Shadow Coaching Improves Patient Experience for English-Preferring Patients but not for Spanish-Preferring Patients.
Shadow Coaching Improves Patient Experience for English-Preferring Patients but not for Spanish-Preferring Patients.
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阴影教练可以改善英语偏爱患者的患者经验，但不能改善西班牙偏爱的患者的经验。
DOI：
10.1007/s11606-023-08045-2
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发表时间：
2023-08
影响因子：
5.7
通讯作者：
Hays, Ron D.
中科院分区：
文献类型：
--
作者：
Quigley, Denise D.;Elliott, Marc N.;Slaughter, Mary E.;Talamantes, Efrain;Hays, Ron D.
影子辅导是一种由受过培训的同行提供的一对一提供者咨询，是改善提供者行为和患者互动的有效策略，但其对改善英语和西班牙语患者体验的效果尚不清楚。评估影子辅导对喜欢英语和西班牙语的患者的患者体验的影响。我们分析了 2012 年至 2019 年临床医生和团体消费者对医疗保健提供者和系统的评估 (CG-CAHPS) 数据 (n=46,089)，这些数据来自一个城市联邦合格健康中心，该中心拥有 44 个初级保健机构和 320 个提供者。三分之一（n = 14,631）是喜欢西班牙语的患者。我们拟合了混合效应回归模型，其中包括提供者的随机效应（治疗分配的水平）和时间的固定效应（在辅导日期有结和“跳跃”的时间线性样条）、患者特征和场所指标，并按首选语言分层。 CAHPS 整体提供商评级 6 个月平均顶盒得分低于 90（100 分制）的 74 家提供商接受了影子辅导。经过辅导的医疗服务提供者发现，喜欢英语的患者 (45%) 和喜欢西班牙语的患者 (43%) 的比例相似。训练有素的提供者观察同事对患者的护理并提出改进建议。观察后立即提供口头反馈，参与者收到一份总结辅导课程意见和建议的书面报告。 CG-CAHPS 访问调查 2.0 提供商沟通综合和总体提供商评级（0-100 分）。我们发现，在接受辅导的提供者的英语偏好患者中，CAHPS 提供者沟通和整体提供者评级在统计上显着提升了 2 点（小）。没有证据表明辅导对喜欢西班牙语的患者的患者体验有影响。辅导可以改善喜欢英语的患者的护理体验，但可能不会改善喜欢西班牙语的患者的患者体验。需要选择和培训提供者与喜欢西班牙语的患者进行有效沟通，以将影子辅导的好处扩大到喜欢西班牙语的患者。
Shadow coaching, a type of one-on-one provider counseling by trained peers, is an effective strategy for improving provider behaviors and patient interactions, but its effects on improving patient experience for English- and Spanish-preferring patients is unknown. Assess effects of shadow coaching on patient experience for English- and for Spanish-preferring patients. We analyzed 2012–2019 Clinician and Group Consumer Assessment of Healthcare Providers and Systems (CG-CAHPS) data (n=46,089) from an urban Federally Qualified Health Center with 44 primary care practices and 320 providers. One-third (n=14,631) were Spanish-preferring patients. We fit mixed-effects regression models with random effects for provider (the level of treatment assignment) and fixed effects for time (a linear spline for time with a knot and “jump” at coaching date), patient characteristics, and site indicators, stratified by preferred language. The 74 providers who had a 6-month average top-box score on the CAHPS overall provider rating below 90 (on a 100-point scale) were shadow coached. Similar percentages of English-preferring (45%) and Spanish-preferring patients (43%) were seen by coached providers. Trained providers observed patient care by colleagues and provided suggestions for improvement. Verbal feedback was provided immediately after the observation and the participant received a written report summarizing the comments and recommendations from the coaching session. CG-CAHPS Visit Survey 2.0 provider communication composite and overall provider rating (0–100 scoring). We found a statistically significant 2-point (small) jump in CAHPS provider communication and overall provider rating among English-preferring patients of coached providers. There was no evidence of a coaching effect on patient experience for Spanish-preferring patients. Coaching improved care experiences for English-preferring patients but may not have improved patient experience for Spanish-preferring patients. Selection and training of providers to communicate effectively with Spanish-preferring patients is needed to extend the benefits of shadow coaching to Spanish-preferring patients.
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影响因子：
3
作者：
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通讯作者：
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