How Nurses Communicate

We recently asked hospital-based nurses to tell us about their communication challenges at work.  No surprise, really, they said easier communication would improve patient care and satisfaction, improve productivity and save as much as 10 hours of overtime per week.  But they also said they don’t have the communication technology and devices they need to do their jobs.  You have to step back and ask yourself “why not?”

Here’s my thought about “why not.” It’s been ten years—yes, ten years—since the Institute of Medicine published To Err is Human.  It was the shot heard ‘round the healthcare world. We heard the alarming statistics about avoidable medical errors and immediately focused on CPOE, bar-code medication administration, and EHRs to save lives.  And now, with ARRA, we have “all-hands-on deck” to deploy EHRs

But I think we may well have lost our ability to see the trees for the forest. Clinical systems won’t solve all of healthcare’s problems. Equally important, we need to help clinicians communicate and collaborate. We need to start with nurses—the largest group of professionals working in hospitals—and what they tell us works for them.  Amazingly, one-in-five of the nurses in our national survey have no access to a mobile communication device at work.

The next time I’m a patient I want my nurse to be able to quickly clarify confusing medication orders.  I sure want my care team to talk with each other—nurses, the hospitalist, my internist and all of those wonderful ancillary departments.  It’s been years since I was a hospital administrator, but my final leadership role inside a health system was in a physical rehabilitation hospital.  We held weekly care conferences for every inpatient.  The entire team—physiatrists, speech pathologists, nurses, physical and occupational therapists, quality assurance staff, and care managers—sat around a table and talked about the patient’s progress, updating the care plan as we went.  Imagine that kind of collaborative communication whenever it’s needed, and even when care team members are in different locations.

It’s time to include the exchange of expertise and insight between people within our definition of health information exchange.  People “interoperability” is as important as data interoperability. It’s time to balance and connect the “three C’s”:  clinical solutions with communication and collaboration technologies. 

I believe nurses when they tell us our healthcare depends on it.

Want to know more about what nurses had to say in the survey?  Read the results and let us know what you think.

Posted by Frances Dare at 08:55AM PST