Improving patient satisfaction with the transfer of care
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OBJECTIVE: To determine whether educational sessions with medical residents, with or without letters to their patients, improve patient satisfaction with transfer of their care from a departing to a new resident in an internal medicine clinic.
DESIGN: Observational study in Year 1 to establish a historical control, with a randomized intervention in Year 2.
SETTING: An internal medicine clinic in a teaching hospital.
PATIENTS/PARTICIPANTS: Patients of departing residents completed questionnaires in the waiting room at their first visit with a new resident, with mail-administered questionnaires for patients not presenting to the clinic within 3 months after transfer of their care. In Year 1, 376 patients completed questionnaires without intervention. The following spring, we conducted interactive seminars with 12 senior residents to improve their transfer of care skills (first intervention). Half of their patients were then randomized to receive a letter from the new doctor informing them of the change (second intervention). We assessed the efficacy of the interventions by administering questionnaires to 437 patients in the months following the interventions.
MEASUREMENTS AND MAIN RESULTS: Multivariate analysis of Year 1 results identified doctors personally informing patients prior to leaving as the single strongest predictor of patient satisfaction (partial R 2=.41). In Year 2, our first intervention increased the percentage of patients informed by their doctors from 71% in 1991 to 79% in 1992 (P<.001). Mean satisfaction dramatically improved, with the fraction of fully satisfied patients increasing from 47% at baseline, to 61% with the first intervention alone, and 72% with both interventions (P<.0001).
CONCLUSIONS: Simple methods such as resident education and direct mailings to patients significantly ease the difficult process of transferring patients from one physician to another. This has implications not only for residency programs, but for managed care networks competing to attract and retain patients.
- Rogers, J, Curtis, P (1980) The concept and measurement of continuity in primary care. Am J Public Health 70: pp. 122-7
- Hjortdahl, P, Laerum, E (1992) Continuity of care in general practice: effect on patient satisfaction. BMJ 304: pp. 1287-90
- Baker, R (1996) Characteristics of practices, general practitioners and patients related to levels of patients’ satisfaction with consultations. Br J Gen Pract 46: pp. 601-5
- Wasson, JH, Sauvigne, AE, Mogielnicki, RP (1984) Continuity of outpatient medical care in elderly men. A randomized trial. JAMA 252: pp. 2413-7 CrossRef
- Roy, MJ, Kroenke, K, Herbers, JE (1995) When the physician leaves the patient: predictors of satisfaction with the transfer of care in a primary care clinic. J Gen Intern Med 10: pp. 206-10 CrossRef
- Hulka, BS, Cassel, JC, Kupper, LL, Burdette, JA (1976) Communication, compliance, and concordance between physicians and patients with prescribed medications. Am J Public Health 66: pp. 847-53 CrossRef
- Linn, MW, Linn, BS, Stein, SR (1982) Satisfaction with ambulatory care and compliance in older patients. Med Care 20: pp. 606-14 CrossRef
- Wartman, SA, Morlock, LL, Malitz, FE, Palm, EA (1983) Patient understanding and satisfaction as predictors of compliance. Med Care 21: pp. 886-91 CrossRef
- Weisman, CS, Nathanson, CA (1985) Professional satisfaction and client outcomes: a comparative organizational analysis. Med Care 23: pp. 1179-92 CrossRef
- Yancy, WS, Macpherson, DS, Hanusa, BH (2001) Patient satisfaction in resident and ambulatory care clinics. J Gen Intern Med 16: pp. 755-62 CrossRef
- Johnson, JE, Pinholt, EM, Jenkins, TR, Carpenter, JL (1988) Content of ambulatory internal medicine practice in an academic Army medical center and an Army community hospital. Mil Med 153: pp. 21-5
- Jackson, JL, Strong, J, Cheng, EY, Meyer, G (1999) Patients, diagnoses, and procedures in a military internal medicine clinic: comparison with civilian practices. Mil Med 164: pp. 194-7
- Jackson, JL, O’Malley, PG, Kroenke, K (1999) A psychometric comparison of military practices. Mil Med 164: pp. 112-5
- Improving patient satisfaction with the transfer of care
Journal of General Internal Medicine
Volume 18, Issue 5 , pp 364-369
- Cover Date
- Print ISSN
- Online ISSN
- Additional Links
- patient satisfaction
- doctor-patient relationship
- primary care
- medical education
- continuity of care
- Industry Sectors
- Author Affiliations
- 1. the Department of Medicine, Uniformed Services University of the Health Sciences, Bethesda, Md
- 3. Washington Veterans Affairs Medical Center, Washington, DC
- 4. Holy Cross Hospital, Silver Spring, Md
- 5. Regenstrief Institute of Health Care, Indiana University School of Medicine, Indianapolis, Ind