Background:

Effective communication between a hospitalist and his or her patients is essential. In the United States, the Accreditation Council for Graduate Medical Education and the American Board of Medical Specialties have recognized interpersonal and communication skills as 1 of the 6 general competencies for physicians. Previous research in the outpatient setting documented that patient satisfaction is highly correlated with communication patterns of physicians and duration of contact. We examined whether the length of time hospitalists spent with patients correlated with patient perception of communication.

Methods:

We combined results of a time–work flow analysis of hospitalists with results from patient surveys of hospitalist communication skills. We evaluated 20 hospitalists who were each observed for 2 complete 12‐hour shifts (7 am‐7 pm). Trained observers collected continuous time‐flow data of each hospitalists activities including time spent communicating with patients and families, using Work Study+ software® on a Palm Pilot. The communication assessment project used the previously validated Communication Assessment Tool (CAT) to evaluate hospitalists' communication scores. Patients were asked the core 14 items from the CAT instrument, with the 15th question, The doctor's staff treated me with respect,” dropped given that hospitalists do not have staff. Items were answered on a 5‐point scale, with 1 = poor and 5 = excellent. Consistent with previous research, hospitalists' communication scores were calculated using the percentage of excellent ratings they received. Data from the 2 projects were analyzed using Pearson's r correlation.

Results:

The amount of time individual hospitalists spent communicating with patients and their CAT were not correlated (Pearson's r = 0.120, P = 0.613). The average time hospitalists spent on direct in‐person communication with each patient was 9.8 minutes, with a range of 5.8–15.9 minutes. The average CAT score was 68.2%, with a range of 48%–84.4%.

Conclusions:

Our findings suggest that in an inpatient setting, the quality of the communication taking place outweighs the quantity of communication. Efforts at improving communication may be successful by developing training focused on improving the quality of communication instead of simply providing more time through reduced patient workload. Additional research might examine the context of communication that a patient describes as “excellent.”

Author Disclosure:

V. Forth, none; D. Ferranti, none; D. Malkenson, none; M. Tipping, none; D. Magill, none; M. Williams, Society of Hospital Medicine, Editor.