Table 2.
Comparison of Patient and Team Characteristics for SDM Encounters Across Patient Engagement Project Study Periodsa
| Characteristic | Preintervention period | Postintervention period | P value | |
|---|---|---|---|---|
| SDM patients assessed, no. | 254 | 273 | ||
| Patient age (years). median (Q1–Q3) | ||||
| Pediatrics | 6.0 (2.0–13) | 5.0 (1.0–12) | .55 | .48 |
| Medicine | 59 (42–69) | 62 (46–71) | .36 | .53 |
| Male patient, no. (%) | 128 (51) | 141 (52) | .92 | .02 |
| Patient race, no. (%) | .25 | .15 | ||
| White | 136 (54) | 128 (47) | ||
| Asian | 28 (11) | 33 (12) | ||
| African American | 26 (10) | 29 (11) | ||
| Pacific Islander/Native American | 10 (3.9) | 3 (1) | ||
| Other | 54 (21) | 64 (23) | ||
| Unknown | 0 (0) | 16 (6) | ||
| Patient primary language, no. (%) | .39 | .80 | ||
| English | 220 (87) | 228 (84) | ||
| Spanish | 21 (8.3) | 29 (11) | ||
| Other | 13 (5.1) | 9 (3) | ||
| Unknown | 0 (0) | 7 (3) | ||
| Duration of SDM patient encounter (minutes) | .09 | .77 | ||
| Median (Q1–Q3) | 13.0 (9–18) | 13.0 (8–18) | ||
| ≤ 6, no. (%) | 34 (13) | 40 (15) | ||
| 7–12, no. (%) | 80 (32) | 90 (33) | ||
| 13–18, no. (%) | 78 (31) | 80 (29) | ||
| 19–24, no. (%) | 27 (11) | 36 (1) | ||
| > 24, no. (%) | 35 (14) | 27 (10) | ||
| Primary decision discussed, no. (%)b | < .001 | < .001 | ||
| Treatment | 120 (47) | 130 (48) | ||
| Diagnosis | 39 (15) | 34 (12) | ||
| Diagnosis and treatment | 77 (30) | 57 (21) | ||
| Neither (other) | 18 (7.1) | 52 (19) | ||
| Presenting clinician, no. (%) | .18 | .10 | ||
| Medical student | 89 (35) | 84 (31) | ||
| Intern | 132 (52) | 160 (59) | ||
| Resident | 30 (12) | 21 (8) | ||
| Attending hospitalist | 4 (1.6) | 2 (1) | ||
| Unknown | 0 (0) | 6 (2) | ||
| Rounds observed, no. | 88 | 87 | ||
| Rounds duration in hours, median (Q1–Q3)c | 1.8 (1.5–2.4) | 2.1 (1.6–2.9) | .14 | < .001 |
| Team size, median (Q1–Q3) | 7.0 (6–10) | 7.0 (5–9) | .01 | .73 |
| Trainee percentage of team, median (Q1–Q3)d | 50 (40–55) | 50 (40–60) | .08 | 11 |
Abbreviations: SDM indicates shared decision making; Q1, 25th percentile, Q3, 75th percentile.
Continuous characteristics are summarized by median (Q1–Q3) and categorical characteristics by no. (%); P values arise from random-effects models that address variation of each characteristic between periods and differential period effects among services (interaction effect). The 8-week Patient Engagement Project Study intervention was delivered at four 4 services (Med-1, Med-2, Peds-1, and Peds-2) at teaching hospitals at Stanford University and the University of California, San Francisco between November 2014 and January 2015. Rounds were observed during 12-week pre- and postintervention periods (August to November 2014 and December 2014 to April 2015) to evaluate rounding teams’ SDM behaviors with patients. SDM encounters were restricted to patients who were present during observed rounds (including guardian for pediatrics), did not have altered mental status, and were deemed medically stable by the hospitalist.
SDM topics could address other matters, such as discharge timing.
Round-level hours per patient = round duration divided by the patient census per round.
Trainees were residents, interns, and medical students; hospitalists were attendings and fellows. Other team members could include nurses, pharmacists, social workers, interpreters, and consultants.