Senior Lecturer, Asst. Director, MIS PhD Program
I am currently working on three closely related projects, and they are at very different stages. My research focus is the hospitalist model, and I’ve spent the last six years studying the impact of this new professional model on patients, other medical personnel, communication technologists, and the hospitalist profession. Hospitalists are board-certified internists who practice medicine solely within the hospital setting. They take over care from the primary care physicians (PCPs) while the patient is hospitalized, and then transfer care back to the PCP after discharge.
The common thread in all of these projects is communication within the hospital setting. The “closest to completion” project is a book chapter that looks at hospitals’ online communication to the public about the hospitalist model. The chapter is almost ready to be marked up immensely by edits. The idea for this research came from my interviews with hospitalists. I noticed that almost all hospitalists mentioned that they have to overcome patients’ initial anxiety when they meet patients in the hospital because patients want their PCPs to treat them. This chapter looks at hospital websites and how they inform (or don’t inform) the public about hospitalists.
The second is a book chapter that is based on a 2013 4C’s presentation. In it I’ve looked at the discharge summary (DS) document and the transmission challenges that hospitalists and patients encounter. The purpose of the DS document is to list new medications, future tests that need to be made, the patient’s diagnosis, and care recommendations. It’s the handoff of information from inpatient to outpatient status and is crucial to patient care—both for the patient and for the PCP. I’ll be taking this presentation and making it a chapter with all of the challenges that go with that process!
My third project is a study that is in the IRB stage (I had an initial meeting with a physician and been given a green light to proceed.). It’s always interesting to follow a research path, and this project is no exception. I hoped that this would be a case study following a hospital’s attempts to improve tracking patient admissions and also discharge summaries with the hospital’s networked clinics. There are all kinds of issues nationwide involving discharge summaries not being transmitted to the patient’s PCP. Also, often when a patient is admitted to a hospital, the patient’s PCP has no idea about the admission. If the PCPs are notified of admissions, they can also look for a discharge summary transmission when the patient is discharged. However, that’s not the path that this study is taking. Instead, I’m finding that one critically key and overlooked population is the patients who are discharged to nursing homes. For all of the factors that are involved when combining aging and health challenges, these patients depend on physicians to communicate DS information. And, sadly, the transmission is sometimes not happening. In my initial interview, I’m finding that trust may be the central factor. And, it’s a theme that I studied in my dissertation research as I looked at trust among hospitalists and patients, hospitalists and other medical personnel, and hospitalists and IT.
Keywords to describe research
medical communication, hospitalist, patient communication, transition of care, discharge summary, medical handoffs
Work in relation to symposium keywords
The two key words that most resonate with me are connections and dissemination.
I see connections in two areas–as fellow researchers studying the same discipline and also connections with researchers and practitioners. As several have noted, we need to push past the goal of publishing and look at the “So what?” of our research. I believe that connections with practitioners can be the key.
Dissemination is tied closely to connections in that we have to get our messages out to those we are researching. For example, in my field, I need to disseminate my research to practitioners and the community (as possible future inpatients).
- How do you explain/define what you do to medical personnel and/or other stakeholders in the research process or to the public?
I study communication within the hospital setting, and it’s an interesting and challenging area to study. For patients and patient families, the inpatient stay is very stressful and communication both received and transmitted is critical to patient health. For professionals, meeting and gaining patient trust, interacting with other professionals, and transferring patient information at discharge. I study three areas—how hospitalists gain the trust of patients and patient families, how hospitalists communicate with other professionals in the hospital, and the technologies they use to write and transmit the discharge summary.
- How would you describe the relationship between medical rhetoric/health communication (however you see yourself) with other fields and sub-fields (e.g., rhetoric of science)? For example, we struggled with what to name the symposium. Some suggested medical rhetoric, but that doesn’t comfortably fit some from Communication nor from English Studies. In other words, how do you align what may be a specific focus with broader disciplinary concerns and tensions?
I’ve been debating this myself as I’ve looked at how my research aligns with a discipline in business. At this moment, I believe that it’s the persuasive elements of what we study that link us together. Whether we study prose, new media, IT, marketing, or medical rhetoric, it is the conversation—the discourse—is the connector.
- What are some of the most pressing questions in health and healthcare that health communication/medical rhetoric scholars can help answer?
I’ve taken on more intricate research questions which have led me back to a very basic question–What does communication mean to patients and to medical professionals? For example, a patient might not see his or her hospitalist for a full day and perceive that the hospitalist is not communicating with the patient. That same hospitalist perceives that he or she is effectively communicating because the hospitalist is ordering tests, checking test results, and monitoring/prescribing medications. Beyond the obvious reasons for this information, each participant could advocate and participate in the healthcare experience.