Physician–patient communication in single-bedded versus four-bedded hospital rooms

Glind, Irene van de; Dulmen, Sandra van; Goossensen, Anne

doi:10.1016/j.pec.2008.07.004

Cited by 34 publications

(34 citation statements)

References 16 publications

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“…The literature suggests that ill patients wanted nurses to be closer. 12,13,42 Some patients in our study reported a high level of connection with staff, with staff perceived to be giving them full attention, listening and interested in the patient as a person, while others felt a sense of disconnection. A study of cancer patients in Denmark 68 found that refuge from fellow patients was hard to achieve in multibedded rooms and the fact that personal conversations might be overheard by fellow patients caused important information to be withheld from health-care professionals.…”

Section: Design Implicationsmentioning

confidence: 79%

“…29 In other studies, patients rated privacy and personal space as important but they also said that when ill they wanted nurses to be closer. 12,13,42 There is also evidence of more speech privacy and higher patient-reported satisfaction with doctor and nurse communication in single room patient accommodation. 11 A study of patient-physician communication in the Netherlands suggested that patients find it easier to raise questions with staff during ward rounds in single rooms than in multibedded rooms and feel that staff are more empathetic towards them.…”

Section: Box 1 Advantages and Disadvantages Of Single Rooms For Patiementioning

confidence: 99%

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Evaluating a major innovation in hospital design: workforce implications and impact on patient and staff experiences of all single room hospital accommodation

Maben

Griffiths

Penfold

et al. 2015

Health Services and Delivery Research

177

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BackgroundNew hospital design includes more single room accommodation but there is scant and ambiguous evidence relating to the impact on patient safety and staff and patient experiences.ObjectivesTo explore the impact of the move to a newly built acute hospital with all single rooms on care delivery, working practices, staff and patient experience, safety outcomes and costs.Design(1) Mixed-methods study to inform a pre-/post-‘move’ comparison within a single hospital, (2) quasi-experimental study in two control hospitals and (3) analysis of capital and operational costs associated with single rooms.SettingFour nested case study wards [postnatal, acute admissions unit (AAU), general surgery and older people’s] within a new hospital with all single rooms. Matched wards in two control hospitals formed the comparator group.Data sourcesTwenty-one stakeholder interviews; 250 hours of observation, 24 staff interviews, 32 patient interviews, staff survey (n = 55) and staff pedometer data (n = 56) in the four case study wards; routinely collected data at ward level in the control hospitals (e.g. infection rates) and costs associated with hospital design (e.g. cleaning and staffing) in the new hospital.Results(1) There was no significant change to the proportion of time spent by nursing staff on different activities. Staff perceived improvements (patient comfort and confidentiality), but thought the new accommodation worse for visibility and surveillance, teamwork, monitoring, safeguarding and remaining close to patients. Giving sufficient time and attention to each patient, locating other staff and discussing care with colleagues proved difficult. Two-thirds of patients expressed a clear preference for single rooms, with the benefits of comfort and control outweighing any disadvantages. Some patients experienced care as task-driven and functional, and interaction with other patients was absent, leading to a sense of isolation. Staff walking distances increased significantly after the move. (2) A temporary increase in falls and medication errors within the AAU was likely to be associated with the need to adjust work patterns rather than associated with single rooms, although staff perceived the loss of panoptic surveillance as the key to increases in falls. Because of the fall in infection rates nationally and the low incidence at our study site and comparator hospitals, it is difficult to conclude from our data that it is the ‘single room’ factor that prevents infection. (3) Building an all single room hospital can cost 5% more but the difference is marginal over time. Housekeeping and cleaning costs are higher.ConclusionsThe nature of tasks undertaken by nurses did not change, but staff needed to adapt their working practices significantly and felt ill prepared for the new ways of working, with potentially significant implications for the nature of teamwork in the longer term. Staff preference remained for a mix of single rooms and bays. Patients preferred single rooms. There was no strong evidence that single rooms had any impact on patient safety but housekeeping and cleaning costs are higher. In terms of future work, patient experience and preferences in hospitals with different proportions of single rooms/designs need to be explored with a larger patient sample. The long-term impact of single room working on the nature of teamwork and informal learning and on clinical/care outcomes should also be explored.FundingThe National Institute for Health Research Health Services and Delivery Research programme.

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Section: Design Implicationsmentioning

confidence: 79%

Section: Box 1 Advantages and Disadvantages Of Single Rooms For Patiementioning

confidence: 99%

Evaluating a major innovation in hospital design: workforce implications and impact on patient and staff experiences of all single room hospital accommodation

Maben

Griffiths

Penfold

et al. 2015

Health Services and Delivery Research

177

View full text Add to dashboard Cite

show abstract

“…This change seems to have come about from the combination of three separate, but interrelated, interventions: firstly, moving from a very hierarchical structure -with physicians standing and patients lying downtowards a more equal perspective where both sit in a chair facing each other; secondly, using a special room allowing privacy during the round conversation; and thirdly, having the physicians meet the patient together with the nurse and the nurse assistant. Physician-patient communication in single-bedded versus four-bedded hospital rooms was studied by van de Glind and colleagues [13] . They concluded that single rooms seemed to contribute to physician-patient communication in a positive way since patients asked more questions and affective reactions from physicians were more frequent in single rooms.…”

Section: Discussionmentioning

confidence: 99%

“…Large variation between physicians time-motion patterns during walking rounds was also reported using real-time location systems [39] . Research showed that single-room rounding took longer time compared to rounding four-bedded rooms [13] .…”

Section: Discussionmentioning

confidence: 99%

“…Physician-patient communication in single-bedded versus four-bedded hospital rooms differed with patients asking more questions and making more remarks in single-bedded rooms and physicians showing more empathic reactions [13] . Patient-nurse-physician interaction analysis during ward rounds indicated there was a dyad between physician and patient with the nurse having limited inclusion [14] and family-centered multidisciplinary rounds enhanced staff satisfaction in pediatrics [15] .…”

mentioning

confidence: 98%

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Physician experiences of patient-centered and team- based ward rounding – an interview based case-study

Bååthe

Ahlborg²,

Lagström³

et al. 2014

JHA

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What can we learn from patient dissatisfaction? An analysis of dissatisfying events at an academic medical center

Lee

Moriarty

Borgstrom

et al. 2010

Journal of Hospital Medicine

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BACKGROUND:Patient satisfaction is typically measured by quantitative surveys using predetermined domains. However, dissatisfaction may be an entity distinct from satisfaction, may have different determinants, and may better reflect problems in healthcare delivery.OBJECTIVE:The aim of this study was to describe domains of dissatisfaction experienced by patients during hospitalization.SETTING:The setting was a U.S. urban academic medical center.PATIENTS:The patients were adults discharged between July 1, 2007 and June 30, 2008INTERVENTION:The intervention was a postdischarge telephone interview: “If there was one thing we could have done to improve your experience in the hospital, what would it have been?”MEASUREMENTS:The measurements were standard qualitative analysis of suggestions for improvement.RESULTS:We randomly selected 976 of 9,764 interviews. A total of 439/976 (45.0%) included at least one suggestion for improvement. We identified six major domains of dissatisfaction: ineptitude (7.7%), disrespect (6.1%), waits (15.8%), ineffective communication (7.4%), lack of environmental control (15.6%), and substandard amenities (6.9%). These domains corresponded to six implicit expectations for quality hospital care: safety, treatment with respect and dignity, minimized wait times, effective communication, control over physical surroundings, and high‐quality amenities. Some of these expectations, such as for safe care, effective communication between providers, and lack of disrespect, may not be adequately captured in existing patient satisfaction assessments.CONCLUSIONS:The results represent patient‐generated priorities for quality improvement in healthcare. These priorities are not all consistently represented in standard patient satisfaction surveys and quality improvement initiatives. Patient input is critical to assessing the quality of hospital care and to identifying areas for improvement. Journal of Hospital Medicine 2010. © 2010 Society of Hospital Medicine.

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Physician–patient communication in single-bedded versus four-bedded hospital rooms

Abstract: The research findings indicate the relevance of taking account of the context in which physician-patient communication takes place.

Cited by 34 publications

References 16 publications

Evaluating a major innovation in hospital design: workforce implications and impact on patient and staff experiences of all single room hospital accommodation

Evaluating a major innovation in hospital design: workforce implications and impact on patient and staff experiences of all single room hospital accommodation

Physician experiences of patient-centered and team- based ward rounding – an interview based case-study

What can we learn from patient dissatisfaction? An analysis of dissatisfying events at an academic medical center

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