Nine best practices to build governance standards for care team communications

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Effective care team collaboration is essential to each healthcare organization’s transition to value-based payment models.

Implementing secure communications technology supports a standardized process for patient care coordination across the enterprise and geographically beyond, possibly encompassing multiple provider organizations. But what is the process for enabling timely focused communication between colleagues and the broader care team?

Communication and collaboration across the care team depends on automatic and immediate connection to the right team member who can act at the right time — regardless of location. Along with
a clinical communications platform that enables care team coordination, shared governance and
collaborative leadership are critical to overcoming the historically entrenched care team communication
hierarchy.

The following are nine best practices to help organizations create and implement governance standards for clinical communication across the continuum.

1. Establish a governance committee, supported by the board of directors, through your medical executive committee or medical staff leadership. Make certain members support the governance structure and standard of work before you present it to physicians.

2. Identify a physician champion to assist with securing buy-in from their colleagues. Cite safety and quality issues to entice and engage physicians. Share true-life stories about negative outcomes of critically ill patients when no one knows who is on call or if the call schedule is outdated — meaning the inability to contact the right person in the moment.

3. Ensure clinician-backed governance is in place before implementing new technology.

4. Once the technology is launched, ensure standards are communicated to users — a critical step to avoid backtracking and rework.

5. Build into governance the flexibility to go back and make changes in the moment to address unanticipated issues.

6. Don’t skimp on technology. Investing in a comprehensive, secure and flexible platform is well worth the expense. As the application evolves, providers must be ready and expect to make workflow changes align with upgrades. Maintain a comprehensive tech infrastructure that evolves with your organization.

7. Establish a formalized, reliable chain of command. If the first level fails, what is the escalation process? Ensure redundancies are in place if needed.

8. Create a charter involving all the right interconnected stakeholders, with influence and support of the board through medical staff leadership. Include representatives who will operationalize communication tools:
o Medical staff leadership
o Nursing or operational leadership
o Executive leadership
o Information technology and systems
o Privacy and security team
o Regional leadership (for large systems)
o Legal, risk and compliance team
o Disaster planning/management team
o Marketing team
o Technology vendor (ad hoc)

9. Once the charter is written, meet monthly for a while and then quarterly. Build the charter into a
governance structure for all communication tools. The underlying reasons for an enterprisewide
governance initiative that standardizes communication protocol are compelling. The risks of poor
clinical communication are clear. Inefficiencies can cause delays in care, jeopardize patient safety and lead to regulatory noncompliance.

The underlying reasons for an enterprisewide governance initiative that standardizes communication protocol are compelling. The risks of poor clinical communication are clear. Inefficiencies can cause delays in care, jeopardize patient safety and lead to regulatory noncompliance.

By Matthew Denenberg, M.D., vice president of medical affairs, Spectrum Health Helen DeVos Children's Hospital, and Michelle McCleerey, Ph.D., MA, MEd, MBA, R.N., vice president of product management, PerfectServe, MGMA Connection

Note: This article is adapted from “Technology and governance enable enterprise care team collaboration,” by Matthew Denenberg, M.D., vice president, medical affairs, Spectrum Health Helen DeVos Children’s Hospital, and Michelle McCleerey, Ph.D., MA, MEd, MBA, R.N., vice president, product management, PerfectServe. Reprinted with permission from MGMA. MGMA Connection, Vol. 17, No. 30, p. 30. © 2017 MGMA.

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