How Well Does Your Nursing Team Communicate?

 

Post-Acute and Long Term Care (PA/LTC) is rapidly changing, but is our ability to communicate clinically meaningful information amongst our nurses adequately supporting rapid cycle change?  We are admitting higher acuity patients while simultaneously partnering with our referral hospitals and home health agencies to improve measurable patient outcomes.

Rapid and effective communication with licensed staff via email is one way we are adapting to these changes.  Prior to adopting this system we struggled with the below communication challenges:

1.      A “near miss” event occurred and was investigated, but the POC is conveyed by special in-services, snail mail, or word of mouth.
2.     A good idea is expressed, but is communicated by word of mouth to whoever is present and can remember to share it.
3.     Timely feedback to nurses would be great, but they aren’t working for the next several days, or they work on a shift when you won’t be present
4.     A front line nurse sees a system problem, but doesn’t know how to efficiently channel the concern within your facility?
5.     A challenging case is in your facility, but nurses in your facility hear about the specific care and clinical issues by random encounters with other nurses or management.

 

At Park View Gardens Post-Acute Care in Santa Rosa, we oversee the care of up to 110 residents.  We have adopted the Point Click Care EHR.  Our nurses are familiar with computers and have access to their email account at work and most can access their account in their homes.  For each of these employees we have paid a licensing fee to set up a work email account which is HIPAA and HITECH compliant.  

With this system we can send out group emails to all current licensed staff or to specific nurses or teams regarding quality or educational issues.  We provide training for all of our licensed nurses on use of this email system, HIPAA issues, and the expected frequency for checking their account.  If timely responses are expected, these are built into each email.

With this system in place, we have been able to immediately address the communication problems noted above.  We have sent emails for the entire clinical team that may include PowerPoint presentations from staff meetings, evidence-based practice presentations, recent mandatory in-services, current best practice approaches and studies, electronic health record updates, specialty program information, readmission and unplanned transfer case assessments, and team building/culture improvement ideas.

While our experience with this new avenue of timely communication is limited, already we have seen the following benefits:

1.     Quicker response times to audits:  MARs and TARs with missing or inaccurate documentation
2.     Better communication between IDT and the nursing staff re specific patient, physician or other provider feedback.
3.     More frequent emails from front line nurses to department heads regarding their concerns related to patient care.
4.     More responses from our nurse to the education sessions offered as well as requests for future specific education topics.
5.     Reduction in 30 day readmission rate for Medicare Part A (6.2%) and Medicare Managed Care patients (9.1%).  This is the lowest rate in all of the Ensign facilities.
6.     Improved timely restocking of nursing supplies by Central Supply
7.     Reduced falls and use of Antipsychotics
8.     Improved nursing documentation with reduced findings on audits.

 

Our team is still discovering how to optimally use this tool for improving team communication.

We look forward to hearing what you are doing to improve communication at the upcoming CALTCM annual meeting.

I hope to see you there,

Skelly Wingard
RN, MSN, CNL, PHN
Vice President of Care Continuum
Ensign Services, Inc.
[email protected]