Short communication Patient perspectives on communication with the medical team: Pilot study using the communication assessment tool-team (CAT-T) Laura Min Mercer a , Paula Tanabe a , Peter S. Pang a, *, Michael A. Gisondi a , D. Mark Courtney a , Kirsten G. Engel a , Sarah M. Donlan a , James G. Adams a , Gregory Makoul b a Department of Emergency Medicine, Northwestern University Feinberg School of Medicine, United States b Center for Communication and Medicine and Division of General Internal Medicine, Northwestern University Feinberg School of Medicine, United States 1. Introduction There is international recognition that effective communica- tion is fundamental to high-quality patient care [1–7]. In the U.S., the Accreditation Council for Graduate Medical Education (ACGME), American Board of Medical Specialties (ABMS), and the Joint Commission (JCAHO) have all established communica- tion as a core competency for physicians [4,8,9]. Despite the acknowledged importance of communication, assessment of communication skills in team-based care settings has not been well established. Traditionally, communication assessment has focused on communication processes [10,11] and individual caregivers, despite evidence that effective teams improve both safety and quality [12]. Improving communication is particularly important in the emergency department (ED), where patients experience care in a seemingly chaotic but well orchestrated team environment. Communication challenges include multiple hand-offs (informa- tion exchange to the next shift/person responsible), transitions in patient care between medical team members, frequent team- member substitution, 24/7 operations, frequent interruptions, overcrowding, high-risk diagnoses, time compression, and lack of previously established provider–patient relationships. We con- ducted a pilot study to test the feasibility of collecting patient perspectives of communication with the medical team in the ED. Our approach was to tailor a psychometrically validated instru- ment, the Communication Assessment Tool, for use in Team settings (CAT-T). Patient Education and Counseling 73 (2008) 220–223 ARTICLE INFO Article history: Received 13 February 2008 Received in revised form 20 June 2008 Accepted 1 July 2008 Keywords: Emergency medicine Assessment Communication skills Medical team communication ABSTRACT Objective: Effective communication is an essential aspect of high-quality patient care and a core competency for physicians. To date, assessment of communication skills in team-based settings has not been well established. We sought to tailor a psychometrically validated instrument, the Communication Assessment Tool, for use in Team settings (CAT-T), and test the feasibility of collecting patient perspectives of communication with medical teams in the emergency department (ED). Methods: A prospective, cross-sectional study in an academic, tertiary, urban, Level 1 trauma center using the CAT-T, a 15-item instrument. Items were answered via a 5-point scale, with 5 = excellent. All adult ED patients (18 y/o) were eligible if the following exclusion criteria did not apply: primary psychiatric issues, critically ill, physiologically unstable, non-English speaking, or under arrest. Results: 81 patients were enrolled (mean age: 44, S.D. = 17; 44% male). Highest ratings were for treating the patient with respect (69% excellent), paying attention to the patient (69% excellent), and showing care and concern (69% excellent). Lowest ratings were for greeting the patient appropriately (54%), encouraging the patient to ask questions (54%), showing interest in the patient’s ideas about his or her health (53% excellent), and involving the patient in decisions as much as he or she wanted (53% excellent). Conclusion: Although this pilot study has several methodological limitations, it demonstrates a signal that patient assessment of communication with the medical team is feasible and offers important feedback. Results indicate the need to improve communication in the ED. Practice implications: In the ED, focusing on the medical team rather then individual caregivers may more accurately reflect patients’ experience. ß 2008 Elsevier Ireland Ltd. All rights reserved. * Corresponding author at: Department of Emergency Medicine, Northwestern University Feinberg School of Medicine, 259 East Erie, Suite 100, Chicago, IL 60611, United States. Tel.: +1 312 694 7000; fax: +1 312 926 6274. E-mail address: ppang@northwestern.edu (P.S. Pang). Contents lists available at ScienceDirect Patient Education and Counseling journal homepage: www.elsevier.com/locate/pateducou 0738-3991/$ – see front matter ß 2008 Elsevier Ireland Ltd. All rights reserved. doi:10.1016/j.pec.2008.07.003