The Use of Roles to improve healthcare communication
Current communication practices in healthcare organisations like NHS Trusts tend to rely on identifying individuals best placed to help provide advice or support. As staff shortages lead to more fluidity in the workforce and models evolve to support more care in different settings, the burden placed on administrative teams to coordinate communication and the delays associated with finding the right individual to contact will only grow unless a new model is adopted.
Communication is already a massive challenge. Numerous studies point to poor communication as one of the leading causes of medical errors and patient harm, with various papers referenced by the Royal College of Physicians in their publication “Improving teams in healthcare” and The World Health Organization (WHO) referring to ineffective communication as the root cause in over 70% of sentinel events.
The current dominant methods of electronic communication are bleeps and social media messaging. In a recent audit of the use of bleeps, one of our customers found:
– 26% of individuals reported being bleeped incorrectly
– A bleep audit by Junior Doctors identified 47.6% of bleeps as inappropriate.
– 24.4% of bleeps interrupted critical clinical tasks
How the use of roles in digital communication can help
As healthcare staff get used to adopting roles digitally, staff no longer need to identify the person they need and can communicate with colleagues in their roles rather than as individuals. A digital role is a specific responsibility that is fulfilled by a number of rotating team members. Maintaining the role in digital form means that relevant information and history can be retained and accessed by assuming the role.
The benefits of communicating in this way can be realised in several ways:
– The everyday scenario of finding the person you need as fast as possible, with the opportunity for automatic escalation where the target recipient occupying a role is too busy to respond
– The seamless extension of communication to bank staff who have signed in
– Reducing pressure on switchboards so they can focus on other activities
– Peer-to-peer handover, usually at the end of the shift (more on this below)
– Reduced risk that sensitive patient information is shared with colleagues who shouldn’t have access to this information
– Quick identification of roles that are inadequately resourced so that corrective action can be taken
Better Handover protocols
Research shows that poor handovers result in significant morbidity, mortality, dissatisfaction, and excess financial costs, with one study* showing that two-thirds of communication breakdown issues were related to problems with handovers. Evidence suggests that using a standardised framework for handovers, such as ISBAR (endorsed by the WHO), significantly improves patient outcomes. There are five key elements to this –
- Introduction (your role)
- Situation (patient information)
- Background (patient and care history)
- Assessment (diagnosis and feedback)
- Recommendation (advice on what to do next)
A framework like this is more easily implemented using a structured approach within a digital communication product using roles.
What Measurable benefits can be realised
So far, the benefits we’ve seen realised include:
– A 49% reduction in average response times
– A significant reduction in the number of steps required to contact a colleague
– 38% of staff reported savings of over an hour a shift, with 8.7% reporting 3+ hours
We’re confident there are many more benefits to come, if you’d like to learn more please get in touch.
*Gawande AA, Zinner MJ, Studdert DM, et al. Analysis of errors reported by surgeons at three teaching hospitals. Surgery. 2003;133:614–621.