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How a 5-minute hospital intervention can improve inpatient satisfaction

Turns out talking with patients about their overall well being, as well as their medical symptoms, makes a huge difference.

Jeff Lagasse, Associate Editor

With hospitals competing for business and seeking ways to improve inpatient satisfaction, a method of doing so has emerged which takes only a few minutes and involves no expensive equipment. A study at the University of Virginia School of Medicine recently found that a daily five-minute conversation that focused on hospitalized patients "as people" significantly improved their satisfaction with their medical care.

Family Medicine doctors at the University of Virginia Health System studied whether making a small but significant change -- talking with patients about their overall well being, as well as medical symptoms -- would make a difference in patient satisfaction.

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UVA associate professor and clinical psychologist Claudia Allen, JD, Ph.D., regularly teaches a brief psychosocial intervention called BATHE (Background, Affect, Trouble, Handling and Empathy) to family medicine residents. Patients often share psychological or life problems as well as medical symptoms, and BATHE is designed to help doctors address those psychosocial issues briefly and effectively. Doctors using the approach encourage patients to talk about anything that's bothering them, and then doctors respond with empathy and encouragement.

BATHE is used frequently in outpatient clinics nationally, but hadn't yet been tested with inpatients. After a family medicine resident told Allen that he had found the approach helpful with distressed patients in the UVA Emergency Department, she and a team of residents decided to examine the technique's effectiveness with inpatients at UVA Medical Center.

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From February to March 2015 and February to March 2016, 25 UVA Family Medicine inpatients were randomly chosen to receive either BATHE or standard care, which is focused on treatment plans and how patients are recovering from their illness or injury.

Patients who had the brief BATHE conversation daily with a resident were significantly more likely to rate their medical care as excellent and to express a high degree of satisfaction with their hospital stay. Asked to rate on a five-point scale whether their medical care was excellent, patients receiving the approach gave their doctors an average score of 4.77 compared with an average score of 4.0 for patients receiving standard care -- a statistically significant difference.

And the improvement in patient satisfaction didn't occur because patients had lengthier visits with their doctors. There was no significant difference in the average score of either group of patients when they were asked to rate how much time they spent with their doctors. Rather, the improvement in satisfaction was associated with the BATHE patients' perceptions that their physician "showed a genuine interest in me as a person."

The technique also received good reviews from the Family Medicine doctors, who reported that using it didn't add significantly to the time they spent with patients; it just better focused their conversations.

Researchers are now exploring ways to study whether the use of BATHE improves medical outcomes, and to expand its use on UVA inpatient units.

Twitter: @JELagasse
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