Improving Discharge Communication in the Emergency Department Through Information Structuring

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

The goal of the proposed study is to assess the potential of information structuring for improving discharge communication. Specifically, the investigators aim to examine the advantages of an information-structuring skills training for physicians (compared to an empathy skills training) on discharge communication and associated patient outcomes, such as patients' information recall and adherence to physician recommendations. The investigators 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 in empathy skills).

Study Overview

• Status: Completed
• Conditions: Information Structuring Skills; Empathy Skills
• Intervention / Treatment: Behavioral: Communication skills training "information structuring skills"; Behavioral: Communication skills training "empathy skills"

• Study Type: Interventional
• Enrollment (Actual): 196
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Switzerland
  • Baselstadt
    • Basel, Baselstadt, Switzerland, 4031
      • University Hospital Basel, Emergency Department

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

Inclusion Criteria:

• Outpatients with chest pain
• Outpatients with abdominal pain

Exclusion criteria:

• Patients younger than 18 years of age (limited ability to provide informed consent)
• Patients with limited ability to communicate in German, the default language at the hospital (confounder related to language proficiency)
• Patients with dementia (confounder arising from pathological memory deficits)

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Health Services Research
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Single

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Information structuring skills training; Physicians received a communication skills training focusing on information structuring with the so-called book metaphor for a structured discharge communication with the patient.	Behavioral: Communication skills training "information structuring skills"
Active Comparator: Empathy skills training; Physicians received a communication skills training focusing on empathy skills with the acronym NURSE for an empathetic discharge communication with the patient.	Behavioral: Communication skills training "empathy skills"

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Time Frame
Patients' recall of the information provided during discharge communication	3 times: immediately after discharge, one week after discharge, one month after discharge

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Adherence to recommendations		2 times: one week and one month after discharge
Patient satisfaction in four dimensions	(1) comprehension, (2) structuredness (3) recommendation of the physician to family and friends (4) informativeness	Immediately after discharge

Collaborators and Investigators

• Sponsor: University Hospital, Basel, Switzerland
• Collaborators: University of Basel; Max Planck Institute for Human Development
• Investigators: Principal Investigator: Roland Bingisser, Prof. Dr., University Hospital, Basel, Switzerland

Study record dates

Study Major Dates

• Study Start (Actual): April 1, 2015
• Primary Completion (Actual): April 1, 2017
• Study Completion (Actual): April 1, 2017

Study Registration Dates

• First Submitted: May 27, 2015
• First Submitted That Met QC Criteria: June 8, 2015
• First Posted (Estimate): June 11, 2015

Study Record Updates

• Last Update Posted (Actual): October 23, 2018
• Last Update Submitted That Met QC Criteria: October 22, 2018
• Last Verified: October 1, 2018

More Information

Terms related to this study

• Keywords: Adherence; Satisfaction; Recall; Discharge communication; Information structuring; Empathy skills
• Additional Relevant MeSH Terms: Pathologic Processes; Disease Attributes; Emergencies
• Other Study ID Numbers: BACOP2