Patient Satisfaction
Conditions
Keywords
Attire, White coat, Patient physician communication
Brief summary
Wearing white coat during hospital rounds has been associated with increased risk of colonization and transmission of resistant pathogens. On the other hand, studies have shown that physicians' attire affects patients' confidence in their physician and the patient-physician relationship. The results of these studies were highly dependent on the practice setting, with no data in postpartum patients. The objective is to test the hypothesis that not wearing a white coat during physician postpartum rounds impact patient-physician communication scores.
Detailed description
Patient satisfaction is an important measure of quality of care. One of the most important variables in patients satisfaction scores is the physician communication skills. There have been several studies evaluating different strategies to improve the patient perceptions of patient - physician communication including delayed physician rounds, improvement of handoff strategies, and family centered rounds. Additionally, research has shown that patients develop a first impression of their physician based on the physician's verbal and nonverbal communication, including the clothing and cleanliness. Patient - physician communication scores not only have an impact on patient care, but are also now linked to Medicare reimbursements. White coats have been widely used in the medical profession, however some physicians believe that this can be a nonverbal barrier to patient's interaction. Prior studies on the impact of physician attire have reported conflicting results. In a survey published by Cha et al, obstetric and gynecologic patients seen in the outpatient clinic preferred that the resident use white coats. Another study showed that patients favor the use of white coat in the Internal Medicine outpatient clinic which may favorably influence trust and confidence in the medical encounter. No randomized controlled trial has been published on the impact of the use of white coat on patient - physician communication scores in the postpartum patients. This trial's primary outcome is to evaluate the impact of physician attire (specifically wearing white coat) during postpartum rounds on patient - physician communication scores. This study is a randomized controlled trial performed in postpartum patients to evaluate the impact of not wearing white coat during rounds on patient - physician communication scores.
Interventions
OTHERnon White coat
Postpartum patients are randomized to either arm of the study (white coat or standard scrub suit only) by location. All the obstetric physicians associated with patient's postpartum care should use or not use white coat in every single encounter with patient.
Sponsors
The University of Texas Medical Branch, Galveston
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
OTHER
Masking
NONE
Intervention model description
Women are randomly assigned to having their postpartum physician team wear a white coat (WC) or not (no-WC) during rounds.
Eligibility
Sex/Gender
FEMALE
Age
18 Years to 50 Years
Healthy volunteers
Yes
Inclusion criteria
* Maternal age ≥ 18 years and \<50 years * Patient admitted to postpartum floor at University of Texas Medical Branch (UTMB) * Patient care managed by obstetric physicians during the postpartum period.
Exclusion criteria
* Patient admitted to ICU * Delivery resulting in stillbirth Patient not fluent in Spanish and/or English
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Patient - physician communication score | 24 to 120 hours | Obtained from the three Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) questions. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Hospital rating scores | 24 to 120 hours | Obtained from one question of the HCAHPS survey |
| Recommending the hospital to friends and family | 24 to 120 hours | Obtained from one question of the HCAHPS survey |
| Physician attire rating score | 24 to 120 hours | Rated from 1 to 4 |
| White coat use | 24 to 120 hours | Patient answer if she remember or not if their physician were using white coat. |
Countries
United States
Outcome results
None listed