Advancing clinician–patient communication in academic hospitals: Insights from a multisite rapid qualitative analysis

BACKGROUND: High-quality clinician-patient communication is associated with improved patient understanding, trust, and healthcare outcomes. However, the hospital environment poses unique challenges to effective communication, and research documents that many hospitalized patients report poor communication with clinicians. OBJECTIVE: Characterize current efforts and barriers to improving clinician-patient communication across hospital medicine. METHODS: We conducted a multi-methods study using virtual focus groups with an online survey. Focus groups were held with hospital medicine clinicians and members of the Hospital Medicine ReEngineering Network (HOMERuN) Patient and Family Advisory Council (PFAC). We analyzed focus groups using rapid qualitative analysis. RESULTS: Across 8 total focus groups, 37 clinicians and 4 PFAC members participated. We received 26 survey responses (63% response rate); the majority (19, 73%) reported their institution had initiatives in place to improve clinician-patient communication. Our qualitative analysis revealed four primary themes: (1) hospital medicine communication initiatives vary widely in approaches and objectives; (2) trainees are taught foundational communication skills through formal and informal mechanisms, but these efforts may be siloed from other initiatives; (3) hospital medicine clinicians perceive multiple barriers to improving individual communication behaviors; and (4) systems-level factors make it challenging to effectively develop, evaluate, and sustain communication initiatives. CONCLUSIONS: Hospital medicine groups are actively engaged in diverse communication initiatives, but these efforts are undermined by fragmentation, inadequate feedback mechanisms, and competing priorities. Our findings highlight a need for coordinated strategies that align communication projects with real-world clinical workflows, provide clinicians with actionable feedback, and incorporate genuine partnership with patients and caregivers.