Do Bedside Visual Tools Improve Patient and Caregiver Satisfaction? A Systematic Review of the Literature.

Abstract

BACKGROUND: Although common, the impact of low-cost bedside visual tools, such as whiteboards, on patient care is unclear. PURPOSE: To systematically review the literature and assess the influence of bedside visual tools on patient satisfaction. DATA SOURCES: Medline, Embase, SCOPUS, Web of Science, CINAHL, and CENTRAL. DATA EXTRACTION: Studies of adult or pediatric hospitalized patients reporting physician identification, understanding of provider roles, patient–provider communication, and satisfaction with care from the use of visual tools were included. Outcomes were categorized as positive, negative, or neutral based on survey responses for identification, communication, and satisfaction. Two reviewers screened studies, extracted data, and assessed the risk of study bias. DATA SYNTHESIS: Sixteen studies met the inclusion criteria. Visual tools included whiteboards (n = 4), physician pictures (n = 7), whiteboard and picture (n = 1), electronic medical record-based patient portals (n = 3), and formatted notepads (n = 1). Tools improved patients’ identification of providers (13/13 studies). The impact on understanding the providers’ roles was largely positive (8/10 studies). Visual tools improved patient–provider communication (4/5 studies) and satisfaction (6/8 studies). In adults, satisfaction varied between positive with the use of whiteboards (2/5 studies) and neutral with pictures (1/5 studies). Satisfaction related to pictures in pediatric patients was either positive (1/3 studies) or neutral (1/3 studies). Differences in tool format (individual pictures vs handouts with pictures of all providers) and study design (randomized vs cohort) may explain variable outcomes. CONCLUSION: The use of bedside visual tools appears to improve patient recognition of providers and patient–provider communication. Future studies that include better design and outcome assessment are necessary before widespread use can be recommended.