Evaluating the impact of interprofessional training wards on patient satisfaction and clinical outcomes: a mixed-methods analysis

Abstract

Introduction: Interprofessional teamwork is pivotal in modern healthcare, prompting the establishment of interprofessional training wards since 1996. While these wards serve as hubs for optimizing healthcare professional collaboration and communication, research into patient outcomes remains notably sparse and geographically limited, predominantly examining patient satisfaction and sparingly exploring other metrics like mortality or self-discharge rates. This study seeks to bridge this gap, comparing patient outcomes in interprofessional training wards and conventional wards under the hypothesis that the former offers no disadvantage to patient outcomes.

Materials and methods: We explored patient outcomes within an interprofessional student ward called A-STAR at a University Hospital from October 2019 to December 2022. Engaging with patients discharged between May 2021 and April 2022, we utilized digital and paper-based anonymous questionnaires, catering to patient preference, to gather pertinent data.

Results: Analysis of outcomes for 1,482 A-STAR (interprofessional student ward) and 5,752 conventional ward patients revealed noteworthy findings. A-STAR patients tended to be younger (59 vs. 61 years, p < 0.01) and more frequently male (73.5% vs. 70.4%, p = 0.025). Vital clinical outcomes, such as discharges against medical advice, complication-driven readmissions, and ICU transfers, were statistically similar between groups, as were mortality rates (1.2% vs. 1.3%, p = 0.468). A-STAR demonstrated high patient satisfaction, underscored by positive reflections on team competence, ward atmosphere, and responsiveness to concerns, emphasizing the value placed on interprofessional collaboration. Patient narratives commended team kindness, lucid explanations, and proactive involvement.

Discussion: This data collectively underscores the safety and reliability of patient care within training wards, affirming that patients can trust the care provided in these settings. Patients on the interprofessional ward demonstrated high satisfaction levels: 96.7% appreciated the atmosphere and conduct of ward rounds. In comparison, 98.3% were satisfied with the discussion and information about their treatment during their hospital stay.

Keywords: clinical outcome; collaborative care; healthcare education; internal medicine; interprofessional education; interprofessional training ward; patient satisfaction; quality of care.

Figure 1

Enhanced patient interaction and query resolution in A-STAR vs. conventional wards. Patients in the A-STAR interprofessional training ward (n = 118) experienced more consideration of their fears and concerns compared to those in conventional wards (n = 148), (χ²(3) = 10.66; p = 0.014; φ = 0.203). Moreover, a significantly larger proportion of A-STAR patients (n = 121) reported having all their medical questions addressed by the team, in contrast to patients in the conventional wards (n = 154), (χ²(3) = 11.32, p = 0.010, φ = 0.200).

Figure 2

High levels of patient satisfaction across various care aspects in A-STAR interprofessional training ward. Patients in the A-STAR training ward expressed substantial satisfaction across multiple facets of their care and ward rounds. Satisfaction levels in these areas showed no significant variance compared to conventional wards, with equally excellent results across all ward types. Specifically, 99.1% (n = 112) were satisfied with the treatment of their medical complaints (χ²(3) = 3.43, p = 0.330), 98.4% (n = 121) appreciated discussions about their treatment during the stay (χ²(3) = 5.87, p = 0.118), and 98.3% (n = 123) endorsed the general atmosphere on the ward (χ²(3) = 3.41, p = 0.333). Additionally, satisfaction levels remained high concerning how interprofessional ward rounds were conducted (96.7%, n = 123; χ²(3) = 5.39, p = 0.146) and their atmosphere (96.0%, n = 124; χ²(3) = 1,814, p = 0.612). Furthermore, 92.9% (n = 112) were content with the medical outcome and acknowledged collaborating with the interprofessional medical team to decide on further care (χ²(3) = 1.97, p = 0.580). Notably, these results mirrored the perceptions from conventional wards, as evidenced by the Chi-Square test.

Figure 3

Comparative patient perceptions of medical team competency: A-STAR vs. conventional wards. Patients generally perceived medical teams in the A-STAR interprofessional training ward—led by final-year medical students and nursing trainees—as equivalently competent to the professional teams in conventional wards (CW), which professional doctors and nurses led. Notably, no significant differences were found in patient evaluations between the two ward types in terms of: Knowledge (A-STAR: n = 75, CW: n = 83; χ²(3) = 2.31. p = 0.315), communication (A-STAR: n = 77, CW: n = 88; χ²(3) = 2.37, p = 0.500), professional appearance (A-STAR: n = 75, CW: n = 86; χ²(3) = 2.33, p = 0.312), and empathy (A-STAR: n = 77; CW: n = 82; χ²(3) = 7.30, p = 0.063), as determined by the Chi-Square test.

Figure 4

Clinical outcomes exhibited in A-STAR interprofessional training (n = 1,482, star) ward patients (n = 1,482, star) as compared to conventional wards (CW, n = 5,752). No significant difference was observed between the A-STAR group and conventional wards regarding discharge against medical advice (1.0% [n = 14] vs. 0.8% [n = 47]; χ²(1) = 0.53, p = 0.468). Comparable readmission rates due to complications were experienced in both groups (0.4% [n = 5] vs. 0.3% [n = 17]; χ²(1) = 0.17, p = 0.683). Patient transfers from both A-STAR and conventional wards to the intensive care unit were not significantly different (9.4% [n = 125] vs. 8.9% [n = 496]; χ²(1) = 0.30, p = 0.582). Mortality rates exhibited no significant divergence between the A-STAR group and conventional wards (1.2% [n = 16] vs. 1.3% [n = 71]; χ²(1) = 0.05, p = 0.892).

Figure 5

Optimized patient experiences and favorable perceptions of care and collaboration in the A-STAR Ward. A substantial majority of A-STAR patients positively reviewed their care, comparable to those of conventional wards: 96.6% (n = 117) affirmed the team’s collaboration beneficially impacted their well-being (χ²(3) = 6.55, p = 0.088); 97.4% (n = 114) felt the interprofessional team grasped their priorities (χ²(3) = 3.53, p = 0.317); 98.3% (n = 119) would recommend the interprofessional ward to friends/family (χ²(3) = 2.19, p = 0.534); 99.2% (n = 123) felt well cared for (χ²(3) = 1.78, p = 0.411); and 100% (n = 121) agreed the team facilitated understanding of medical information (χ²(3) = 5.10, p = 0.165).