Communication in Caregiving
Some of the many interactions involved and what makes them significant
Communication between physicians, nurses, health care provides and caregivers is essential to provide patients with continuity of care.
As per a study conducted by the University of Colorado with 50 participants (including nurses, managers, administrators, and quality assurance clinicians), 60 % of home health workers do not receive adequate information from hospitals. 44% of participants claimed that they almost always encounter problems directly related to receiving inadequate patient information from hospitals. Not having all the required information can lead to delay in patient care and discrepancies in medication lists. In fact, another study found that 94% of patients had a discrepancy between medication lists given by the referring provider and the one with the home health care aid. Incorrect or inadequate medication could in turn lead to higher hospital readmission rates. An owner and operator of a healthcare franchise also claims that communication-related issues cause 50% of her patients to receive the care they need a day or two late. The study concluded that better communication could be enabled by giving health care providers access to Electronic Health Records(EHR’s).
In an article published by Home Health Care News, a board-certified physician, Suzanne Mitchell, expresses that there’s not really any point where a physician gets to directly communicate with a caregiver. She emphasizes the need for this by highlighting how most communication depends on documentation — documentation that is not always up to par. A professor of medicine at Johns Hopkins University, Bruce Leff, says that physicians really do care about what goes on in their patient’s lives but don’t always have the liberty of time to follow up themselves. He sees potential in-home health care workers having the ability to bridge that gap for them. He also echos Mitchells concern about documentation. He talks about the CMS-485 form and says that it’s “extremely difficult to read” because of technical jargon and small print. It also doesn’t account for general observations and insights that could affect a patient’s diagnosis in the long run.
A study published in NCBI mentions that since communication breakdowns are a common cause of medical error, it probably extends to home health care as well. It also explores the complexity of home health care in that it is a more informal aspect of medicine, and caregivers do not have formal training about communication strategies imperative to effective healthcare.
A publication in Relias Media points out two of the main issues with communication in this space. Firstly, physicians and caregivers often don’t have enough information about the hospital's discharge plans. Secondly, caregivers find it difficult to reach a physician when questions arise about patient care. The health care aids interviewed as a part of this study believe that communication could be streamlined by employing a “single point of contact” to connect stakeholders. Another surprising finding was that patients didn’t seem prepared to receive at-home care — they didn’t know what to expect and no one had communicated the services to them before.
A publication in Ankota focuses on communication and good listening among the health care team and members of a patient's family. They argue that strong communication and listening skills are required for “patient safety, cultural sensitivity, and the pillar of palliative care”.
When exploring tools for secure communication, a representative from GeriTech points out that although she’s sure that someone out there has created “care coordination software that includes secure messaging”, it is unlikely that all concerned stakeholders have access to it and the solution doesn’t really work unless everyone subscribes.
The research discussed above indicates the need for a robust, scalable, and secure framework of communication in healthcare.