Six Strategies to Help Hospitalists Improve Communication

The Hospitalist. 2016 February;2016(02):

February 8, 2016 | The Hospitalist

Cincinnati Children’s Hospitalists Ramp Up Communication in Cases That Show Need

Cincinnati Children’s is embarking on an effort that is innovative but is such a simple idea that perhaps it shouldn’t seem so novel: tailoring discharges according to the needs of the patients and their families.

The project, known as H2O, or Hospital-to-Home Outcomes, is funded by PCORI, the Patient-Centered Outcomes Research Institute, on the philosophy that, as Cincinnati Children’s Jeffrey Simmons, MD, MSc, puts it, the “best research is research that’s informed by what patients really want, as opposed to what the scientists think is important.”

Interviews and focus groups were conducted with families who had recently been admitted and discharged, and researchers learned what matters to patients at the time of discharge. Researchers frequently heard families describe themselves as being “in a fog” and “exhausted” at the time of discharge, limiting the amount of information they could take in at the time.

“We’ve really learned that there’s a significant gap when [patients] go home, in terms of what they need to know and how they get help,” Dr. Simmons says.

Researchers also were struck by the emotional toll the hospitalization had taken on patient and family.

“This is a massively major stress event for them,” he says. “I think the medical system can do a better job understanding the emotional impact on them.”

Although some families might not need any follow-up at all, some really benefit from a follow-up discussion. For those in need, a nurse will travel to the homes of families the hospital determines are likely benefit from a “nontraditional” visit for which the family wouldn’t otherwise qualify. The nurse will review any “red flag” issues that might have been noted at discharge, provide emotional support, and make sure the patient has connected for follow-up care.

“We’re studying the impact of these visits,” Dr. Simmons says. “We’ll see what the results are.”

— Thomas R. Collins