What's The Best Way To Offer Safe & Successful Patient Care?

This week we’re celebrating National Nurses week here at Magnatag, and we would like to thank every nurse that has dedicated his or her time and energy into saving lives. We’re dedicating the entirety of our blog posts this week to topics generated by a handful of interactions we’ve had with members of the nursing community. We recently got the opportunity to speak to a handful of Nurse Practitioners that were willing to share their story about how they believe nurses can offer their patients the best care in the future, and one topic of conversation continuously came up on conversation: Teamwork—or more specifically, communication within a collaborative environment.

I’m sure to many familiar with the healthcare industry, this does not seem surprising in the slightest, and after doing some digging of our own, we’re not all that surprised either.

In a 1985 study on outcomes of intensive care conducted by William A. Knaus, communication—or lack thereof— between nurses and physicians was the single factor most closely associated with excess hospital mortality. To add even more credence to these findings, a study conducted in 2007 by Milisa Manojlovich built upon this research suggesting, “Nurse-physician communication may not influence all outcomes, but its effect on nurse-assessed medication errors suggests that small but significant decreases in medication errors can be achieved when nurses and physicians communicate better.”

Both studies seemed to back up many of the thoughts we received from the community, begging the question: How can things be changed?

One suggestion we received thought it was the responsibility of upper management to take control of the system and implement a culture change to trickle down the ladder.

“To protect our patients, there needs to be teamwork or a group of collaborative minds that can work on uncommon, challenging, situations in order to offer the best and safest nursing care. We’ve all collectively been through thousands of years worth of schooling to prepare us for the situations we face on a regular basis, but no amount of knowledge can prepare you to work in an environment that’s unresponsive and uncooperative. There has to be some way to guarantee that both nurses and physicians are receiving necessary information.” — Shauna E.

An emphasis on culture change is a good place to start with building a strategy, and there are many organizations that can help. For example, CEP America partners with healthcare facilities across the nation to help enhance integration of urgent, emergent, inpatient and post-discharge care of patients with acute medical conditions. As a part of their program, CEP Physicians will partner with hospital leaders to develop a patient care program that best suits both patients and staff.

In a blog post featured on the company’s website, you can find a detailed case study that was designed to improve RN-MD communication. The study was conducted in conjunction with the hospital’s Medical Director and Nurse Managers, setting expectations for team rounding and patient communication. You can read the entirety of the blog post here, but there’s one finding that should be unpacked here:

“We learned that physicians were contacting nurses in person or by phone to discuss the care plan 50–100 percent of the time (depending on the physician). However, team rounding occurred only 40–60 percent of the time… Having been through the process, we now realize that team rounding is absolutely vital to improving both patient care and staff relationships.”

Team rounding is something that is rather commonplace in hospitals, but is frequently overlooked or abandoned as patients continuously add to the census. Understandably, MD’s and RN’s want to maximize their time with patients, thus viewing cooperative rounding as counterproductive. With hospitals proving to be incredibly chaotic work zones, it’s easy to imagine the purpose behind team rounds getting lost when there are quite literally hundreds of patients requiring immediate attention. However, the purpose of team rounds is to do just that: bring attention to issues of concern.

Team rounds bring together service providers of all disciplines, discussing treatment plans and procedures for patients under their respective care. The goal of cooperative rounding is to improve the patient care experience, not diminish it. By foregoing rounds in favor of one-on-one attention, service care providers are doing a tremendous disservice to their patients by not taking the time to document and discuss potential barriers to patient discharge—but communication doesn’t have to stop there.

Patient bedside boards, staffing schedules, and questionnaires are all effective tools that can—and should—be taken advantage of in an effort to increase communication in your healthcare facility. However, these tools are designed as a way to supplement communication and should never be used as a substitute. With technology evolving at an increasingly rapid pace, patient care should not be jeopardized due to a lack of effective communication. Communication has to be at the center of a hospital’s culture in 2017, there’s simply no way around it.

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