Observation tool to measure patient-centered behaviors on rounds in an academic medical center

Figures & data

Figure 1. Patient encounters in study PCC, patient-centered care.

Table 1. Characteristics of rounds by team PCC, patient-centered care

	PCC team observations N = 118	Standard team observations N = 330	P value (PCC vs standard team)
Mean team census	10.0 (2.7)	10.2 (2.3)	0.75
Patients seen by medical team on morning rounds when observer available	5.6 (2.0)	6.1 (1.8)	0.31
All patient discussions
Total time discussing each patient,* minutes	18.1 (10.5)	18.3 (11.9)	0.73
Time at patient’s bedside,** minutes	8.5 (4.8)	7.1 (5.2)	<0.01
Time at patient’s bedside** as percentage of total time discussing patient	53.0% (23%)	43.0% (22%)	<0.01
New patient discussions
Total time discussing each patient,* minutes	27.9 (10.2)	31.3 (11.1)	0.09
Time at patient’s bedside,** minutes	10.9 (5.2)	10.7 (6.7)	0.43
Time at patient’s bedside** as percentage of total time discussing patient	41.4% (19.0%)	35.2% (20.4%)	0.11
Follow-up discussions
Total time discussing each patient,* minutes	13.4 (6.8)	12.4 (6.2)	0.37
Time at patient’s bedside,** minutes	7.3 (4.1)	5.4 (3.3)	<0.01
Time at patient’s bedside** as percentage of total time discussing patient	58.8% (23.0%)	46.8% (21.7%)	<0.01

^ǂMean census calculated these values based on 77 observation dates, due to missing data on some dates.

*Time discussing patient in any location, including hallway, team room, at bedside, or any other location during rounds.

**Subset of total time discussing each patient, limited to time at the patient’s bedside.

Values are expressed as mean (SD).

Table 2. Performance of patient-centered behaviors by team PCC, patient-centered care values are expressed as N (% frequency)

	PCC team N = 118*	Standard teams N = 330*	P value (PCC vs standard team)
Patient-centered communication
Plan for day discussed with patient	112 (94.9)	283 (86.8)	0.02
Provider eye level when speaking	50 (44.3)	86 (26.9)	<0.01
Incorporated social touch	63 (53.9)	142 (43.6)	0.06
Etiquette-based behaviors
Knocking upon entering room	81 (78.6)	118 (38.4)	<0.01
Permission to adjust room	14 (28.6)	19 (17.8)	0.13
Permission to examine patient	50 (73.5)	147 (62.6)	0.01
Shared decision-making
Patient asked if he/she had any questions	56 (49.6)	109 (34.3)	<0.01
Patient’s perspective, hopes, goals, worries, or concerns expressed	43 (36.8)	83 (25.6)	0.02

*Not all checklist items were applicable to each patient-team encounter; therefore, the denominator used to calculate rate of performance of each checklist item reflects removal of ‘not applicable’ patient-team encounters for that item.