Examining the Relationship among Hospitalist Continuing Education, Hospitalist Communication Competency, and Stroke Patient Outcomes

Studies of effective continuing education (CE) often related to individual knowledge base, behavior, and patient outcomes. Physician communication affects patient outcomes. Nevertheless, understanding is limited regarding the interactions among CE, communication competency, and stroke patient outcomes. The purpose of this study was to examine the relationship between hospitalist CE and stroke patient outcomes and to explore the relationship among the three study constructs, which included CE, communication competency, and stroke patient outcomes. The research methodology consisted of a mixed methods design. Using a combination of qualitative and quantitative methodologies provides greater assurance that the research results reflect reality rather than methodological error. Continuing education data and stroke patient outcomes data were collected from archival data for primary analyses from two American Heart Association databases: The Professional Education Center and Get With The Guidelines-Stroke RTM databases. The final sample for the first research question was comprised of 284 Mid-western (encompassing 11 states) non-profit, governmental, and for-profit hospitals that reported data related to stroke patient outcomes from January 1, 2015 through December 31, 2016. Hospitalist self-reported data were collected for secondary analyses via an online survey that included both demographic and open-ended questions. The final sample for the second research question was comprised of 42 surveys completed by the hospitalists employed by the Mid-western hospitals included in the final sample relative to the first research question. A myriad of descriptive and inferential statistical analyses was completed to address both research questions. Relative to the first research question, regression analyses were completed to regress the dependent variable (stroke patient outcomes) on the independent variable (CE). The qualitative data analyses encompassed relationship coding and cluster analysis using NVivo. Three main empirical findings emerged from the study. First, hospitalists' CE in communication had a statistically significant negative relationship with Readmission Rates. Second, CE in communication improved hospitalists' communication competencies. Finally, hospitalists' improved communication competency improved stroke patients' outcomes, including reduced Readmission Rates, Mortality Rate, Disability Rate, Treatment Related Complication Rate, and Average Length of Stay.;The study's descriptive and empirical results imply that CE in communication may improve collaboration and teamwork among hospitalists, and better hospitalist-patient communication may also help reduce medical errors. The summary discussion of the study results and the implications for practitioners collectively facilitated the identification of several recommendations for practitioners, including leadership development of hospitalists, engagement and retention of hospitalists, engagement of patients and their families, and enhancement of medical curricula. This study presents several limitations, including validity of the stroke patients' outcome data, low response rate of survey data, and the study's scope in the U.S. Midwestern region. The summary discussion of the study results and the study limitations collectively facilitated the identification of several opportunities for future research, including the impact of CE in communication on patient outcomes post hospital discharge, the impact of hospitalists' communication on patient experience, the role of provider communication in medical errors, and the exploration of ways in which to improve communication within the medical profession.