Marlon Mundt, PhD
Madison, Wisconsin – When it comes to reducing unexpected medical visits and resulting costs for heart patients, a little more talk can go a long way.
University of Wisconsin School of Medicine and Public Health researchers report that primary-care teams with more members talking to each other face-to-face every day deliver higher-quality cardiovascular disease (CVD) care at a lower cost.
Furthermore, teams with significantly better patient CVD outcomes demonstrate higher levels of shared team vision, which is linked to greater face-to-face interaction among team members.
The study was published in this week’s edition of the Annals of Family Medicine.
The research, led by
of the UW-Madison Department of Family Medicine, found that primary-care teams with more members engaged in frequent, daily face-to-face interactions about patient care had 66 percent fewer urgent-care visits and a 73 percent reduction in emergency-department visits for the team’s patients with cardiovascular disease.
In addition, teams that involve more people in communications about patient care had $506 less in medical costs per patient with cardiovascular disease in the past 12 months.
“Our data suggest that having more team members involved in frequent daily communication about patient care may be a cost-effective way to deliver better CVD care,” said Mundt.
The research team surveyed 155 health professionals from 31 teams at six primary care clinics in southern Wisconsin. Two of the clinics are urban clinics, three suburban and one rural. During the 30-minute face-to-face survey that used a staff roster to aid memory, health professionals were asked to identify with whom and how frequently they interacted in person and through electronic health records (EHR) in the clinic. They also responded to a team-climate inventory to evaluate whether teams focused on clear and realistic goals and if team interactions were non-threatening and supported innovation.
The researchers used EHR data to determine health outcomes of patients with cardiovascular disease, who were identified by a diagnosis of hypertension, congestive heart failure, coronary artery disease, heart attack, arrhythmia, cerebrovascular disease or stroke. They also accounted for urgent care and emergency department visits as well as hospital stays and medical costs for patients with CVD.
Mundt said that neither individual professional excellence nor EHR solutions alone are sufficient to improve quality of cardiovascular disease care. He said future studies are needed to develop interventions targeting team communication patterns in primary care.
“Successful primary-care teams with better CVD patient outcomes and lower costs make it possible for more team members to directly interact face-to-face,” said Mundt. “Future studies need to explore how clinics could encourage more frequent team face-to-face interactions about patient care.”
Cardiovascular disease in the U.S. was responsible for nearly 33 percent of deaths and almost $300 billion in health care costs in 2008.