SHM Converge Scientific Abstract ePoster Gallery-Discrepancies in Hospitalist and Nurse Perceptions of Care Plan Communication

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This study examined differences between hospitalists’ and nurses’ perceptions of daily care plan communication at a large urban academic medical center as part of a quality improvement initiative. Using written and verbal surveys across 196 patient encounters, the researchers compared whether hospitalists and nurses believed a patient’s care plan had been communicated.<br /><br />The results showed consistent discrepancies: hospitalists reported sharing the care plan more often than nurses reported receiving it. For encounters with responses from both groups, 86% of hospitalists said they had shared the care plan, while nurses reported it was shared in only 55% of their responses. When both hospitalists and nurses responded about the same encounter, they agreed most of the time, but disagreements still occurred, especially when nurses said no care plan had been communicated and hospitalists said it had.<br /><br />Qualitative analysis identified several reasons for these differences in perception. Nurses often interpreted “care plan” as referring specifically to a discharge plan, while hospitalists used the term more broadly. Nurses also did not always view repeated or unchanged daily updates as a true “care plan” communication. In addition, updates that described immediate tasks or orders without connecting them to the larger treatment plan were less likely to be seen by nurses as meaningful care plan communication. Nurses also discounted information they did not consider relevant or actionable.<br /><br />The authors conclude that future efforts to improve physician-nurse communication should focus on establishing shared expectations about what counts as a care plan, delivering consistent daily updates, and placing actionable information within the broader context of the patient’s treatment trajectory.

Asset Subtitle

Claire Howlett

Meta Tag

Author List Claire Howlett, Esther Y. Hsiang, Molly A. Kantor, Sarah J. Flynn

Category Research

Concept Care Plan

Concept Communication

Concept Hospitalist

Concept NURSE

Concept Shared Expectation

Distinguished Non-Finalist

Presenter Organization Columbia University

Presenting Author Claire Howlett

Track Quality Improvement

Keywords

hospitalist-nurse communication

care plan communication

daily updates

quality improvement

patient encounters

perception differences

discharge plan

physician-nurse collaboration

treatment trajectory

actionable information

Care Plan

Communication

Hospitalist

NURSE

Shared Expectation