Background: Effective patient-physician communication is integral for meaningful clinical relationships and patient satisfaction; thus, it is measured by the Hospital Consumer Assessment of Hospitals and Health Systems (HCAHPS) survey. Unfortunately, such surveys often demonstrate significant room for improvement in physician communication. A critical element of effective communication is the ability of patients to recognize those responsible for their care. Not surprisingly, with so many consulting and covering providers and trainees, a substantial number of patients are unable to correctly name the attending physician in charge of their care. The aim of this study was to evaluate whether a provider identification (ID) card used in an academic hospital would improve patient identification of their primary attending.
Methods: The attending provider ID card was designed using a rapid prototyping process including contextual inquiry of patients to understand their assumptions about physicians and their roles. The card ultimately included attendings’ pictures, names, role, and expectations of role based on elicited patients’ values. Attendings received guidance on use of the card to introduce themselves. The intervention was implemented on 3/17/14 and 3/30/14 on the non-teaching and teaching hospitalist units, respectively. Subjects were interviewed before and after implementation, and were asked to name “the doctor in charge of your care.” Data was obtained from a random sample of patients hospitalized for 2 or more days, and was collected in the 5 weeks before and 12 weeks after the intervention. Proportions were compared using chi-square tests.
Results: Sixty five percent of patients (43/66) were hospitalized for > 5 days at the time of interview in the pre period, and this was similar in the post period (61%, 39/64, p=0.62). Thirty five percent of patients (23/66) correctly identified the physician in charge of their care in the pre period, compared to 55% (35/64) in the post period (p=0.02). Correct attending identification increased on the non-teaching service [47% (9/19) vs. 73% (27/37), p=0.06], but not on the teaching service [30% (14/47) vs. 30% (8/27), p=0.94]. Of the 66% of patients (42/64) who reported receiving the provider ID card in the post period, 88% (37/42) had the card at the bedside or hanging on the whiteboard. Eighty four percent (31/37) on the non-teaching service and 41% (11/27) on the teaching service had the card. Qualitative feedback from patients suggested a favorable response to the card and few improvements to the tool.
Conclusions: When presented to patients an attending provider ID card helped patients better identify the physician in charge of their care and was well-received by patients; yet, adherence to the intervention differed by hospitalist service type. Whether this intervention is associated with more meaningful patient-physician relationships or improved patient perception of physician communication is unknown.