The lost art of inter-provider communication.

Abstract

From the days of Neanderthal drawings on cave walls to the sophisticated tools of cell phones, cable phones, and satellite phones, communication among humans has evolved at a dizzying pace. Or has it? Communication among and between healthcare providers in the 21st century may have actually devolved. Computers and smart phones have taken the place of interpersonal communication. While communication among healthcare providers has become more efficient, one can argue that it has become less safe for the patient. Gone are the days of consultants speaking directly to one another about a mutual patient. Now, physicians and mid-level providers read one another's notes either on paper or in a computerized medical record. Gone also are the days of nurses trading information on a patient between shifts. Shift report is either done through tape recordings or, again, via computerized notes. The rationale of decreased interpersonal communication between healthcare providers is “I am too busy.” Yes, we are constantly fighting the clock in our efforts to take care of patients in an environment that is wrought with “crossing Ts and dotting Is” to satisfy increasingly suffocating regulatory demands. Yet, while relying solely on digital communication, we are sacrificing the gain of subtle nuances of patient information that can be of supreme importance in their outcome. Family dynamics, psychosocial situations, or even a vague deviation from a normal exam may not be properly articulated to one another, and this can make a difference in the course of a patient's hospitalization. Perhaps, the quality and quantity of interpersonal communication has suffered because of poorly defined roles and tasks,[4] “turf wars” among hospital departments/units, difficulty in socialization skills between professionals, or competing priorities among hospital staff. The problem of poor communication may be related to all of these factors. Irrespective of the underlying causes of communication breakdown between healthcare professionals, the adverse affect on patient outcome and development of tools to enhance and improve collaboration and communication is well documented in the literature.[1,2] Poor communication among healthcare providers also makes for a stressful workplace and encourages disruptive behavior among clinicians.[3] There is no healthcare professional that is too important or too busy to speak or interact with a colleague, especially when it concerns a patient care issue. Leave egos and personal feelings at the door. Provide unencumbered quality patient care. Let us get back to the fundamentals of patient care and do the best we can for our patients all day, every day.