University of Colorado investigators reveal finding numerous communication gaps between physicians and home health care (HHC) agencies dealing with elderly patients following hospital discharge. These gaps could contribute to readmissions, they suggest.
Among the lapses in communication are discrepancies in medication lists, confusion over who was responsible to write patient care orders, inaccessible hospital records, and resistance from clinicians and staff for accountability.
In the study, published in the Journal of General Internal Medicine, Christine D. Jones, MD, MS, assistant professor at the University of Colorado School of Medicine and her team conducted focus groups with HHC nurses from six different agencies in Colorado, asking about their general experience with caring for patients after discharge from any of their referring hospitals.
“We found that communication breakdowns can have consequences for patients,” says Jones, in a media release from University of Colorado Anschutz Medical Campus. “These are some of our most fragile patients, most are over 65, and more seamless communication is needed.”
Some of the HHC nurses interviewed complained of a lack of accountability, medical errors, and difficulty in reaching doctors.
Another problem was revealed regarding ordering medications. HHC nurses and staff shared during their focus groups that most of the medication lists they receive are incorrect due to the number of doctors and specialties involved.
Jones stresses that her study focuses not on one specific hospital, but on hospitals in general.
Per the release, the study proposes a series of solutions to the communication issues, including: Hospitals and primary care physicians could provide HHC agencies direct access to Electronic Medical Records and direct phone lines to doctors; and enact laws allowing nurse practitioners and physician’s assistants to write HHC orders.
Additional solutions include: Clearly establishing accountability for hospital clinicians to manage HHC orders until a primary care physician can see a patient and help HHC nurses with questions; and create better communication methods with PCPs to ensure safer transitions.
“Our findings suggest that improvements to accountability and communication could address patient needs and goals, avoid medication discrepancies and ultimately improve safety for patients and HHC nurses,” Jones concludes.
[Source(s): University of Colorado Anschutz Medical Campus, Science Daily]
