Addressing communication gaps between physicians, in-home nurses

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Efficient communication is key in providing quality care to patients. But according to a new study published in the Journal of General Internal Medicine, communication between physicians and home healthcare (HHC) agencies has major gaps. This gap, mainly concerning the care of elderly patients discharged from hospitals, could increase readmission rates.

Led by Christine D. Jones, MD, MS, assistant professor at the University of Colorado School of Medicine, researchers at the University of Colorado Anschutz Medical Campus reported discrepancies in medication lists, confusion on who writes patient care orders, inaccessibility to health records and low rates of accountability as factors negatively effecting communication.

"We found that communication breakdowns can have consequences for patients," said Jones. "These are some of our most fragile patients, most are over 65, and more seamless communication is needed. As hospitalists, we need to think about what happens beyond the hospital walls and how we can support our patients after discharge, especially when it comes to home healthcare patients who can be very vulnerable.”

Researchers noted the following possible solutions to fix the communication gap and improve patient care:

  • Provide HHC agencies access to electronic health records and phone lines to doctors.
  • Put laws in place allowing nurse practitioner and physician’s assistants to write HHC orders.
  • Clearly establish accountability for hospital clinicians to manage HHC orders until a primary care physician can attend to the patient and answer questions.
  • Develop more effective communication methods with primary care physicians for more secure 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," said Jones.