What is my role? You have a critical role in ensuring that the care provided in your organisation is safe. Implementing systems and processes to support effective patient-clinician communication at transitions of care is a key element of ensuring safety and quality. This includes: supporting and encouraging communication across your organisation fostering a culture of engagement and teamwork, where the patient is recognised as part of the team leading and managing change to improve patient-clinician communication supporting your healthcare providers by providing resources and for engaging patients, families and carers in transition communications acknowledging best practice implementing improvements, when necessary. How can I improve patient- clinician communication in my organisation? In collaboration with healthcare providers and consumers, organisations should take a systems approach. This requires the implementation and integration of systems and processes that support effective patient-clinician communication across the organisation – from the highest level of governance to the point where care is delivered. It takes the team, the nursing team, the allied health team, the medical team and the family and patient. Everybody’s on board. We’re here for the patient. Nurse Manager7 Excellence here… it looks at aligning our goals, aligning our behaviours and guiding our processes to get a consistent outcome. Nurse Manager7 patient- clinician
Multidisciplinary leadership and commitment to engaging patients in transition communications is key One large Australian hospital has taken active steps to engage patients in communication at transitions of care. The hospital has demonstrated leadership and commitment to person-centred care at an organisational, service and individual staff level. Leaders in this service articulate their goals as being to: develop trust-based discussion and collaboration to achieve continuity of care pause long enough to give patients the opportunity to enter discussions create spaces for patients to get into the conversation. The hospital has unit-level multidisciplinary collaborative practice teams, designed to ensure inclusiveness of staff, patients and families and consistency of how and what information is communicated. STRATEGY Multidisciplinary collaborative practice teams are formal groups that include doctors, nurses, allied health professionals and a patient advocate. The group reviews processes, identifies areas for improvement and can assist in maintaining a patient centred focus. Implement standardised strategies and tools to support effective communication; recognising the barriers to, and potential enablers of, communication Staff use a number of tools that are part of the TeamSTEPPS approach, including: the mnemonic (Introduction, Situation, Background, Assessment, Recommendations) for handovers, which incorporate steps to engage the patient, and their family or carer, in communications formal discharge planning processes that keep patients of their expected date of discharge structured multidisciplinary team handovers that every day at a set time checklists and protocols to ensure communication and patient information is provided for all care transitions. Often these involve prompts to involve patients and families. One of the major challenges faced by this hospital was maintaining a culture of person- centred care, which was affected by: dealing with the time pressures of high workloads bed block and lack of space the need to integrate goals (especially for those who may be only intermittently employed in the unit) accommodating numerous, often rapid patient transitions across services. There was also the challenge of encouraging participation among patients and families with cultural and linguistic diversity, Aboriginal and Torres Strait Islander patients, children, and those with mental health issues or who were distressed. Engaged and supported nurses who are good listeners can act as enablers of person-centred care by including patients in conversations about pain relief, access to care, comfort, nutrition, and social support.