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Effective Communications: Steps For Automating, Streamlining And Improving Healthcare Communications

Communications

The average 500-bed hospital in the United States loses $4 million each year directly due to inefficient communication, according to a study published in the Journal of Healthcare Management.

Effective and efficient communication is essential to fulfilling a healthcare organization’s mission of providing high quality care. It is also crucial to eliminating unnecessary costs and maintaining an organization’s fiscal health.

Yet communication inefficiencies occur across the healthcare system: between departments, between providers, and between providers and patients.

When communication suffers, healthcare organizations bear significant financial and legal costs. Overall, the study published in the Journal of Healthcare Management found that United States hospitals waste $12 billion each year as a result of just the communication inefficiencies between providers. Fifty-three percent of that cost is due to an increased length of patient stay.

Healthcare organizations can eliminate many root causes of inefficient communication with a combination of communication training, and technology implementation and automation.

Healthcare Communication Chain

Hospitals are epicenters of communication. The moment a patient arrives at a hospital, a complex chain of communication kicks off. The patient is admitted, their medical records are retrieved, a bed is assigned, care team members are assigned to their case, a discharge plan is created, diagnoses and treatment plans are recorded and handed off to new clinicians, the patient is eventually discharged with education and instructions, and someone clears the bed.

Clear communication in each of these events is crucial to maintaining quality of care throughout the process and operational efficiency.

And yet, the Joint Commission found that poor communication is the root cause of more than 65 percent of sentinel events (events that cause death or serious harm).

A 2015 report published by CRICO Strategies, a division of the Risk Management Foundation of the Harvard Medical Institutions, Inc., provided several illustrative examples, including:

  • A provider fails to respond to calls from a diabetic patient, which were documented but not relayed to the provider by office staff. The patient collapses and dies from diabetic ketoacidosis.
  • A positive pathology result is entered into the EHR (electronic health record) but isn’t flagged for primary care provider review. As a result, the patient is not notified and her cancer diagnosis is delayed by a year.
  • A text message about vital sign changes is sent to a patient’s doctor. The doctor has switched phone numbers and does not receive the text message, leading to the patient’s decline.

Why is communication in hospitals suffering so much? Factors include increasing clinician workloads, outdated technology, and lack of communication skills training.

The Consequences of Communication Breakdowns

The impact of ineffective communications has a significant role on the quality of care patients receive as well as on healthcare organizations’ bottom lines.

In the report published by CRICO Strategies, CRICO examined over 23,000 medical malpractice claims filed between 2009 and 2013. Three out of every 10 cases filed were directly tied to at least one specific breakdown in communication. “Errors often occur because information is unrecorded, misdirected, never received, never retrieved, or ignored,” the report states.

Cases that were tied to communication errors were more likely to end in an indemnity payment. Those payments were, on average, greater than the average of the indemnity payments overall.

Altogether, the CRICO report found that communication-related incidents cost the healthcare industry a total of $1.7 billion — and that’s just the cost of cases that ended in malpractice suits.

Malpractice cases are higher profile but they account for a very small fraction of healthcare encounters. There are many more incidents of ineffective communication that create negative health outcomes and operational inefficiencies that do not result in malpractice suits.

Altogether, in a conservative calculation, the Journal of Healthcare Management estimates that the average 500-bed United States hospital loses $4 million per year due to communication inefficiencies.

Solutions for Improving Communications

The most viable and impactful approach to solving communication inefficiencies at healthcare organizations is to combine standardized communication training with streamlined communication technology.

A two-part solution takes into the reality of healthcare operations. Human care providers are essential to providing compassionate, empathetic care and yet they are also prone to fatigue, flawed assumptions, and human error.

Technology can help remove opportunities for human error throughout the patient’s journey through the healthcare system. Staff training can help bridge the remaining gap.

Communications Technology

Healthcare organizations should leverage technology at every level of their institution to automate, streamline, and improve communication.

At the point-of-care level, healthcare organizations can use technology to improve the legibility and thoroughness of provider documentation, provide HIPAAcompliant text messaging between care team members, send secure notifications to clinicians, and much more.

Healthcare organizations can also embed technology throughout their organizational infrastructure to capture efficiency gains in perhaps unexpected places.

For example, healthcare organizations can turn to products that automate communication throughout their organization such as by:

  • Automatically messaging building personnel notifications when a thermostat malfunctions
  • Automatically sending a secure message to housekeeping when a patient is discharged and a room is ready for cleaning

Advantages of Automation

Automation reduces response time and staffing costs by removing the need for a staff member to identify an issue and deliver the message. Not only is the message sent immediately, reducing lag time, it also reduces the amount of staff resources allocated to rote tasks. Automation also greatly removes opportunities for human errors, such as forgetting to deliver the message or delivering the message to the wrong recipient.

According to the authors of the Journal of Healthcare Management article: “The complexity of inpatient care delivery and discharge planning in hospitals is undisputed: It demands rapid and timely access to information, the ability to locate important stakeholders at any point in time, and platforms for coordinating the work of providers and other actors who may be temporally distributed.”

Technology can help organizations meet the complex demands of the hospital setting. Technology allows healthcare organizations to implement a streamlined, automated technological solution that, touching back on the requirements described above, provides:

  • Rapid and timely access to information. An enterprise-wide communications system should be in place that can access information about patients, care providers, and ancillary staff within seconds. That system should be able to pull in information from different departments, and it should be easy for staff to update and maintain.
  • The ability to locate important stakeholders at any point in time. The enterprise-wide communication system should be able to contact care providers and hospital staff for both emergency notifications and routine communication via pager, secure text messaging, e-mail, and more.
  • Platforms for coordinating the work of providers and other actors who may be temporally distributed. The enterprise-wide communication system needs to be able to schedule and coordinate the care that a patient receives across departments and shifts in the hospital, as well as the work of staff members in support roles.

Communication Training and Standardization

Technology is a crucial part of improving communication efficiency and accuracy. Healthcare organizations remain places where care is provided by humans, however, and staff training is an important part of any solution.

In addition to training staff on any new technology they interact with, it’s important to train care providers and hospital staff on communica-tion skills so that handoffs and other forms of communication contain all of the necessary and relevant information.

For example, many healthcare organizations are adopting a handoff method known as I-PASS. The mnemonic training method emphasizes covering Illness severity, Patient summary, Action items, Situation Awareness, and Synthesis by receiver during verbal handoffs.

According to a study published in the New England Journal of Medicine, implementing I-PASS at nine hospitals resulted in 23 percent decrease in overall medical errors across all sites. There was also a 30 percent reduction in preventable adverse events across all sites.

Conclusion

Inefficient communication costs hospitals millions of dollars each year in loss of productivity and efficiency and in legal costs from malpractice suits. The average 500-bed hospital in the United States loses over $4 million each year due to inefficiencies, and the industry as a whole loses billions of dollars each year.

Healthcare organizations can reduce those losses by implementing modern technological solutions that streamline and automate communication throughout healthcare organizations, as well as staff training to improve the efficacy of the human conversations that will always take place in a healthcare setting.

Sources Cited

Agarwal, Ritu, Daniel Z. Sands, and Jorge Díaz Schneider. “Quantifying the Economic Impact of Communication Inefficiencies in U.S. Hospitals.” Journal of Healthcare Management 55, no 4. (July/Aug 2010): 265-281. www.undana.ac.id/jsmallfib_top/JURNAL/EKONOMI/EKONOMI 2010 Quantifying the Economic Impact of Communication Inefficiencies in U.S. Hospitals.pdf

Hoffman, Jock, Dana Siegal, and Kyle Bergquist. Edited by Gretchen Ruott. “Malpractice Risks in Communication Failures.” Crico Strategies. 2015. www.rmf.harvard.edu/cbsreport

Michtalik, Henry J., Hsin-Chieh Yeh, Peter J. Pronovost, et al. “Impact of Attending Physician Workload on Patient Care: A Survey of Hospitalists.” JAMA Internal Medicine 173, 5 (2013): 375-377. jamanetwork.com/journals/jamainternalmedicine/fullarticle/1566604

Starmer, Amy J. et al. “Changes in Medical Errors after Implementation of a Handoff Program.” The New England Journal of Medicine 371 (November 2014): 1803-1812. www.nejm.org/doi/full/10.1056/NEJMsa1405556

About 1Call

The 1Call Division of AMTELCO specializes in offering enterprise-wide communication solutions for healthcare organizations. AMTELCO, 1Call’s parent company, has been a leading provider of innovative communication applications since 1976. AMTELCO has its roots in the early 1950s when its founder, William J. Curtin, invented and patented solutions for his call center. With AMTELCO systems currently in operation in all 50 of the United States, and in more than 20 foreign countries, AMTELCO customers process millions of calls each month. AMTELCO is well-known in various industries for continually developing innovative solutions designed to streamline communications, all backed by AMTELCO’s superior 5-star service and support.

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