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Improving Discharge Communication in the Emergency Department Through Information Structuring: A Cluster Randomized Controlled Trial

English title Improving Discharge Communication in the Emergency Department Through Information Structuring: A Cluster Randomized Controlled Trial
Applicant Bingisser Roland Martin
Number 159841
Funding scheme Interdisciplinary projects
Research institution Interdisziplinäre Notfallstation Innere Medizin Universitätsspital Basel
Institution of higher education University of Basel - BS
Main discipline Health Education
Start/End 01.04.2015 - 31.03.2018
Approved amount 292'051.00
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All Disciplines (2)

Discipline
Health Education
Psychology

Keywords (4)

memory; discharge communication; information structuring; physician-patient communication

Lay Summary (German)

Lead
Patientenzentrierte Kommunikation spielt eine wichtige Rolle in der medizinischen Versorgung. Während wichtige Informationen in gewissen Bereichen repetitiv dargeboten werden können, sind Patienten im Kontext der Notfallversorgung auf ein einziges, qualitativ möglichst hochstehendes Austrittsgespräch angewiesen. Auf diesem Hintergrund leistet das Projekt einen Beitrag zur Verbesserung der Kommunikation zwischen Ärztinnen und Patientinnen.
Lay summary

Inhalt und Ziele des Forschungsprojekts

 

Die bisherige Forschung konzentrierte sich vor allem auf die Form der Informationsvermittlung (z.B. mündlich vs. schriftlich); die Darbietung und der sinnvolle Inhalt der Austrittsinformation, insbesondere im Notfall-Setting, wurde bis anhin kaum erforscht.

Das Projekt soll durch Ärztetrainings die Erinnerungsleistung von Patienten verbessern. Zu diesem Zweck wird eine Gruppe von Ärzten darin geschult, Informationen strukturiert wiederzugeben, während die andere Gruppe von Ärzten darin geschult wird Informationen auf eine empathische Art wiederzugeben.

Wir gehen davon aus, dass beide Trainings zu einer Verbesserung der Erinnerungsleistung führen werden, wobei die Patientengruppe welche strukturierte Informationen erhält, der Gruppe mit den auf Empathie geschulten Ärzten überlegen sein dürfte. Unsere Untersuchungen werden dazu beitragen, die psychologischen Mechanismen hinter einem effektiven Arzt-Patienten Gespräch besser zu verstehen.

 

Wissenschaftlicher und gesellschaftlicher Kontext des Forschungsprojekts

 

Das Projekt soll Erkenntnisse darüber liefern, wie Austrittsgespräche optimal gestaltet werden. Zusätzlich wird der Zusammenhang von Informationsstrukturierung und Gedächtnis unter dem Gesichtspunkt der Psychologie untersucht.

 

Key words

 

discharge, communication, recall, information-giving

 

 

 

30. März 2015

Direct link to Lay Summary Last update: 30.03.2015

Responsible applicant and co-applicants

Employees

Collaboration

Group / person Country
Types of collaboration
Max Planck Institute for Human Development in Berlin Germany (Europe)
- in-depth/constructive exchanges on approaches, methods or results
- Publication

Scientific events

Active participation

Title Type of contribution Title of article or contribution Date Place Persons involved
Clinical Research Day 2018 Talk given at a conference Improving discharge communication in the emergency department through information structuring - A cluster randomized controlled trial 25.01.2018 Basel, Switzerland Bingisser Roland Martin; Mata Rui; Langewitz Wolf Axel; Siegrist Victoria;
7th OCHER workshop on Clinical Communication Research Talk given at a conference Improving discharge communication in the emergency department through information structuring: A cluster randomized controlled trial 10.01.2018 Oslo, Norway Mata Rui; Siegrist Victoria; Langewitz Wolf Axel; Bingisser Roland Martin;
International Conference on Communication in Healthcare Talk given at a conference Structure vs. Empathy Skills Training in Discharge Communication in the Emergency Department 09.09.2017 Baltimore, United States of America Langewitz Wolf Axel; Bingisser Roland Martin; Siegrist Victoria; Mata Rui;
16th European Congress of Internal Medicine Poster Usability of a Patient History-taking Application in the Emergency Department 31.08.2017 Mailand, Italy Eken Ceylan; Siegrist Victoria; Bingisser Roland Martin; Nieves Ortega Ricardo;
Clinical Research Day 2017 Poster Effects of Empathy vs. Structure Skills Training in Discharge Communication in the Emergency Department 19.01.2017 Basel, Switzerland Siegrist Victoria; Mata Rui; Bingisser Roland Martin; Langewitz Wolf Axel;
PhD conference 2017 Talk given at a conference Communication in Healthcare - Information Structuring and its Influence on Patient Satisfaction – Preliminary Results 10.01.2017 Basel, Switzerland Mata Rui; Langewitz Wolf Axel; Siegrist Victoria; Bingisser Roland Martin;
EUSEM 2016 Poster End-of-life Decisions in Patients Admitted through the Emergency Department 30.09.2016 Wien, Austria Siegrist Victoria; Mata Rui; Eken Ceylan; Bingisser Roland Martin;
Gastvortrag Max Planck Institut für Bildungsforschung Individual talk Discharge communication at the Emergency Department: Prelimiary Results 28.04.2016 Berlin, Germany Mata Rui; Bingisser Roland Martin; Siegrist Victoria; Langewitz Wolf Axel;
PhD Conference 2016 Talk given at a conference End-of-life Decisions in the Emergency Department 22.01.2016 Basel, Switzerland Bingisser Roland Martin; Mata Rui; Eken Ceylan; Siegrist Victoria;
Gastvortrag Max Planck Institut für Bildungsforschung Individual talk End-of-life Decisions in the Emergency Department 06.08.2015 Berlin, Germany Siegrist Victoria; Eken Ceylan; Bingisser Roland Martin; Mata Rui;


Self-organised

Title Date Place
JDMx Meeting 2016 for Early-Career Researchers 08.06.2016 Basel, Switzerland

Knowledge transfer events

Active participation

Title Type of contribution Date Place Persons involved
How to Teach in Communication Skills Teaching: Experiential Communication Skills Teaching Workshop 27.03.2017 Cambridge, Great Britain and Northern Ireland Siegrist Victoria;
What to Teach in Communication Skills Teaching: Skills Structure, and how to Analyse an Observed Interaction Workshop 06.09.2016 Heidelberg, Germany Siegrist Victoria;
Ready4Therapy Workshop 13.01.2016 Flüeli-Ranft, Switzerland Siegrist Victoria; Langewitz Wolf Axel;


Awards

Title Year
Price for scientific presentation at the Clinical Research Day of the University Hospital Basel 2018
Participation in the career program antelope of the University of Basel. The program aimes at highly qualified female doctoral students and postdoctoral researchers from all faculties. 2017
Price for the best poster at the Clinical Research Day of the University Hospital Basel 2017

Abstract

1.1. BackgroundIn an emergency department, effective discharge communication-the communicationi.e. information on of diagnosis diagnoses information as well asand instructions for the ongoingon further management of patients’ conditions given by an attending physician at the time of discharge-represents a key step in medical care, with the potential to improve patient well-being and satisfaction, adherence to medication, and, ultimately, better health outcomes. Past research suggests that physicians’ communication is often not optimally structured and that patients fail to fully recall and understand the information received at discharge. In turn, psychological research suggests that information structuring can be a powerful tool to improve memory recall and understanding. Consequently, information structuring represents a possible tool to improve discharge communication and associated patient outcomes.1.2. Goal and HypothesisThe goal of the proposed study is to assess the potential of information structuring for improving discharge communication. Specifically, we aim to examine the advantages of an information structuring skills training for physicians (relative tocompared to an emotion skills training) on discharge communication and associated patient outcomes, such as patients’ information recall and adherence to physician recommendations. We hypothesize that patients receiving structured discharge information from their trained physicians will be able to recall more information and show higher adherence to recommendations relative to controls (i.e., patients receiving discharge information from doctors trained on emotion- handling skills).1.3. Study DesignThe study will use a cluster randomized controlled trial: by which clusters of physicians (cohorts of 6 physicians commencing training in a 3-month period; total of 4 clusters in the 1-year intervention period) will be assigned to one of two types of training (information structuring skills vs. emotion-handling skills). The primary outcome of the study will be patients’ recall of information as a function of physician’s training. For this purpose, we aim to recruit 50 patients presenting to the emergency department with chest pain in each 3-month period (N = 200, in the 1-year study period) and document the respective discharge communication (via audio recordings). In addition, each patient will be asked to recall the discharge information immediately after the discharge event, and, in a telephone interview, 7 days later (, telephone interview), as well as complete a number of other measures to assess secondary outcomes, such as overall satisfaction, and adherence to recommendations. The study will be conducted at the emergency department of the University Hospital of Basel (Switzerland).1.4. SignificanceThe current proposal represents an effort to engage in interdisciplinary crosstalk, in particular, it aims to use established insights from psychological theory-the beneficial role of information structuring for memory performance and comprehension-to improve discharge communication and patient care in an emergency department setting.
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