1. INCREASING ADOPTION OF AIDET: A STUDENT-LED QUALITY IMPROVEMENT RESEARCH PROJECT
Research Club
1/23/18

2. Background
Many hospitalized patients do not understand their treatment and care plans1.
Prior research shows that better physician communication skills improve patient outcomes2.
Since these communication skills are teachable, many institutions implement a standardized communication tool for physicians and trainees3, 4, 5, 6.
The evidence-based Acknowledge, Introduce, Duration, Explanation, and Thank (AIDET) communication tool improves patient and provider interactions via a demonstrated increase in patient satisfaction scores in both institutional and national HCAHPS metrics7, 8, 9.

3. Study Questions
Aim Statement: In the next 6 months, we will increase the adoption of AIDET in observed patient interactions in Internal Medicine to > 85% in all categories.
Baseline data
UNM IM night accept team rounds

4. Study Questions Intervention or methods
What statistical analysis did/will you perform? percentage analysis
Was this IRB approved? Yes
Intervention: resident and attending educational sessions
Post intervention measures: audits and real-time feedback

5. Pre-intervention data
88.89% (24/27)
92.60% (25/27)
85.19% (23/27)
92.60% (25/27)
80.00% (20/25) 2 N/As
33.33% (9/27)
55.56% (15/27)

6. Post-intervention data
96% (25/26)
100% (26/26)
88% (23/26)
88% (23/26)
85% (22/26)

7. Team and Roles Melissa Martinez, MS4 Christopher Bartlett, PGY3
Christina DeShayes, SON
Greg Fahl, MS4
Anna Jones, PGY3
Gina Miller, MS4
Katie Ogawa, MS4
Aaron Stecker, PGY2
Gina Stroud, MS4
Dr. Eileen Barrett, supervising physician

8. Planning/Study Phase Site visit Literature review
Pre-intervention data
Intervention: education
Post-intervention data collection & comparison

9. Study Limitations Only IM teams were surveyed
Not all teams within IM were surveyed
Interventions did not reach all subsequently surveyed

10. UNM QI and Patient Safety Goal
List which goal(s) your project falls under:
2016 Strategic Goals
Goal 1 – Develop Clinical Master Facility Plan 
Goal 2 – Increase Ambulatory access and throughput – Increase clinic volumes 4% – Complete centralized scheduling for adult clinics – Expand ambulatory capacity with new clinics – Implement the full scope of PCMH model 
Goal 3 – Increase Inpatient capacity – Decrease adult LOS (excluding OB) to 6.56 • Increase daily discharge by 3 • Decrease Adult LOS >15 days by 20% • Increase monthly adult discharges (excluding OB) by 2pm to 500/month • Home Health program • Post-Acute Care affiliations
Goal 4.1 – Improve tertiary referral transfer capabilities – Increase transfers from outside by 6 per month (72 annual) 
Goal 5 – Information Technology Implementation – EMR improvements – Population Health – Revenue Cycle – Consumer Access 
Goal 6.1 – Increase surgical volumes by 5% 
Goal 7 – Maintain accreditation deemed status 
Goal 8 – Improve National Patient Safety Goal, Core Measures and Mortality Index Outcomes
Goal 9 and 10 – Improve Patient satisfaction
Goal 11 – Foster strong community engagement, proactively address community concerns and meet community needs – Partner with Bernalillo County and Indian Health Services in the development of Behavioral Health Programs and Community based clinics
Goal 12 – Improve staff and faculty engagement and satisfaction – Turnover rates less than 15% – Improve staff satisfaction by 10% – Implement provider ease of practice programs – Conduct physician satisfaction survey 
Goal 13 – Develop shared governance for Magnet status

11. Next Steps Share results with IM leadership Present findings at SHM
Project sustainability

12. Barriers/Challenges Language barriers. Night accept team at capacity.
Hawthorne effect.
Time constraints.

13. What I would do with my project if I had unlimited resources
Expand audits hospital-wide
Regular audits hospital-wide
Correlating patient satisfaction with AIDET use.
Influence of AIDET use on HCAHPS data.

14. Questions?

15. Upcoming Deadlines AAMC-Integrating Quality – usually in Spring
National Healthcare Coalition Preparedness Conference-June
Mountain West SGIM is usually in July
UNM Health Science Center Annual Education Day - August
NM ACP HVC, QI, research, clinical vignettes - September
NM SHM research and innovations abstracts - September
National SGIM – September
Western Regional Meeting of the American Federation of Medical Research​- Sept
SACME- October
APDIM- Academic Internal Medicine week- November
National ACP - November
American Geriatrics Society -December
National SHM – December
Please leave this in at the end

16. Sources:
O’leary K, Kulkarni N, Landler M, et al. Hospitalized patients’ understanding of their plan of care. Mayo Clinic Proceedings
Studer Q. Keep your patients coming back. MGMA Connexion
Braverman A, Kunkel E, Katz L, Katona A, et al. Do I Buy It? How AIDET Training Changes Residents' Values about Patient Care. Journal of Patient Experience
Makoul G, Zick A, Green M. An Evidence-Based Perspective on Greetings in Medical Encounters. Arch Intern Med
Kelley J, Kraft-Todd G, Schapira L, Kossowsky J, Riess H. The influence of the patient-clinician relationship on health care outcomes: a systematic review and meta-analysis of randomized controlled trials. PLoS ONE. 2014,
Rao J, Anderson L, Inui T, et al. Communication interventions make a difference in conversations between physicians and patients: a systematic review of the evidence. Med Care 2007.
Allen T, Rieck T, Salsbury S. Patient perceptions of an AIDET and hourly rounding program in a community hospital: Results of a qualitative study. Patient Experience Journal
Scott J. Utilizing AIDET and Other Tools to Increase Patient Satisfaction Scores. Radiology Management
Zamora R. Influence of AIDET in the Improving Quality Metrics in a Small Community Hospital - before and after Analysis. Journal of Hospital Administration