Pediatric Hospitalists and Primary Care Providers: a Communication Needs Assessment

Overview

Journal J Hosp Med

Publisher Wiley

Specialties General Medicine
Health Services

Date 2009 Mar 6

PMID 19263485

Citations 9

Authors

Gregory Harlan

Rajendu Srivastava

Lanny Harrison

Glen McBride

Christopher Maloney

Affiliations

Soon will be listed here.

Abstract

Background/objective: Existing research on hospitalist-primary care provider (PCP) communication focuses mainly on adult hospitalist models with little known about the quality of current pediatric hospitalist-PCP communication. Our objective was to perform a needs assessment by exploring important issues around communication between pediatric hospitalists and PCPs.

Methods: Six previously identified issues around hospitalist-PCP communication from the adult hospitalist literature were abstracted and incorporated into an open-ended and closed-ended questionnaire. The questionnaire was pretested, revised, and administered by phone to 10 pediatric hospitalists and 12 pediatric PCPs residing in our 5-state catchment area. Interviews were transcribed and openly coded, and themes compared using qualitative methods.

Results: The 6 identified issues were: quality of communication, barriers to communication, methods of information sharing, key data element requirements, critical timing, and perceived benefits. Hospitalists and PCPs rated overall quality of communication from "poor" to "very good." Both groups acknowledge that significant barriers to optimal communication currently exist, yet the barriers differ for each group. Hospitalists and PCPs agree on what information is important to transmit (diagnoses, medications, follow-up needs, and pending laboratory test results) and critical times for communication during the hospitalization (at discharge, admission, and during major clinical changes). Both groups also agree that optimal communication could improve many aspects of patient care.

Conclusions: Identifying and addressing barriers to these 6 issues may help both hospitalists and PCPs implement targeted interventions aimed at improving communication. Future studies will need to demonstrate the link between improved hospitalist-PCP communication and improved patient care and outcomes.

Citing Articles

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References

Pantilat S, Lindenauer P, Katz P, Wachter R . Primary care physician attitudes regarding communication with hospitalists. Am J Med. 2002; 111(9B):15S-20S. DOI: 10.1016/s0002-9343(01)00964-0. View

Plauth 3rd W, Pantilat S, Wachter R, Fenton C . Hospitalists' perceptions of their residency training needs: results of a national survey. Am J Med. 2001; 111(3):247-54. DOI: 10.1016/s0002-9343(01)00837-3. View

Srivastava R, Norlin C, James B, Muret-Wagstaff S, Young P, Auerbach A . Community and hospital-based physicians' attitudes regarding pediatric hospitalist systems. Pediatrics. 2005; 115(1):34-8. DOI: 10.1542/peds.2004-0855. View

OLeary K, Liebovitz D, Feinglass J, Liss D, Baker D . Outpatient physicians' satisfaction with discharge summaries and perceived need for an electronic discharge summary. J Hosp Med. 2007; 1(5):317-20. DOI: 10.1002/jhm.118. View

Moore C, McGinn T, Halm E . Tying up loose ends: discharging patients with unresolved medical issues. Arch Intern Med. 2007; 167(12):1305-11. DOI: 10.1001/archinte.167.12.1305. View

Kripalani S, Lefevre F, Phillips C, Williams M, Basaviah P, Baker D . Deficits in communication and information transfer between hospital-based and primary care physicians: implications for patient safety and continuity of care. JAMA. 2007; 297(8):831-41. DOI: 10.1001/jama.297.8.831. View

Gandhi T, Sittig D, Franklin M, Sussman A, Fairchild D, Bates D . Communication breakdown in the outpatient referral process. J Gen Intern Med. 2000; 15(9):626-31. PMC: 1495590. DOI: 10.1046/j.1525-1497.2000.91119.x. View

Hruby M, Pantilat S, Lo B . How do patients view the role of the primary care physician in inpatient care?. Dis Mon. 2002; 48(4):230-8. DOI: 10.1016/s0011-5029(02)90030-1. View

Auerbach A, Davis R, Phillips R . Physician views on caring for hospitalized patients and the hospitalist model of inpatient care. J Gen Intern Med. 2001; 16(2):116-9. PMC: 1495177. DOI: 10.1111/j.1525-1497.2001.91154.x. View

10.

Mays N, Pope C . Rigour and qualitative research. BMJ. 1995; 311(6997):109-12. PMC: 2550154. DOI: 10.1136/bmj.311.6997.109. View

11.

Ratnapalan S, Hilliard R . Needs Assessment in Postgraduate Medical Education: A Review. Med Educ Online. 2017; 7(1):4542. DOI: 10.3402/meo.v7i.4542. View

12.

Auerbach A, Aronson M, Davis R, Phillips R . How physicians perceive hospitalist services after implementation: anticipation vs reality. Arch Intern Med. 2003; 163(19):2330-6. DOI: 10.1001/archinte.163.19.2330. View

13.

Auerbach A, Nelson E, Lindenauer P, Pantilat S, Katz P, Wachter R . Physician attitudes toward and prevalence of the hospitalist model of care: results of a national survey. Am J Med. 2000; 109(8):648-53. DOI: 10.1016/s0002-9343(00)00597-0. View

14.

Stille C, Primack W, Savageau J . Generalist-subspecialist communication for children with chronic conditions: a regional physician survey. Pediatrics. 2003; 112(6 Pt 1):1314-20. DOI: 10.1542/peds.112.6.1314. View

15.

Landrigan C, Srivastava R, Dyck I, Homer C, Goldmann D . Pediatric hospitalists: what do we know, and where do we go from here?. Ambul Pediatr. 2002; 1(6):340-5. DOI: 10.1367/1539-4409(2001)001<0340:phwdwk>2.0.co;2. View

16.

Wachter R, Pantilat S . The "continuity visit" and the hospitalist model of care. Dis Mon. 2002; 48(4):267-72. DOI: 10.1016/s0011-5029(02)90034-9. View

17.

Schabetsberger T, Ammenwerth E, Andreatta S, Gratl G, Haux R, Lechleitner G . From a paper-based transmission of discharge summaries to electronic communication in health care regions. Int J Med Inform. 2005; 75(3-4):209-15. DOI: 10.1016/j.ijmedinf.2005.07.018. View

18.

Pantilat S, Wachter R . The patient provider relationship and the hospitalist movement. Introduction. Dis Mon. 2002; 48(4):189-90. DOI: 10.1016/s0011-5029(02)90025-8. View

19.

Paterson J, Allega R . Improving communication between hospital and community physicians. Feasibility study of a handwritten, faxed hospital discharge summary. Discharge Summary Study Group. Can Fam Physician. 2000; 45:2893-9. PMC: 2328492. View

20.

Lo B . Ethical and policy implications of hospitalist systems. Dis Mon. 2002; 48(4):281-90. DOI: 10.1016/s0011-5029(02)90037-4. View