Dr. Shattuck is Chief of Medical Staff at Blount Memorial Hospital in Maryville, TN. We caught up with him to talk about the importance of improving clinical communications processes and how it can be inspired in nurses and physicians.
Q: Why is clinical communications such a challenge in today’s healthcare environment?
There’s no question that healthcare is growing more and more fragmented; and as care gets more fragmented, communication gets poorer. Communication and data management can be difficult even under the best circumstances, but it is crucial when we are talking about patient care. In hospital medicine, we talk about a voltage loss — when a provider that is unfamiliar with a patient has to make critical and complex decisions. Often, the only communication physicians have is what I call two-dimensional (aka, reading a chart). But there is no substitute for the physician speaking to the other physician.
Q: What’s the value in direct physician communication?
When two physicians interact, a much fuller picture of the patient and the care plan can be developed collaboratively. It’s a two-way communication where you can ask questions of the patient’s primary care doctor for example, and interact. The result is more nuanced and individualized care. In an age when we all have cell phones and technology that is almost out of “Star Trek,” you would think this would be easy, but it’s often not.
Q: So, smartphones and mobile solutions are not the answer?
One would think that having more technology would make it easier to communicate with one another, but it often does not. For the four years I’ve been in medical leadership, we’ve really tried to figure out ways to get the doctors in better touch with one another. Frankly, we’ve made very limited progress. Regardless of the technology, there still needs to be a process and platform in place to quickly get the doctors in direct touch with one another.
Q: How do you get physicians and nurses to change their communication approach/process?
Clinicians today are busier than ever before, and many of us wear multiple hats. For example, I run a hospitalist group, I’m the chief of staff and I do clinical medicine. An easy-to-use system that people understand and like will lead to an organic culture change. You want it to be, “How does this make my life easier?” and then they’re going to use it more and actually explore and optimize the full application of the system.
Over the last year, Blount Memorial’s nurses have started sending physicians text messages, and they like this much better than paging. The doctors are also starting to use smartphones rather than pagers. These tools have substantially improved nurse-to-physician and physician-to-physician communication, and they’re easy to use, making it more comfortable to adapt to. The doctors see the nurses using it and liking it — that’s where you really get process improvement. For the first time, I really see an opportunity that will improve direct communication.