were randomized controlled trials; studies were single-center; outcomes measured were heterogeneous across studies.


Use of bedside visual tools appears to improve patient recognition of providers, patient-provider communication and patient satisfaction. Variation in study designs, populations and outcomes limit generalizability of findings. Future research focusing on development and use of standardized tool(s) for dedicated populations appears necessary.