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Where is the patient's chair? Differences in general practitioner consultation room layouts - an exploratory questionnaire.

ABSTRACT: BACKGROUND:Consultation room design varies from country to country. The layout of a general practitioner's (GP's) consulting room may influence the physician's or patient's experience. The aim of this study is to explore and investigate the layout of GP's consulting rooms around the world and to describe any significant differences. METHODS:Between 3rd July and 2nd August 2018, an internet-based questionnaire on Google Docs was distributed by email, social media and WhatsApp platforms to several worldwide rural medicine groups. Analysis of an internet-based questionnaire to explore possible layouts of consultation rooms within practices was performed. The questionnaire was designed with three distinct sections: first, a GP demographic profile including gender, year of graduation from medical school, country of graduation, and type of practice (private or public); second, questions relating to the office layout; third, a section for questionnaire feedback. Results: 502 responses to the questionnaire were received; 65.3% women and 34.7% men. The most common layout in Europe and America was where the physician and the patient were separated by a desk. The layout where the physician and the patient had a 90º angle facing each other was the most commonly used layout in Asia-Pacific and Africa. For GPs who graduated before 1990 and between 1990-2010, the layout where the table was between the patient and physician was preferred. However, physicians graduating after 2010 preferred a layout with the physician and the patient with a 90º angle facing each other. CONCLUSION:The position of the GP's desk differs between and within countries as well as the gender of the physician and year of graduation. Next steps should focus on gathering an even greater breadth of GP input, as well as comparing and contrasting those to the preferences of our patients and communities.

SUBMITTER: Floss M

PROVIDER: S-EPMC7194339 | biostudies-literature | 2019

REPOSITORIES: biostudies-literature

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Where is the patient's chair? Differences in general practitioner consultation room layouts - an exploratory questionnaire.

Floss Mayara M Hoedebecke Kyle K Vidal-Alaball Josep J

F1000Research 20190815

<h4>Background</h4>Consultation room design varies from country to country. The layout of a general practitioner's (GP's) consulting room may influence the physician's or patient's experience. The aim of this study is to explore and investigate the layout of GP's consulting rooms around the world and to describe any significant differences.<h4>Methods</h4>Between 3rd July and 2nd August 2018, an internet-based questionnaire on Google Docs was distributed by email, social media and WhatsApp platf ...[more]

PMID: 32399181

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Project description:BackgroundGeneral Practitioners (GPs) are central in the care of Dutch older people and in a good position to have Advance Care Planning (ACP) conversations. Interview studies reveal that the doctor-patient relationship is important when initiating ACP conversations and can also be influenced by ACP conversations. We aimed to examine the association between having an ACP conversation and the patient feeling the GP knows him or her and the patient trusting the GP and vice versa.MethodsImplementation of ACP in primary care was evaluated in a pre-and post design. Questionnaires before implementation of ACP and 14 months later were sent to patients aged 75 years or older within 10 GP-practices and 2 care homes. Multivariable logistic regression was used to model the relationship between ACP conversations during implementation and the patient-GP relationship before implementation. Odds ratios were adjusted for potential confounders. Generalized ordered logistic regression was used to model the relationship between the changes in patient-GP relationship before and after implementation and ACP conversations during implementation.ResultsFour hundred fifty-eight patients filled out the pre- and post-test questionnaire. There was no association between the GP knowing the patient and trust in the pre-test and having an ACP conversation during the implementation. For people who had had an ACP conversation at the end of the implementation period their trust remained more often the same or was higher after implementation (trust to provide good care OR 2.93; trust to follow their wishes OR 2.59), compared to patients who did not have an ACP conversation. A reduction in trust was less likely to happen to patients who had an ACP conversation compared to patients who did not have an ACP conversation.ConclusionsAlthough we have not found evidence for trust as a prerequisite for ACP conversations, this paper shows that ACP conversations can be beneficial for the doctor-patient relationship.

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Project description:BackgroundAssessment of medical communication performance usually focuses on rating generically applicable, well-defined communication skills. However, in daily practice, communication is determined by (specific) context factors, such as acquaintance with the patient, or the presented problem. Merely valuing the presence of generic skills may not do justice to the doctor's proficiency.Our aim was to perform an exploratory study on how assessment of general practitioner (GP) communication performance changes if context factors are explicitly taken into account.MethodsWe used a mixed method design to explore how ratings would change. A random sample of 40 everyday GP consultations was used to see if previously identified context factors could be observed again. The sample was rated twice using a widely used assessment instrument (the MAAS-Global), first in the standard way and secondly after context factors were explicitly taken into account, by using a context-specific rating protocol to assess communication performance in the workplace. In between first and second rating, the presence of context factors was established. Item score differences were calculated using paired sample t-tests.ResultsIn 38 out of 40 consultations, context factors prompted application of the context-specific rating protocol. Mean overall score on the 7-point MAAS-Global scale increased from 2.98 in standard to 3.66 in the context-specific rating (p<0.00); the effect size for the total mean score was 0.84. In earlier research the minimum standard score for adequate communication was set at 3.17.ConclusionsApplying the protocol, the mean overall score rose above the level set in an earlier study for the MAAS-Global scores to represent 'adequate GP communication behaviour'. Our findings indicate that incorporating context factors in communication assessment thus makes a meaningful difference and shows that context factors should be considered as 'signal' instead of 'noise' in GP communication assessment. Explicating context factors leads to a more deliberate and transparent rating of GP communication performance.

Dataset Information

Where is the patient's chair? Differences in general practitioner consultation room layouts - an exploratory questionnaire.

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Where is the patient's chair? Differences in general practitioner consultation room layouts - an exploratory questionnaire.

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