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 "Small expressions of gratitude originating from the patients or
their families (but not from a medical authority) facilitate patient
care and enhance patient safety," said lead study author Dr. Arieh
Riskin, director of the neonatal intensive care unit (NICU) at Bnai
Zion Medical Center in Haifa, Israel.
"While this is something that many long assumed to be true, the
effects were never systematically demonstrated," Riskin said by
email. "More importantly, the magnitude of the effect is
substantially larger than we ever expected, explaining far more of
the variance in team performance outcomes than many other patient
safety interventions typically implemented."
For the study, researchers asked 43 NICU teams to participate in
training workshops with simulations of common acute care problems
that can develop in vulnerable babies. Each team had two doctors and
two nurses.
Teams were randomly assigned to one of four forms of interaction
with parents and colleagues: mothers expressing gratitude; thanks
from physicians; expressions of gratitude from both mothers and
doctors; or a control group that got only neutral feedback.
Maternal gratitude had the biggest impact on medical team
performance, mainly because this was associated with improved
communications and information sharing within medical teams,
researchers report in Pediatrics.
Forty percent of the variance in team information sharing was
explained by maternal gratitude, the study found.
Improved information sharing resulted in medical teams providing
better care - this explained 33 percent of the variance in
diagnostic performance and 41 percent of the variance in treatment
performance.
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One limitation of the study is that it was only a simulation, and
it's possible doctors and nurses might react differently to feedback
in the real world.
The study also wasn't designed to assess the impact of rudeness or
negative social interactions, which have been tied to worse clinical
outcomes in some previous research.
Even so, the results suggest that a little praise can go a long way
in helping doctors and nurses feel like their work has meaning, said
Cynda Rushton, a researcher at the Berman Institute of Bioethics and
School of Nursing at Johns Hopkins University in Baltimore.
"When clinicians hear that their efforts have produced benefit to
their patients or families and that it has made a difference in the
lives of others, it can reinforce that their efforts matter and are
appreciated," Rushton, who wasn't involved in the study, said by
email.
"With burnout being reported at alarming levels, helping clinicians
to reconnect to the meaning of their work is vital for sustaining
the healthcare workforce," Rushton added.
It's also possible that expressions of gratitude might ignite
regions of the brain associated with positive emotions and shift
awareness in ways that facilitate better collaboration and
relationships among members of medical teams, Rushton said.
"When teams are functioning well, patients are likely to experience
better communication and collaboration with them," Rushton said.
SOURCE: http://bit.ly/2UzoOzQ Pediatrics, online March 7, 2019.
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