I recently read the research article in JOGNN November/December 2014 titled “Using A Team-Centered Approach To Evaluate Effectiveness of Nurse-Physician Communication.” 1 The article made me start thinking about communication overall and how electronic documentation can help. I loved how it compared health care communication to the aviation industry. We should look at other leading industries to learn how to improve our practice. Healthcare is a business and your unit is a part of that overall business! The article findings actually did not surprise me, as I have experienced and communicated like this in the past. “Physicians tended to issue commands, and the nurses relied on queries to initiate decisions on patient care with the physicians; nurses tended to prompt the physicians to authorize actions either by asking permission or through an indirect inquiry.” This type of communication is the norm and we have all experienced it and overall can be very effective. The article does challenge us to take our communication to the next level as there potentially can be hidden costs to overall patient care in this direct status type of communication. At times, depending on those in the initial communication, things could be overlooked and not realized until something else happens. Team centered communication can help support all the members of the overall team. Per the article, this type of communication can lead to a “we do approach to planning and negotiating of patient care needs.” The EMR can help guide team centered communication by having critical items flow from both the physician and nursing documentation to a joint form that can then be used as a guide for a report. An example is the SBAR in Centricity™ Perinatal. Just think how awesome report and rounding can be when the focused status items are already outlined in a logical order.
Of course electronic documentation should never take away that critical clinical assessment that we all recognize at times cannot be captured in any type of documentation. However, electronic documentation can help guide our overall communication. As we enter into 2015 let’s challenge ourselves to focus on how we communicate with each other and the overall healthcare team.
1JOGNN 2014: Vol.43, Issue 6. Using a Team-Centered Approach to Evaluate Effectiveness of Nurse-Physician Communication. Brenda Matzke, Susan Houston, Ute Fisher, and Martha J. Bradshaw.