Table 3.
Comparison of Standard Setting Between Scoring Groups
| Uncertainty Communication Checklist26 | Patient | Program Director | Difference |
| Mean (95% CI) | Mean (95% CI) | Mean Difference (95% CI of Mean Difference) | |
| 1. Explain to the patient that they are being discharged | 86.9 (79.8–93.9) | 95.8 (93.4–98.3) | 8.9 (-0.8–18.7) |
| 2. Ask if there is anyone else that the patient wishes to have included in this conversation in person and/or by telephone | 65.7 (56.9–74.6) | 85.4 (78.2–92.5) | 19.7 (6.6–32.7)a |
| 3. Clearly state that either “life-threatening” or “dangerous” conditions have not been found | 86.4 (78.9–93.8) | 91.4 (87.7–95.0) | 5.0 (-5.4–15.5) |
| 4. Discuss diagnoses that were considered (using both medical and lay terminology) | 81.0 (75.0–87.0) | 84.5 (76.6–92.3) | 3.5 (-6.3–13.2) |
| 5. Communicate relevant results of tests to the patient (normal or abnormal) | 84.4 (79.3–89.4) | 84.6 (79.6–89.6) | 0.2 (-7.4–7.9) |
| 6. Ask patient if there are any questions about testing and/or results | 88.9 (81.8–96.1) | 93.8 (91.0–96.6) | 4.9 (-5.1–14.9) |
| 7. Ask if patient was expecting anything else to be done during their encounter; if yes, address reasons not done | 60.0 (51.1–68.9) | 82.3 (76.7–87.9) | 22.3 (9.5–35.1)a |
| 8. Discuss possible alternate or working diagnoses | 73.9 (65.7–82.0) | 86.8 (80.3–93.2) | 12.9 (0.9–24.9)a |
| 9. Clearly state that there is a not a confirmed explanation (diagnosis) for what the patient has been experiencing | 81.7 (73.5–89.9) | 89.6 (84.0–95.2) | 7.9 (-3.9–19.8) |
| 10. Validate the patient's symptoms | 81.0 (74.3–87.7) | 81.2 (73.2–89.1) | 0.2 (-10.4–10.7) |
| 11. Discuss that the ED role is to identify conditions that require immediate attention | 79.4 (70.4–88.3) | 88.8 (85.1–92.6) | 9.4 (-3.1–22.0) |
| 12. Normalize leaving the ED with uncertainty | 84.7 (79.6–89.8) | 87.7 (82.8–92.6) | 3.0 (-4.7–10.7) |
| 13. Suggest realistic expectations/trajectory for symptoms | 86.7 (81.8–91.6) | 83.1 (77.8–88.4) | -3.6 (-11.2–3.9) |
| 14. Discuss next tests that are needed, if any | 87.8 (80.2–95.4) | 88.1 (82.6–93.5) | 0.3 (-10.8–11.3) |
| 15. Discuss who to see next and in what time frame | 91.9 (87.2–96.6) | 86.5 (80.9–92.1) | -5.4 (-12.8–2.1) |
| 16. Discuss a plan for managing symptoms at home | 89.6 (84.5–94.6) | 90.8 (86.3–95.2) | 1.2 (-6.3–8.8) |
| 17. Discuss any medication changes | 90.2 (83.9–96.4) | 86.6 (79.6–93.4) | -3.6 (-13.3–6.1) |
| 18. Ask patient if there are any questions and/or anticipated problems related to next steps (self-care and future medical care) after discharge | 88.6 (83.1–94.1) | 85.2 (78.2–92.2) | -3.4 (-12.2–5.5) |
| 19. Discuss what symptoms should prompt immediate return to the ED | 90.6 (84.6–96.5) | 90.6 (86.9–94.4) | 0.0 (-8.5–8.6) |
| 20. Make eye contact | 89.4 (82.9–95.9) | 95.0 (91.9–98.0) | 5.6 (-3.5–14.7) |
| 21. Ask patient if there are any other questions or concerns | 95.8 (92.9–98.7) | 93.7 (91.0–96.4) | -2.1 (-6.5–2.2) |
Abbreviations: CI, confidence interval; ED, emergency department.
a
P < .05.