Physician Attire and Appreciation of Physician Communication in Postpartum Women

Wearing white coat during hospital rounds has been associated with increased risk of colonization and transmission of resistant pathogens. On the other hand, studies have shown that physicians' attire affects patients' confidence in their physician and the patient-physician relationship. The results of these studies were highly dependent on the practice setting, with no data in postpartum patients.

The objective is to test the hypothesis that not wearing a white coat during physician postpartum rounds impact patient-physician communication scores.

Study Overview

• Status: Completed
• Conditions: Patient Satisfaction
• Intervention / Treatment: Other: non White coat

Detailed Description

Patient satisfaction is an important measure of quality of care. One of the most important variables in patients satisfaction scores is the physician communication skills. There have been several studies evaluating different strategies to improve the patient perceptions of patient - physician communication including delayed physician rounds, improvement of handoff strategies, and family centered rounds. Additionally, research has shown that patients develop a first impression of their physician based on the physician's verbal and nonverbal communication, including the clothing and cleanliness. Patient - physician communication scores not only have an impact on patient care, but are also now linked to Medicare reimbursements.

White coats have been widely used in the medical profession, however some physicians believe that this can be a nonverbal barrier to patient's interaction. Prior studies on the impact of physician attire have reported conflicting results. In a survey published by Cha et al, obstetric and gynecologic patients seen in the outpatient clinic preferred that the resident use white coats. Another study showed that patients favor the use of white coat in the Internal Medicine outpatient clinic which may favorably influence trust and confidence in the medical encounter.

No randomized controlled trial has been published on the impact of the use of white coat on patient - physician communication scores in the postpartum patients. This trial's primary outcome is to evaluate the impact of physician attire (specifically wearing white coat) during postpartum rounds on "patient - physician communication" scores.

This study is a randomized controlled trial performed in postpartum patients to evaluate the impact of not wearing white coat during rounds on "patient - physician communication" scores.

• Study Type: Interventional
• Enrollment (Actual): 178
• Phase: Not Applicable

Contacts and Locations

Study Locations

• United States
  • Texas
    • Galveston, Texas, United States, 77550
      • Universty of Texas Medical Branch

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years to 50 years (Adult)
• Accepts Healthy Volunteers: Yes
• Genders Eligible for Study: Female

Description

Inclusion Criteria:

• Maternal age ≥ 18 years and <50 years
• Patient admitted to postpartum floor at University of Texas Medical Branch (UTMB)
• Patient care managed by obstetric physicians during the postpartum period.

Exclusion Criteria:

• Patient admitted to ICU
• Delivery resulting in stillbirth Patient not fluent in Spanish and/or English

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Other
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: None (Open Label)

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: non white coat rounding; The postpartum physician rounding in this group will be performed wearing white coat.	Other: non White coat; Postpartum patients are randomized to either arm of the study (white coat or standard scrub suit only) by location. All the obstetric physicians associated with patient's postpartum care should use or not use white coat in every single encounter with patient.
Placebo Comparator: White coat rounding; The postpartum physician rounding in this group will be performed not wearing white coat.	Other: non White coat; Postpartum patients are randomized to either arm of the study (white coat or standard scrub suit only) by location. All the obstetric physicians associated with patient's postpartum care should use or not use white coat in every single encounter with patient.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Patient - physician communication score	Obtained from the three Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) questions.	24 to 120 hours

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Hospital rating scores	Obtained from one question of the HCAHPS survey	24 to 120 hours
Recommending the hospital to friends and family	Obtained from one question of the HCAHPS survey	24 to 120 hours
Physician attire rating score	Rated from 1 to 4	24 to 120 hours
White coat use	Patient answer if she remember or not if their physician were using white coat.	24 to 120 hours

Collaborators and Investigators

• Sponsor: The University of Texas Medical Branch, Galveston
• Investigators: Study Director: Mauricio La Rosa, MD, University of Texas

Study record dates

Study Major Dates

• Study Start (Actual): May 1, 2017
• Primary Completion (Actual): June 16, 2017
• Study Completion (Actual): June 16, 2017

Study Registration Dates

• First Submitted: December 20, 2017
• First Submitted That Met QC Criteria: January 17, 2018
• First Posted (Actual): January 18, 2018

Study Record Updates

• Last Update Posted (Actual): February 5, 2018
• Last Update Submitted That Met QC Criteria: January 31, 2018
• Last Verified: January 1, 2018

More Information

Terms related to this study

• Keywords: Attire; White coat; Patient physician communication
• Other Study ID Numbers: IRB 17-0096

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No