University of Wisconsin–Madison Medical College of Wisconsin

Use of Peer- and Self-Evaluation to Improve Conversations with Interfacility Referring Clinicians

Anika Nelson, MD; Svetlana Melamed, MD; Sarah Corey Bauer, MD; Erin Preloger, MD; Kelsey Porada, MA; Jennifer Hadjiev, MD

WMJ. 2022;121(4):301-305

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Background: Pediatric hospital medicine physicians receive little formal training in communicating with interfacility referring clinicians. We sought to improve pediatric hospital medicine physician confidence and communication scores by 10% during patient triage calls from interfacility referring providers via a continuing professional development initiative.

Methods: We conducted a single-center 10-month quality improvement project. Confidence was assessed via survey before and after the initiative. A novel self- and peer-evaluation tool was used to assess accepting pediatric hospital medicine physician communication on recorded calls. Call assessment scores were measured at baseline, cycle 1, and cycle 2. Interventions included group discussion and development of a scripting flowsheet.

Results: Twenty pediatric hospital medicine physicians participated and completed a total of 203 call assessments. From baseline to post-initiative, general confidence communicating with referring clinicians increased by 13% (mean ranks 11.8, 16.8, respectively), and specific confidence communicating when there is a difference of opinion increased significantly by 37% (mean ranks 9.8, 19.2, P < 0.001). Interfacility transfer conversation evaluation scores increased by 11%.

Discussion: Our initiative improved accepting physician’s confidence and communication evaluation scores using self- and peer-evaluation, group reflection, and a scripting flowsheet. Self- and peer-evaluation of recorded calls can be an effective intervention for building physician confidence in communicating with referring clinicians.

Author Affiliations: Department of Pediatrics, Section of Hospital Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin (Nelson, Melamed, Bauer, Preloger, Porada, Hadjiev); Children’s Wisconsin, Milwaukee Campus, Section of Hospital Medicine. Milwaukee, Wis (Nelson, Melamed, Bauer, Preloger, Hadjiev).
Corresponding Author: Anika Nelson, MD, Medical College of Wisconsin, Section of Pediatric Hospital Medicine, PO Box 1997, Milwaukee, WI 53201-1997; phone: 414.337.7050; email; ORCID ID 0000-0003-3451-8919
Funding/Support: None declared.
Financial Disclosures: None declared.
Acknowledgments: The authors thank Patricia Lye, MD; Jacqueline Kuzminski, MD; Jacqueline Gauger; Judy Borchardt; and the Children’s Wisconsin Transport Team for their assistance with this project.
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