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  • Increased Meeting of Patient Expectations is Associated with the Interdisciplinary Approach Focused on Patient Family-Centered Care in a Peripheral Nerve/Brachial Plexus Clinic

    Final Number:

    Ian Beck; Connie McGovern; Kate Wan-Chu Chang MA; Marci Vasaris MS, ATC; Sheela Pandey MSW; Susan Brown Ph.D.; Lynda Jun-San Yang MD, PhD

    Study Design:

    Subject Category:

    Meeting: Congress of Neurological Surgeons 2015 Annual Meeting

    Introduction: Meeting patient expectations in a neurosurgical clinic often relies upon the offering of surgical intervention. For patients who do not meet the indications for surgery, satisfaction is often low. However, the inclusion of multiple specialists focused on Patient Family Centered-Care (PFCC) principles is thought to improve the meeting of patient expectations. Since the University of Michigan (UM) Peripheral Nerve/Brachial Plexus Clinic comprises multiple surgical and medical specialists in a “one-stop shopping” approach via a single point of entry, we assessed the effectiveness of this model in the context of PFCC and patient expectations.

    Methods: Fifty-five patients sequentially recruited from the UM Peripheral Nerve/Brachial Plexus Clinic completed the modified Family-Centered Care Self-Assessment Tool1 and a clinic performance survey. Adherence to PFCC principles was graded from 0 to 3; a score of =2.00 was deemed satisfactory. Descriptive statistics and Student’s T-test were performed for sub-group analyses. The study was approved by the UM Institutional Review Board.

    Results: Although only 35% of patients were offered surgical intervention, 82% reported having their expectations met. A significant interdisciplinary overlap of specialists in a single clinic visit existed among neurosurgeons, physiatrists, orthopedists, and occupational therapists. For the PFCC principles, 71% of the questions yielded satisfactory scores >2, including the “ability of clinicians to give a diagnosis” (2.53±0.66). However, meeting the “linguistic and cultural needs” (1.39±1.13) and “peer/community support” (1.22±0.94) needed improvement. Potential racial and gender inequality existed: non-Whites (vs. Whites) and men (vs. women) rated all PFCC parameters lower.

    Conclusions: Despite the low rate of surgery offered, the interdisciplinary approach emphasizing PFCC principles is an effective system that meets patient expectations and improves satisfaction. Because patient satisfaction is a factor for reimbursement rates from insurers,2 this model may be in the best interest of the patient and the physician.

    Patient Care: We hope this study sheds light on the impact of interdisciplinary approach on PFCC and patient satisfaction.

    Learning Objectives: 1. How an interdisciplinary clinic can meet patient expectations 2. Effectiveness of a PFCC model in an interdisciplinary clinic 3. Increases patient satisfaction with PFCC and interdisciplinary clinic models

    References: 1. Institute for Patient Family Centered Care: A Self-Assessment Inventory. 2. Shirley, E., & Sanders, J. Patient Satisfaction: Implications and Predictors of Success. The Journal of Bone and Joint Surgery (American). 2013; 95(10):E69 1-E69 4.

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