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Understanding patient-provider conversations: what are we talking about?
Danielle M McCarthy1, Barbara A Buckley, Kirsten G Engel
1Department of Emergency Medicine, Northwestern University, Chicago, IL, USA. d-mccarthy2@northwestern.edu.
Summary
Emergency department (ED) communication analysis reveals providers and patients dedicate substantial talk time to information exchange and relationship building. Despite the fast-paced ED environment, building rapport is a significant, albeit unexpected, component of these interactions.
Area of Science:
- Medical Communication
- Emergency Medicine
- Health Services Research
Background:
- Effective patient-provider communication is vital for high-quality healthcare.
- Conversational dynamics within the emergency department (ED) setting are not well understood.
- Analyzing ED visit conversations can inform strategies to improve patient-provider interactions.
Purpose of the Study:
- To analyze complete audio recordings of ED visits.
- To characterize conversational patterns and functional communication categories.
- To determine the proportion of talk time spent on different communication functions.
Main Methods:
- Audio recordings of 26 ED visits for specific diagnoses were analyzed.
- The Roter Interaction Analysis System (RIAS) was used to categorize utterances.
- Descriptive statistics quantified communication patterns in functional groupings.
Main Results:
- Providers dominated conversations (median 239 utterances vs. 145 for patients).
- Provider talk focused on education/counseling (34%) and facilitation (30%).
- Patient talk centered on information giving (47%) and relationship building (45%); question asking was low (5%).
Conclusions:
- Both patients and providers in the ED significantly focused on information exchange.
- A substantial portion of talk time was unexpectedly dedicated to relationship building.
- This occurred despite the absence of traditional, longitudinal provider-patient relationships.
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