Background: Many hospitalized patients do not understand their treatment and care plans [1] and research shows that better physician communication skills improve patient outcomes [2]. Since these communication skills are teachable, many institutions implement a standardized communication tool for physicians and trainees [3, 4, 5, 6]. The evidence-based Acknowledge, Introduce, Duration, Explanation, and Thank (AIDET) communication tool improves patient and provider interactions via a demonstrated increase in patient satisfaction scores in both institutional and national HCAHPS metrics [7, 8, 9]. Additionally, medical students have a particularly valuable role in quality improvement projects due to their idealism, commitment, and that they may have less normalization of deviation from expected practices.
Methods: A student-led team collected prospective data by observing 14 episodes of hospital medicine rounds. Team members collected pre- and post-intervention data in patient and hospital medicine physician interactions using a validated survey. Interactions between patients and either (1) attending hospitalists, (2) resident physicians, or (3) medical students were observed. Consequently, the education and real-time feedback intervention targeted each of these three groups.
The intervention included student-led education about AIDET and its association with increased patient satisfaction scores and health outcomes: (1) to the attending physicians during an in-service, (2) to the resident physicians in a scheduled morning report, and (3) to the medical students in the internal medicine rotation. Team members furthermore communicated real-time feedback to providers following each patient encounter during the post-intervention period.
Results: The three-month pre-intervention data collection analysis showed that providers acknowledge the patient with a personalized greeting 89% of the time, introduce themselves by their title and role 93% of the time, estimate the duration of time left in the hospital only 33% of the time, explain the diagnosis to the patient 93% of the time, and deliberately thank the patient only 56% of the time.
The three-month post-intervention data collection analysis showed that providers acknowledge the patient with a personalized greeting 96% of the time, introduce themselves by their title and role 100% of the time, estimate the duration of time left in the hospital only 85% of the time, explain the diagnosis to the patient 88% of the time, and deliberately thank the patient only 96% of the time.
Conclusions: This ongoing project demonstrates that a student-led education and real time feedback intervention increases the use of AIDET in patient and provider interactions to greater than 85% in all categories. Furthermore, the AIDET model increases patient satisfaction and quality of care. From a broader perspective, this translates to an improved patient experience.