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November 26, 2012

Communication Between Patients, Families and Care Providers Key to Outcome of Patient Experience

Systematic communication between health care providers, patients and their families results in better patient care and shorter hospital stays, and may also improve family outcomes, according to a review of previously published research examining the impact of interventions to improve communication for those with advanced or serious illness.

The evidence review, conducted by the Johns Hopkins Evidence-Based Practice Center (JHUEPC) and funded by the federal Agency for Healthcare Research and Quality, is titled, “Improving Health Care and Palliative Care for Advanced and Serious Illness.” An article based on that work, “A Systematic Review of Communication Quality Improvement Interventions for Patients with Advanced and Serious Illness,” was published online in the Journal of General Internal Medicine’s.

“The research shows that communication interventions implemented in the intensive care unit directly impacted patients’ length of stay, improved the level of care and improved the clinical decision making process,” said author, Sydney Dy, MD, MSc, an associate professor in the Department of Health Policy and Management at the Johns Hopkins Bloomberg School of Public Health. Dy also holds appointments in Oncology and Medicine, Duffy Pain and Palliative Care Program, Kimmel Cancer Center at Johns Hopkins.

According to the authors, the quality of communication in the care of patients with advanced and serious illness is a key determinant of patient and family outcomes. Research in a variety of settings has found that communication is often suboptimal. One study of oncology consultations for patients with advanced cancer showed that fewer than half of oncologists offered alternatives to chemotherapy as an option. Only 58 percent of patients were informed of their life expectancy, and 60 percent were made aware of the risks versus benefits of further chemotherapy treatment.  

“Patients never tell us they want less information from their healthcare providers,” said Eric B. Bass, MD, MPH, co-author of the review and director of the JHUEPC. “Patients and their families do better when they are involved, informed and engaged in the process.” 

The review concluded that communication in the care of patients with advanced and serious illness can be increased using quality improvement interventions, particularly for healthcare utilization as an outcome. Interventions may be more effective using a consultative approach, where additional providers, such as palliative care consults help to facilitate communication. Additional authors of the report include Rebecca Aslakson, MD, and Oluwakemi Fawole, MBChB.

The Johns Hopkins Evidence-Based Practice Center is anchored in the Department of Health Policy and Management at the Johns Hopkins Bloomberg School of Public Health.

Media contact: Tim Parsons, director of Public Affairs, at 410-955-7619 or tmparson@jhsph.edu.