Five Communication Challenges and Solutions for Healthcare Team Coordination Workflows
Inefficient care coordination is one of the biggest complaints reported by both providers and patients. Finding solutions to this problem starts with identifying where the status quo is falling short. In this post, we dig into complex clinical workflows and the key reasons why they generate stress, slowdowns, and patient dissatisfaction. Then we look at how healthcare team communication technology can help.
Speaking at HIMSS in 2018, CMS Administrator Seema Verma told attendees: “We have held meetings in cities across America, and received thousands of letters. And one of the most common complaints we have heard from both patients and providers has been the inefficiency of electronic health records and the inability of providers to effectively coordinate care for their patients.”
A recent Spyglass report, Healthcare without Bounds: Trends in Clinical Communications and Collaboration, backs up this observation. The study quotes a professor of nursing who said: The EHR is “an ineffective tool to support clinical communications and collaboration.”
In multiple ways, the EHR fails to make the connections necessary to advance coordination of care: patient information can be difficult to search and retrieve, qualitative information is often absent, and EHR messaging is accessible only when logged into the EHR. The professor emphasizes that the EHR was designed as a “clinical data repository,” not a communication tool.
The need for more efficient communication in healthcare delivery is especially evident in complex clinical workflows for admissions, discharge, and transitions of care (ADT).
Several informatics executives interviewed for the Spyglass report make the point that their current tools and processes aren’t sufficient for coordinating care delivery at these moments. For example:
- One Director of Clinical Informatics (DCI) noted that their interdisciplinary informatics team was “struggling with how to address the communications and collaboration requirements inherent within more complex clinical workflows.”
- The informatics team, led by the center’s Chief Nursing Informatics Officer (CNIO), found that “existing communication tools and processes are too generic and fail to provide adequate clinical context, especially when caring for high acuity patients.”
What makes some clinical workflows especially challenging?
To find solutions to this care team communication challenge, we need to understand why these critical care delivery junctures call for communication tools that go beyond those typically in use today. The informatics executives interviewed by Spyglass suggested a number of reasons:
The drive for efficiency and improved patient throughput can make many clinicians feel rushed when presented with a patient who needs more complex care coordination, whether that’s because of high acuity at admission or a chronic condition requiring multiple inputs at discharge.
A large number of inter-team coordination tasks
For example, the discharge process for a patient with a chronic condition may require on-site education, detailed instructions from multiple clinicians, follow up support, pharmacy support, and referrals to other providers.
Difficulty tracking down appropriate personnel
During any ADT process, several clinicians and staff members may need to provide guidance or be physically present. It’s not enough to page each one: they also need to respond, and if they don’t respond, it could be for any reason. Are they offsite or unavailable, or is the contact database inaccurate?
Too many tools in use
Overhead public address systems (PAs), landline phones, pagers, and even Blackberrys and smartphones may all be in use at once in some hospitals, alongside multiple healthcare applications with distinct log-ins.
Not using structured communications
Standardized communication protocols can be helpful, but they may be used inconsistently for a variety of reasons, such as time pressures or lack of training. Without structured communication, critical information may be delayed or missed.
These communication challenges are common at many hospitals, and they can have serious consequences. Apart from clinician burnout and patient frustration, poor care coordination leads to reduced reimbursements and life-threatening health events.
How healthcare communication technology can help
Informatics will be just one component of the solution when taming complex workflows in healthcare such as transitions of care, but it will be an essential one. Well-coordinated care delivery can’t happen without well-coordinated communication. The following are just a few examples of how clinical communication and collaboration technology can address the challenges listed above:
Automate routine and repetitive tasks: Reducing the effort spent on managing communications and documentation manually gives providers more time and greater mental focus for care delivery activities.
Support asynchronous communication and collaboration: Much information is not time-critical and needs to be shared among nurses and physicians working on different shifts. Messaging that is available to both senders and recipients when they need it prevents information gaps, as well as delays and interruptions.
Use intelligent contact information: Pre-set groups for specific situations streamline the process of contacting needed personnel. Groups can also be defined by role, skill, or certification when appropriate.
Leverage existing devices: Software-as-a-service (SaaS) cloud-based communication tools can allow clinicians and staff to use the devices they already have and whatever device is most convenient in a particular moment, so everyone is more likely to use appropriate communication channels and no information is dropped.
Simplify communications with pre-defined content: Message templates, pre-written response options, and other means of creating structure around communication make it easy to send and receive information even when the pressure is on.
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