Best Practices for Communication and Coordination in Long-Term Care
Care coordination in long-term care facilities is growing more complex. Eldercare specialist Dr. Richard G. Stefanacci observed in “The Long-Term Care Team of the Future”:
“The long-term care (LTC) team of today is significantly different than it was a few years ago,” in part because “more older adults are living longer with complex health needs that produce significant disability and demand specialized care.”[i]
Challenges ranging from the management of multiple chronic conditions to complex medication management and the prevalence of hospital-acquired infections (HAI) test the capabilities of care providers to work together efficiently.
So many phone calls for coordinating care!
Coordination with off-site care team members is another challenge for long-term care providers. Research has validated what many long-term care nurses already know: telephones are used more for communication in the long-term care setting than in other clinical care settings. As a result, information sharing can be delayed until a connection is made or may remain incomplete because conversations are rushed.[ii]
Long-term care staff reach out to a diverse array of stakeholders:
- Primary care physician: Residents need to see primary care physicians (PCP), sometimes at the long-term care facility, and sometimes at the physician’s office. In either case, a PCP needs to be in the loop.
- Family members: A patient’s child, spouse, or other relative may want to be closely involved in medical decisions. Family members also expect to be notified when their loved one is injured or experiences a significant change in health.
- Acute-care physicians: Patients usually come to long-term care facilities from acute care hospitals.[iii] Post-discharge questions may need to be answered about wound care, medications, and other elements of recovery.
- Transportation services: In the course of a day, long-term care staff may need to arrange transportation to take a resident to a hospital or an appointment, or to request the delivery or return of durable medical equipment.
- Social services: On behalf of a patient, the long-term care staff may need to contact social services or a spiritual support professional.
The telephone alone isn’t going to cut it.
Take a cue from healthcare emergency management systems
In an emergency, long-term care facilities have protocols to handle key emergency management functions:
- Mobilizing resources, both human and material.
- Coordinating activities by sharing information and orchestrating response.
- Logging all activity and communication, both for situational awareness, continuous improvement and regulatory documentation.
- Tracking inventory and resources.
Mobilizing, coordinating, logging and tracking functions also apply to everyday and complex care coordination needs in long-term care facilities:
- When orchestrating care for a patient recovering from surgery, long-term care staff may need to locate or acquire a mobility assistance device.
- Discharge instructions may need to be clarified with the hospital.
- New care tasks require coordination to ensure they become a part of that patient’s care plan.
- Logging communication helps ensure that the patient’s care plan gets fully implemented, and all information is available to share with a patient’s family as needed.
Use the same multi-purpose communication and coordination system every day and in emergencies
When healthcare organizations practice the same protocols for routine and emergency communications, both become more fluent. Using tools that support structured communication, such LiveProcess Emergency Manager, can improve and streamline response both in crisis situations and daily activities.
- Situations as frequent as staffing changes or a resident’s return from the hospital can benefit from structured communications.
- Resources—whether additional staff or durable medical goods—can be mobilized more quickly using pre-defined contacts and/or templated messaging.
- Structured, pre-written response options make it easier and faster to coordinate team efforts.
- Tracking whether information was both sent and received simplifies the work of long-term care staff, promotes accountability, and keeps routines running smoothly.
As complex care demands increase, communication processes in long-term care facilities will need to adapt and evolve. Well-defined emergency communication tools and protocols provide a helpful model for this transformation every day.
Watch the on-demand webinar series for Long-Term Care CMS Emergency Preparedness.
Read more blog posts about how to improve emergency and everyday communications in long-term care, including in nursing homes, continuing care retirement communities, inpatient rehabilitation, institutional care, and senior/eldercare facilities.
Terry Zysk, CEO of LiveProcess, has more than two decades of experience in leading organizations that provide innovative solutions to the healthcare industry.
i Stefanacci, Richard G., et al. “The Long-Term Care Team of the Future.” Annals of Long-Term Care: Clinical Care and Aging. 24 (2016): 17-20.
ii Tija, Jennifer, et al. “Nurse-Physician Communication in the Long-Term Care Setting: Perceived Barriers and Impact on Patient Safety.” Journal of Patient Safety 5 (2009): 145-52.
iii Amin, Iqbal I. Family Communication in Long-Term Care: The Long-Term Care Specialist Perspective. Annals of Long-Term Care 12 (2004).