No longer a “nice-to-have” – Why clinician-to-clinician communication is a NOW issue

By Michael McKenna, MD, VP, Medical Management & Chief Medical Officer, Advocate Lutheran General Hospital  /  19 Feb 2013

Under health care reform, every hospital and health system is under the gun to deliver care more efficiently and cost-effectively. While faced with a number of competing priorities, these organizations can’t afford to waste time or effort on inefficient clinician-to-clinician communications. If the industry is ever going to achieve success with accountable care, new risk models and population health, communications need to be top of mind. Time is of the essence, and we’ve seen major changes at Lutheran General by prioritizing the flow of clinician-to-clinician communication, including:

  • Patient safety and satisfaction – When we were investigating clinician-to-clinician communication, one of the biggest and most important areas we uncovered was its impact on patient safety. When we examined patient safety events that occurred at our hospital, one of the major causes was either a delay or difficulty in physicians reaching each other. Instituting a reliable method of getting responses was critical to the patient safety aspect of our workflow. We also know that if a patient has a concern and it takes hours for the nurse to contact a physician, that patient will have an unsatisfactory experience. There should be no reason that clinicians can’t get the answers to make patients more comfortable as soon as possible.
  • Efficient care and care transitions – When clinicians communicate as timely as possible, tests and procedures can be ordered properly and therapies can be started appropriately. This leads to more efficient care, and possibly to a reduced length of stay and other things that are important to the hospital and the patient. Also, the timely transmission of information is key when considering all the transitions that patients experience throughout the course of their care. Each care transition requires a handoff, offering the next caregiver a seamless transition in their ability to care for a patient. It’s not just about discharges – it’s really how are we transitioning patients to that next or different level of care. And when those occur, hospitals need to make sure the right information communicated to the right clinician to prevent gaps in care.
  • More effective consults – Enabling clinicians to communicate effectively about major aspects of therapy or diagnosis will be more and more necessary as networks of care continue to expand. Whether a clinician is trying to communicate with the nurse about a change in status, or trying to get a critical result from the lab or from an X-ray, or talking to a social worker about placement – we need to be able to help them complete the communication in a timely and efficient manner, and in a way that’s fundamentally different than what we’ve been doing for the last 30 years.

When we were inundated with flow charts, call centers and rolodexes, we knew the problem of clinician-to-clinician communication needed to be tackled before we could continue to evolve to provide higher levels of care and prepare for the changes ahead. Delays in clinician communication prevent the right caregiver from getting them the information they need make critical decisions on a patient’s therapy, and have significant impact on patient and clinician satisfaction. This seemingly fundamental problem plagues even the industry’s most advanced health systems, yet there are clear benefits to addressing this problem now that will play a key role in improving care across the continuum. — Michael McKenna, MD

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