Developing an Inpatient Relationship Centered Communication Curriculum (I-RCCC) rounding framework for surgical teams

Area of Science:

• Medical Education
• Surgical Communication
• Patient Experience

Background:

• Acute care surgery (ACS) rounds in trauma centers face communication challenges due to high patient acuity and volume.
• Limited curricula exist for trauma inpatient communication, leading to a lack of shared mental models among surgical teams.
• A relationship-centered rounding framework was hypothesized to improve the provider-patient experience.

Purpose of the Study:

• To develop and evaluate a relationship-centered communication curriculum for acute care surgery teams.
• To address identified communication gaps and enhance the provider-patient experience in a trauma setting.
• To assess the feasibility, practicality, and impact of the Inpatient Relationship Centered Communication Curriculum (I-RCCC).

Main Methods:

• A mixed-methods approach included a needs assessment using patient satisfaction surveys (Press Ganey, HCAHPS) and direct observation of communication behaviors.
• A five-hour workshop, the Inpatient Relationship Centered Communication Curriculum (I-RCCC), was designed based on identified needs for senior residents and Nurse Practitioners (NPs).
• Pre- and post-course assessments evaluated communication behaviors, and patient satisfaction data was collected six months before and after the intervention.

Main Results:

• Needs assessment revealed a lack of shared communication framework and leadership skills among senior trauma residents, with time constraints and interruptions as barriers.
• Post-workshop surveys showed significant improvement in self-reported communication behaviors, with 100% of participants reporting 'always' listening without interrupting, speaking clearly, repeating key points, and checking for patient understanding.
• Patient satisfaction data indicated a trend towards improvement, with a 20% increase in likelihood to recommend (LTR) and provider-related top box scores.

Conclusions:

• The Inpatient Relationship Centered Communication Curriculum (I-RCCC) is a feasible, practical, and well-received training for surgical residents and NPs.
• The curriculum demonstrated a positive trend in improving patient satisfaction and likelihood to recommend.
• The I-RCCC has the potential for refinement and scalability to other surgical specialties.