SHM Converge Scientific Abstract ePoster Gallery-Geographic Regionalization and Care Plan Agreement: A Cross-Sectional Analysis Revealing Increased Face-to-Face Communication Without Improved Care Plan Agreement

Geographic Regionalization and Care Plan Agreement: A Cross-Sectional Analysis Revealing Increased Face-to-Face Communication Without Improved Care Plan Agreement

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This cross-sectional study examined whether geographic regionalization of hospitalist teams improves agreement between hospitalists/APPs and bedside nurses on a patient’s care plan. The rationale was that placing hospitalists on a single inpatient unit should reduce communication barriers and improve shared understanding, which is important for patient safety and satisfaction.<br /><br />The study included 203 hospitalist–RN dyads. Each pair independently answered four questions about the same patient’s care plan: primary diagnosis, planned tests, estimated length of stay, and the patient’s top concern. Responses were scored for no, partial, or full agreement, and a composite agreement score was calculated. Analyses adjusted for gender and years of experience.<br /><br />Key findings:<br />- Regionalization significantly increased face-to-face communication frequency between nurses and hospitalists.<br />- Despite this increase in contact, overall interprofessional agreement on the care plan did not improve.<br />- The adjusted odds ratio for care plan agreement with regionalization was 1.02 (95% CI 0.51–2.06; p = 0.946), indicating no meaningful effect.<br />- Some factors did matter: RN gender and hospitalist experience were associated with agreement, suggesting that communication quality is influenced by more than physical proximity alone.<br /><br />The main conclusion is that regionalization boosts the quantity of communication but is not enough by itself to improve shared care plan understanding. The authors argue that communication must be formalized through standardized processes and tools, such as structured multidisciplinary rounds, bedside handoffs, whiteboard use, clear role definitions, and SBAR-based communication. Future research should test these enhanced, standardized approaches rather than relying on informal, intuitive communication alone.

Asset Subtitle

Alexandra Castro

Meta Tag

Author List Alexandra Castro, Stephanie Taylor, Vikas Parekh, Ying He

Category Research

Concept Hospitalist Team Regionalization

Concept Interprofessional Communication

Concept Care Plan

Concept Interprofessional Concordance

Concept Care Plan Agreement

Distinguished Non-Finalist

Presenter Organization University of Michigan

Presenting Author Alexandra Castro

Track Communication

Keywords

hospitalist regionalization

interprofessional communication

care plan agreement

bedside nurses

hospitalist teams

patient safety

structured multidisciplinary rounds

SBAR communication

hospitalist-APP dyads

cross-sectional study

Hospitalist Team Regionalization

Interprofessional Communication

Care Plan

Interprofessional Concordance

Care Plan Agreement