Communications gap between doctors and home-care nurses creating issues

Serious communication gaps between doctors and home health care (HHC) agencies are impacting patients discharged from hospital.

Researchers found worrying communication issues between the doctors and nursing agencies responsible for caring for often elderly patients discharged from hospitals, contributing to hospital readmissions.

The research, published in the Journal of General Internal Medicine, cites an array of communication challenges.

The study cited frequent discrepancies in medication lists, confusion over who was responsible for writing patient care orders, inaccessible hospital records and resistance from clinicians and staff for accountability.

Led by Dr Christine Jones, professor at the University of Colorado School of Medicine, the researchers conducted six focus groups with HHC nurses from six different agencies to ask about their general experience with caring for patients after discharge from any of their referring hospitals.

“We found that communication breakdowns can have consequences for patients,” said Dr Jones. “These are some of our most fragile patients, most are over 65, and more seamless communication is needed.”

Some of the HHC nurses interviewed complained of a lack of accountability, medical errors and difficulty in reaching doctors.

“As a general rule, I’ve been told you’re not to contact the hospitals. I actually got in trouble for contacting the hospital, trying to find out, get more information, trying to track a doctor down,” one nurse said in a focus group.

Another nurse said even if they reach a primary care clinician, they often say they didn’t know the patient was in the hospital and they don’t have a report on them.

The researchers found another serious problem when it came to ordering medication. HHC nurses and staff said most of the medication lists they receive are incorrect due to the number of doctors and specialties involved.

“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 health care patients, who can be very vulnerable,” Dr Jones said.

She noted that the study did not focus on any one specific hospital, but hospitals in general.

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