How to overcome the ‘controlled chaos’ of healthcare communication to improve patient safety & staff morale

Rhonda Collins, MSN, RN - Print  | 

Healthcare is teamwork, pure and simple. At every point of the care continuum, care team members depend on each other to have the right information at the right time about the right patient.

Yet research shows that medical errors in the hospital, including those stemming from communication breakdowns, are one of the leading causes of death in U.S. hospitals. This is a seemingly inexplicable fact. How can such a deadly problem exist in an environment where the smooth progression of information among care team members is so critical? Most of the time, it's because the communication methods in place aren't there with the patient, family and staff experiences in mind. What communication methods are in place exist because "that's how we've always done it." Such limiting tools, in turn, limit care team members' capabilities.

Thankfully, many healthcare organizations are breaking out of this problematic status quo that seriously compromises patient care, safety and satisfaction. These enlightened organizations are instead embracing an enterprise communication platform that unites care team members and helps them achieve their common goal of creating better outcomes for patients as well as stronger relationships among colleagues. Platform features vary according to a hospital's unique needs, but the following overarching capabilities assure that hospitals large and small can at last break down the communication barriers that put patients—and staff morale—at risk.

Enables individual communication preferences. An enterprise communication platform supports the holistic, team-oriented nature of healthcare itself. Interestingly, a key to strengthening the team as a whole is to let each member use his or her preferred communication device.

This should absolutely include texting with a smartphone, although some hospitals are understandably concerned about both the optics and keeping PHI secure. But the reality is that texting is a fast and efficient ways to transmit important information about the patient's condition—and today's healthcare patient understands the benefits of texting. A simple explanation at the bedside about why or what the caregiver is texting can easily remove a communication barrier and alleviate a negative perception. Plus, there are secure texting applications that safeguard this information.

Note that in the absence of a secure and easy-to-use solution to transmit information at the patient bedside, the caregiver may not end up relaying it at all. By contrast, when communication is made simple and fast, people are more likely to do the right thing. Of course, common sense will dictate choices these care team members make. A labor and delivery nurse in the midst of assisting with a birth, for example, will obviously prefer a hands-free, voice-activated device to request backup or a needed instrument. After the birth, she or he may prefer to text some instructions or other comments to the nurse coming in on the next shift.

Still other settings—or units or points in the care continuum--may be more conducive to communicating with multiple devices, including a tablet, personal computer or even a landline. To that end, an enterprise communication platform enables and supports devices of choice within the healthcare ecosystem. A first responder may use a hands-free, voice-activated device to give the emergency department (ED) a heads up about an incoming patient—information that ED team members receive on a central computer, wearable device or smartphone.

The point is that even if multiple caregivers are using multiple devices to communicate information about a single patient, an enterprise communication platform assures this information is unbroken.

Supports a strategic and secure communication plan. Circling back to the "controlled chaos" of healthcare, it is critical to have a proactive, enterprise communication strategy in this mission-critical environment. A reactive mode can rule the day if isolated communication challenges are addressed as they arise and the figurative Band-Aid is placed over them. Here is one challenge where that approach just doesn't work: how to communicate sensitive patient information without violating the HIPAA privacy and security rule. Simply deploying a secure text messaging solution only makes one form of communication HIPAA-compliant. What about care teams communicating with other devices?

One of the most meaningful benefits of an enterprise communication platform is that it intelligently connects solutions and integrates with clinical systems across the healthcare enterprise. When thinking in terms of a platform—one that supports multiple devices—hospitals and health systems can create broad and more sound policies regarding patient information and privacy. Indeed, a standardized technology platform will enable HIPAA compliance throughout every means of communication, unifying a broad set of devices and their software applications. This approach is in distinct contrast to the cobbling together of disparate systems, a non-integrated environment that is a recipe for the data breaches that have plagued healthcare for years.

Finally, by supporting the end user's choice of device – whether it is a personal or hospital-provided smartphone, a hands-free communication badge, or other mobile device—healthcare organizations assure end user adoption at scale of important and strategic communication policies.

Provide visibility into team availability. Often times, a team that would otherwise work effectively is hampered by a communication system that hinders more than it helps the team ethos. Team members are forced to play phone tag with landlines or resort to shouting down the hall to get someone's attention. A simple request for pain meds can be drawn out to 20 minutes or even longer while waiting for the on-call physician's approval.

An enterprise communication platform replaces this inefficiency with active directory technology that enables physicians, nurses and other clinical staff—both inside and outside the hospital—to locate other team members by their role, assignment or name. Doctors don't have to give out their phones numbers, either. A nurse can simply use a smartphone or PC to access the directory and select, say, "Call Orthopedic Physician on Call." Or the nurse can send a secure text message directly to the on-call physician, indicating that "Mr. Smith, Room 406, post-knee replacement, is requesting pain medication."

Closing the communication gap

A hallmark of the well-oiled, cohesively working team is that the right message consistently gets to the right people at the right time. Care transactions happen quickly and efficiently, and patients, family members and providers are all on the same page. Dangerous miscommunication errors are also a rarity. While it is possible that healthcare teams can work this way without an enterprise communication platform in place, it is exceedingly difficult. Behind the scenes, a cost is likely being exacted—perhaps in the realms of HIPAA compliance or employee burnout.

Far better instead to enable these care team members with an enterprise-wide communication platform that keeps them connected to each other and the vital information they—and their patients--depend on for a consistently superior healthcare experience.

Rhonda Collins, MSN, RN, has served as Vocera Communications' ( chief nursing officer since January 2014. Through her previous work as vice president of women and children's services at Baylor University Medical Center, and as a practicing labor and delivery nurse for many years, she gained deep experience in crafting best practices for high-performing healthcare teams.

The views, opinions and positions expressed within these guest posts are those of the author alone and do not represent those of Becker's Hospital Review/Becker's Healthcare. The accuracy, completeness and validity of any statements made within this article are not guaranteed. We accept no liability for any errors, omissions or representations. The copyright of this content belongs to the author and any liability with regards to infringement of intellectual property rights remains with them.​

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