Feasibility and early effectiveness of the Tell-us Card communication tool to increase in-hospital patient participation: a cluster randomised controlled pilot study.
Elise van Belle, Getty Huisman-De Waal, Hester Vermeulen and 1 others
PMID 32964468WHAT IT FOUND
Patients found the Tell-us Card helpful for raising issues, but nurses viewed it as redundant and administratively burdensome.
The card improved patient-reported participation scores on one ward but not the other, and did not change overall quality of care ratings.
Key findings
01Patients reported the card helped them communicate important issues to nurses, with 74% finding it somewhat or very helpful.
02A majority of nurses did not believe the card helped patients express what was important to them, citing lack of time and administrative burden.
03The intervention significantly improved Individualized Care Scale scores on the cardiology ward but showed no significant difference on the surgical ward.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study was underpowered as a pilot, with small sample sizes per ward (e.g., 25-39 patients per group at follow-up). There was significant selection bias potential, as nurses may have chosen patients they felt were more receptive to the card. The surgical intervention ward did not receive the card during the T1 assessment period due to timing issues, complicating the interpretation of results for that cluster. Baseline satisfaction scores on the Quality from the Patient’s Perspective questionnaire were already very high, leaving little room to detect improvement (ceiling effect). Response rates were moderate (35-58%), which may limit generalisability.
Declared interests
The study was funded by the Netherlands Organisation for Health Research and Development (ZonMw). No other conflicts of interest were declared.
The easy way to misread this
Do not conclude that the Tell-us Card is an effective intervention for increasing patient participation across all hospital settings. The positive effects were limited to one specialty (cardiology) and did not translate to improved overall quality of care ratings, while nurses in both settings largely rejected the tool as impractical.