Jack L. Cox, M.D., M.M.M., SVP & Chief Quality Officer, Hoag Memorial Hospital Presbyterian
Clinician-to-clinician communications is the true underpinning of achieving more coordinated and cost effective care, but it’s an issue that is largely overlooked. As someone who’s tackled this challenge alongside many others, I know how overwhelming it can be to suggest yet another technology implementation project and process change to clinical and IT teams. But here are five reasons why I believe clinician communications should be a top priority for every health system:
- Patients are demanding better, faster care. The days of physicians receiving a consult request at 8 a.m. and evaluating the patient at 5 p.m. are gone. Patients and their primary care physicians expect they be seen within two or three hours so that they can leave the hospital in a timely manner, demanding shorter hospital stays despite the increasing level of illness in individuals. At the same time, physicians are busier than ever before, particularly those who don’t spend most of their time in the hospital and juggle patients across multiple facilities. All of this means making sure that reaching the right clinician is even more critical than ever before, because the faster patient issues are resolved, the faster they get out of the hospital.
- It’s key to care transitions and readmissions reduction. Everyone is aware that CMS and other organizations are closely evaluating readmission rates. So, making sure patients not only receive quality care within the hospital, but also ensuring seamless transitions outside hospital walls, is critical to preventing their return to the ER within 30 to 50 days. This is even more of an issue with our aging population and an increasing number of patients with comorbidities. It may sound fundamental, but making sure the right information reaches the right clinician in transitioning care to an outpatient setting is an area every health system can improve.
- “Healthcare is a team sport” has never been truer than it is today. Without the ability for care teams to communicate with one another in a timely manner, we see higher incidence of errors, delays in patient treatment and ultimately longer lengths of stay. Today, care- and cost-intensive conditions like congestive heart failure and diabetes require all hands on deck. Better communication amongst physicians means more coordinated, customized patient care, better outcomes and a much smoother patient experience both in and out of the hospital.
- It promotes workflow improvement. Many clinicians are used to years of cumbersome and frankly, costly communications processes, so implementing change can be a challenge. Without considering each department’s workflow and specific requirements, the project is bound to fail. At Hoag, we’re incentivizing individuals for supporting new processes and behaviors because we see how improving communications technology enhances clinical workflow. With lean methodology and ISO-9001 and the right individuals on our teams – including industrial and systems engineers – we’ve been able to both meet the needs of clinicians while removing significant “waste” from our processes.
- It bridges the communications gap between nurses and physician. A recent survey of patients in our hospital found that the average of 2.5 physicians was taking care of a single patient at any given time, with about a third of patients reporting five or more physicians taking care of them. Again, sicker patients with more complex medical problems require more sub specialists helping in the care. But nurses were inundated with lists and lists and lists of information for how to get in touch with each of these physicians. Now, we have a single communications platform for determining who’s on call or caring for a patient, and for connecting with that person. We’ve eliminated the burden of sifting through reams of paper, and documented a daily savings of 20 to 30 minutes that was typically spent trying to figure out who to call and how to get through to them.