Pick up the phone and bring a human touch to the communication process
Every day the medical profession is confronted with a myriad of difficulties. It comes as no surprise that wait times for diagnostic imaging, specialist appointments and surgical procedures continue to be highlighted as an ongoing area of concern within the health-care system. Wait times, despite many good intentions and efforts, are an everyday reality. As physicians, it is our responsibility to work collaboratively with colleagues to find patient-centred solutions to system issues.
A recent report tabled by the Health Quality Council of Alberta (HQCA) entitled Continuity of Patient Care Study (December 19, 2013) highlights a system issue that contributed in the premature death of a young man with testicular cancer. The patient’s family agreed to participate in the study and share details of his medical records “to rightly keep him, and other patients like him, in the centre of the issue of continuity of care.” The report notes: “In these situations patient care is critically dependent on (1) reliable, accurate information being exchanged between providers and between providers and the patient; (2) maintaining continuity among providers in the management of a patient’s condition(s); (3) providers understanding and agreeing on their individual responsibilities for the aspects of a patient’s care; and (4) patients’ awareness of who to contact for assistance with their healthcare needs, especially for emergencies or unexpected complications.” To read the full report visit: https://d10k7k7mywg42z.cloudfront.net/assets/53275975f002ff4d14000011/Dec19_ContinuityofPatientCareStudy.pdf
Occasionally, the College hears from specialists who are concerned about the lack of information they receive about a patient from referring primary care physicians. Likewise, primary care physicians report that they do not receive confirmation from the specialist as to wait times for appointments. The HQCA report contained ten recommendations to ensure that patients are successfully transitioned through consultation, testing and treatment. The relationship between the primary care physician, specialist and institution is an important component. Physicians can ensure effective interactions between primary care physicians and consultants through clear communication. The College provides guidance on the matter in Expectations of the Relationship between the Primary Care / Consulting Physician and Consultant Physician.
The College’s guideline clearly states that a primary care physician is required to provide enough information to the receiving consultant to triage the request. The same applies to requests for diagnostic tests. If the situation is obviously urgent, verbal communication between the consultant and the primary care physician is expected, to expedite the care. Simply put, pick up the phone and bring a human touch to the communication process—this ultimately equates to quality of care. The primary care physician must remain vigilant to any change in the patient’s status, and if the signs are ominous, this information must be conveyed to the consultant or facility where the patient is on a waiting list.
To complete the circle, the consultant must provide a prompt response to the referring physician acknowledging the referral and anticipated appointment date. The consultant and the primary care physician should discuss and mutually agree as to who will take responsibility for scheduling the appointment directly with the patient. Providing this information to the patient is the responsibility of both the primary care physician and consultant, and is an important step in the communication process.
The vast majority of BC physicians are working to achieve patient-centred care. Collaborative, two-way communication has the power to ensure that patients like the young man noted in the HQCA’s report receive coordinated care and a seamless journey through the BC health-care system.
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