Improving Communication Between the Residents and Consultants at HCA Florida Osceola Hospital

From the 2023 HVPA National Conference

Anwar alshaakh mohd mari MD (University of Central Florida HCA Healthcare GME, Greater Orlando, Florida), Geover Virella MD, Hannah Vansumeren MD, Aaron Francisverbeelen MD, Ana Ledo MD, Liliana Franco MD, Manuel Carrazana MD, Joshua Shultz MD, Ashwini Komarla MD

Background:
In the healthcare setting, communication between healthcare professionals is critical to providing timely and effective patient care. Currently, consultants at HCA Florida Osceola Hospital have different preferences for communication. These different preferences lead to confusion for consultees and frustration for consultants when communication/patient care is delayed. Communication is most effective when it is stream-lined and efficient. Primary teams and consultants need pre-determined modes of communication to reach each other when needed, especially when placing emergent consults or for follow-up questions. The use of an incorrect method of communication among referring physicians can lead to physician frustration and delayed consultations and discharges.

Objective:
Identify the current communication barriers between hospital staff and consultants.  Understand the reasons for these barriers and evaluate the impact of poor communication on patient outcomes. Increase consultant communication satisfaction by 20% for new consults within a 6-month period. Increase resident physicians’ level of satisfaction by 20% within 6 months for communication with specialists.Create a centralized database for consultant contact information that includes the preferred method of communication for each consultant.

Methods:
In order to assess the effectiveness and difficulty of the consultation and communication processes at HCA Florida Osceola hospital, we first mapped out the process. A survey was created to assess the resident’s communication process with Nephrology, Infectious Disease and Cardiology. The purpose of the survey was to assess the average level of resident and consultant satisfaction with the consultation process on a 1-10 Likert scale. In response to the results, several actions were taken. Nephrologists came up with a standardized protocol for how to contact them based on time and acuity. Residents were informed via email, text, flyers, and morning report announcements. Cards explaining how to call a consultation were also created to educate new interns. A follow-up survey was conducted to assess satisfaction. Surveys with Infectious Disease and Cardiology led to creation of a centralized electronic database with consultant numbers and preferred methods of contact.

Results:
According to the survey’s findings, resident’s satisfaction with the process of communication with Nephrology increased by 11% within a 6-month period with the biggest increase among senior residents (20%). Nephrologists’ satisfaction with the communication process increased by 20%.

The survey results indicated many barriers to contacting consultants, including the following:
“Not having a clear point of contact such as NP numbers available to call for non-urgent matters.”
“Never clear who is on call and their preferred method of contact.”
“Multiple contacts, not knowing who to contact.”
“Finding the phone number.”

Conclusions:
Interviewing consultants and consultees to standardize the method of communication will lead to an improvement in satisfaction. A resident driven effort to improve methods of communication proved more challenging than anticipated.

Clinical Implications:
In the 21st century, the number of methods to communicate has expanded. Although direct phone communication may have been preferred in the past, busy specialists may find it interrupts tasks and ongoing patient care. Consultees and consultants need to be open to alternative methods of communication to improve contact and minimize disruptions. Efficient communication with consultants can save time and resources, reducing the burden on healthcare professionals and improving overall efficiency in the healthcare system.

 

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