This paper presents findings about weight management programs at the work-

This study aimed to examine variations in patient-physician communication by obesity status. We pooled data from the 2005-2007 Medical Expenditure Panel Survey (MEPS),_included only individuals who completed the self-administered questionnaire themselves, and restricted the sample to patients who received care from primary care physicians. We included a total of 6,628 unique individuals between the ages of 18 and 65 who had at least one office or hospital outpatient visit during the past 12 months. There are six outcomes of interest in this study. The patient-physician communication composite score is based on five questions that the MEPS adapted from the Consumer Assessment of Healthcare Providers and Systems Survey. The other five variables were: respect from providers, providers’ listening skills, explanations from providers, time spent with patients, and patient involvement in treatment decisions. The key independent variable was obesity. Bivariate and multivariate models such as ordinary least squares (OLS) and logistic regression were used to examine the relationship between patient-physician communication and obesity status. Multivariate models showed that obese patients had a reduced physician-patient communication composite score of 0.19 (95% CI 0.03-0.34, p=0.02), physicians’ show of respect OR 0.77 (95% CI 0.61-0.98, p=0.04), listening ability OR 0.82 (95% CI 0.65-1.02, p=0.07), and spending enough time OR 0.80 (95% CI 0.62-0.99, p=0.04) compared to non-obese patients. We found a negative association between physician-patient communication and patients’ obesity status. These findings may inform public health practitioners in the design of effective initiatives that account for the needs and circumstances of obese individuals.

Background Traditional discharge processes lack a patient-centred focus. This project studied the implementation and effectiveness of an individualized discharge tool across Ontario hospitals. The Patient Oriented Discharge Summary (PODS) is an individualized discharge tool with guidelines that was co-designed with patients and families to enable a patient-centred process. Methods Twenty one acute-care and rehabilitation hospitals in Ontario, Canada engaged in a community of practice and worked over a period of 18 months to implement PODS. An effectiveness-implementation hybrid design using a triangulation approach was used with hospital-collected data, patient and provider surveys, and interviews of project teams. Key outcomes included: penetration and fidelity of the intervention, change in patient-centred processes, patient and provider satisfaction and experience, and healthcare utilization. Statistical methods included linear mixed effects models and generalized estimating equations. Results Of 65,221 discharges across hospitals, 41,884 patients (64%) received a PODS. There was variation in reach and implementation pattern between sites, though none of the between site covariates was significantly associated with implementation success. Both high participation in the community of practice and high fidelity were associated with higher penetration. PODS improved family involvement during discharge teaching (7% increase, p = 0.026), use of teach-back (11% increase, p < 0.001) and discussion of help needed (6% increase, p = 0.041). Although unscheduled healthcare utilization decreased with PODS implementation, it was not statistically significant. Conclusions This project highlighted the system-wide adaptability and ease of implementing PODS across multiple patient groups and hospital settings. PODS demonstrated an improvement in patient-centred discharge processes linked to quality standards and health outcomes. A community of practice and high quality content may be needed for successful implementation.

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