Background:
The Institute of Medicine (IOM) has highlighted the importance of patient‐centered care (PCC) to health care quality. We hypothesized that patients cared for by residents exposed to a curriculum that teaches elements of PCC would report a greater level of information, support, and sense of partnership with their hospital physician.
Methods:
The study setting was the general inpatient medicine teaching service at an urban academic medical center. One of 4 ward teams was the intervention team, which utilized a novel PCC curriculum, including postdischarge telephone calls to patients, contact with outpatient providers, medication adherence reviews, and patient‐centered discharge planning. While rotating on the usual care teams, residents were not specifically asked to perform any of the PCC curricular activities, although some residents may have been exposed to the PCC curriculum prior to the study period. We evaluated the intervention between July and November 2011 by conducting telephone surveys of patients within 30 days of discharge. The survey consisted of the 3‐Item Care Transitions Measure (CTM‐3), which assesses patients' perceptions of how well hospital staff considered their preferences in the care plan, clarified patients' responsibilities in self‐management, and ensured patient understanding of the purpose of each medication. We also asked, “Did your doctor call you after discharge?” and “Did your doctor know you as a person?”
Results:
During the study period 14 residents rotated on the PCC team and 38 rotated on the standard teams. The CTM‐3 score was not significantly different for patients cared for on the PCC team (81.6 vs. 79.8, P = 0.69). Patients reported feeling known as a person 83.3% of the time when cared for on the PCC team versus 75.4% of the time when cared for on usual care teams (P = 0.41). As expected, 83.3% of patients cared for on the PCC team reported receiving a postdischarge telephone call from their hospital physician, but 29.6% on a usual care team also reported receiving a call (P < 0.0001). Regardless of team assignment, the CTM‐3 score of the 52 patients who reported receiving a postdischarge telephone call from their doctor was higher than the 99 patients who reported not receiving a call (84.0 vs. 78.1, P = 0.05), and 84.6% of patients who reported receiving a postdischarge telephone call felt that their doctor knew them as a person versus 69.7% of patients who reported not receiving a postdischarge telephone call (P = 0.045).
Conclusions:
Patients who reported receiving a postdischarge telephone call from their doctor, regardless of assignment to PCC versus usual care team, had higher CTM‐3 scores and reported feeling known as a person more often than those who reported not receiving a call. Although these findings were from a small single‐center study, they suggest that the postdischarge telephone call, 1 element of PCC, is associated with improvements in care transitions and patients' perceptions of partnership with their hospital physician.