Marlon Mundt, PhD

Marlon Mundt, PhD

MADISON- UW School of Medicine and Public Health researchers have found that high-performing primary care provider teams with better diabetes patient outcomes and lower medical costs have a uniquely different way of communicating about diabetes patient care. The study determined that highly-cohesive primary care teams that equally engage all team members through daily, frequent face-to-face communication about patient care have 54 percent fewer hospital days and $1220 lower health care costs per diabetes patient in the past 12 months in their teams’ patient panels.

“Our study suggests that high-performing primary care teams delivering better diabetes care at lower cost could be engineered in a scientific way,” said Dr. Marlon Mundt, assistant professor of family medicine. “Our research suggests that we can quantify and measure communication behavior in teams in relation to patient care outcomes. This offers us an amazing possibility to equip every primary care team with the interaction patterns uncovered in successful teams to ensure the best possible diabetes care delivery. This innovation would allow us to meet the Affordable Care Act ‘triple aim’ of rapidly raising health care quality, improving patient experience, and lowering health care costs.”

Mundt said that the study shows that face-to-face communication is the most valuable form of communication for better diabetes care, as it contributes to better team climate and better shared team vision among all team members. In contrast, the study shows that the frequency of electronic health records (EHR) communications did not contribute to team climate and to better diabetes patient outcomes.

“That suggests that technology solutions to diabetes patient care alone may not substitute for face-to-face communication and teamwork among team members. Successful teams with the best diabetes patient outcomes have team members highly- interconnected with strong bonds forged through frequent, daily face-to-face interactions,” said Mundt.

One-hundred-fifty-five health professionals at six UW Health primary care clinics, two urban, three suburban and one rural, participated in the study. All team participants completed a questionnaire regarding team climate and communication with other team members about patient care. An EHR search identified the diabetes patients age 18 and older seen by the teams.

The study also found that teams with a doctor who communicates frequently, daily with a single nurse, rather than with multiple nurses, had better diabetes patient outcomes and lower costs. The interactions between a doctor and a single nurse may allow them to form a stronger working connection which makes it easier for them to communicate and adjust “on the fly.”

Since the study is observational in nature, more studies are necessary to fully understand the underlying causal relationship between team communications patterns and patient diabetes outcomes, according to Mundt.

The American Diabetes Association said prevalence of diabetes is 9.6 percent in the U.S. and economic costs are $245 billion per year.

The study was published in the International Journal of Nursing Studies.

Published: May 2016