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Communication After Dark Strongly Influences Pediatric Hospital Ratings

BOSTON – A new pediatric hospital study proves, once again, why improving hospital quality can’t be a 9-to-5 issue.

The report, published recently in the journal Pediatrics, found that how nighttime providers communicate with parents and the perceptions of communication and teamwork among the medical team have a strong influence on their satisfaction with care provided to their children.

Boston Children’s Hospital researchers and colleagues note that night teams of hospital providers have become more common in the wake of resident physician duty hour changes.

For the study, the team conducted a prospective cohort study of 471 parents of pediatric inpatients ages 17 and younger from May 2013 to October 2014. Parents were asked to rate their overall experience, understanding of the medical plan, quality of nighttime doctors’ and nurses’ communication with them, and quality of nighttime communication between doctors and nurses.

With 398 surveys completed, an 84.5% response rate, 42.5% of parents reported a top overall experience. Analysis showed that top-rated overall experience was associated with higher scores for communication and experience with nighttime doctors, odds ratio (OR) 1.86; for communication and experience with nighttime nurses, OR 6.47; and for nighttime doctor-nurse interaction, OR 2.66.

The highest ratings were for the items related to whether nurses listened to their concerns – 70.5% strongly agreed – while the lowest were for regular communication with nighttime doctors, rated excellent by 31.4%.

For 2015, 30% of a hospital’s performance score used to calculate its Medicare incentive payment is based upon an extensive patient experience survey, and, because 1% of a hospital’s Medicare payments in 2015 are related to its performance – increasing to 2% in 2017 – hospitals are especially concerned about increasing patient satisfaction ratings.

“As hospitals seek to improve the patient-centeredness of care, improving nighttime communication and teamwork will be valuable to explore,” the authors point out.