Everyone from bedside nurses and doctors to CIOs and health system presidents recognizes that clinical communication is a core component of quality patient care. But with technology transforming healthcare at blinding speed, what are today’s best practices for facilitating fast, efficient and effective communication and system-wide clinical collaboration?
Three experts shared their first-hand knowledge and insights about clinical communication during a panel discussion of best practices relating to voice calls, text messages and alarms at HIMSS19. Colin Hung, CMO and Editor of Healthcare Scene, moderated the conversation between these healthcare experts:
- Nick van Terheyden, Founder and CEO of Incremental Healthcare and former Chief Medical Officer for Dell
- Charles Webster, an expert on the relationship between healthcare workflows and communication who has more than 15,000 followers on Twitter @wareFLO
- Dana Peco, MSN, BSN, CCRN, for many years a Neonatal nurse and now Sr. Clinical Solutions Manager at Voalte
Here are excerpts from their spirited conversation with practical advice for selecting and using a clinical communication platform. Watch the entire discussion below.
What are some texting challenges that often are overlooked and how can they be addressed?
Dana: One of the challenges of texting is that the sender and recipient have different expectations about what’s an appropriate response time. Some hospitals have put in acronym markers for texts such as FYI, which means I don’t need a response, or ASAP, which means respond within the next five minutes, or STAT, which means respond right away. A communication system needs to level set for both the sender and recipient what the expectations should be.
Chuck: You want a system that can encode rules and policies for discussions that are transparent and flexible. Feedback from the operations of the system should be used to optimize its outcomes and efficiency, which eventually will be done with artificial intelligence.
Nick: Personally, I’d like to see everything significant encoded to alert recipients of its importance.
Some physicians complain about getting too many texts. What are your thoughts?
Nick: I would say that you should always err on the side of over-communicating because it’s better than under-communicating.
Dana: I totally agree. When you look at sentinel events, the breakdown is usually caused by a lack of communication. But you shouldn’t text just because you have the functionality. You always need to be aware of workflows and physicians’ time, because you don’t want to inundate them with unnecessary texts at the wrong time of day.
What are the advantages of group messaging and how can this be improved?
Dana: It opens a dialogue by having the entire care team on a single thread. There’s no more playing phone tag trying to figure out who said what to whom. Getting the same message across at one time improves not only collaboration but also patient safety and throughput because it impacts everyone across the care continuum.
Chuck: We see activity streams everywhere in social media and increasingly built into healthcare software as well. That kind of activity stream needs to gracefully and securely interoperate with the texts and alerts and phone calls.
Dana: Our platform has clear visibility into who’s responding to a group text. And if attending physicians want everyone on the thread to be aware of the message, they can send it as a high-priority message with a completely different tone that drives users to view the text.
Nick: I just want to say I want that for my family.
Do you have any advice about what not to do in clinical communication?
Nick: Don’t use emojis or abbreviations. And don’t send messages without reading them first to make sure they will be easy for the recipient to understand.
Dana: Just because we’re bringing how we communicate in the outside world into the hospital doesn’t mean we have to also bring our bad habits. It’s important to always use professional language and remember that what you text is discoverable.
What improvements would you like to see regarding alarms and alerts?
Nick: Many of these systems are not delivering value because of over-alerting and not providing useful, actionable insights. A best practice would be applying better filters that only deliver critical information that I can do something about.
Chuck: Alarms and alerts and other forms of clinical communication are like marketing. It’s about delivering the right information to the right person through the channel they prefer.
What advice do you have for a hospital that’s starting down the path to better clinical communication?
Chuck: The one thing you want to avoid is frozen workflow or communication. When you get a demo of a system, ask for something to be changed right there, and then do the demo again. If the system changes the way it was supposed to, then you know it is flexible. When it goes live, you will be able to mold the system’s behavior to adapt to your communication workflows.
Nick: I’d say go back to basics and start by identifying and understanding the communication problem you need to address, which will depend on your circumstances. Find something that keeps clinicians up at night.
Dana: I agree with Nick. We often go onsite and uncover things that people don’t even realize are problems because they’ve learned to work around them.
What else would you like to say about best practices in clinical communication?
Dana: The solution must be a collaborative team effort. To be successful, your IT people, clinicians and physicians all must be involved from the outset to drive the technology adoptions and workflow improvements you want to see.
Nick: I’ll make the old movie reference and say, ‘What we have here is a failure to communicate.’ You need to get at the root cause by bringing all those people Dana mentioned around a table to understand why you’re failing to communicate. Only then can you begin applying technology to solve this problem and improve overall quality and reduce errors.