Ponce de Leon

Communication

- BACK TO BASICS

As we recognize our aging population, more and more Americans are being faced with the difficult decision of long-term care for their loved ones. The demand in the long-term healthcare industry implies a growing level of clinical complexity and intensity in all levels of care, which could then increase the liability of risks. Families entering into this new arena are faced with a number of emotions. Financial planning, feelings of loss and quilt, and the actual selection of the best facility play a tremendous role in this stressful transition.

This already stressful event is then compounded by the difficulty of obtaining and understanding basic information surrounding the facility and the intended care to be provided. Research has shown, on an average, most people only obtain 20 percent of the information conveyed during their health care system experience. Some analysts believe the breakdown in communication with a long-term care resident’s family is one of the leading causes of legal claims against such providers. Communication is essential to managing the risks and treatments in long-term facilities. Embracing both family and resident involvement in the care process will demonstrate success in resident satisfactions and quality of care.

Communication with residents and their families should always be open, professional, empathetic and unrushed. Risk management literature has shown that communication between healthcare providers and patients make a difference in the way the patient perceives their care. Often times, patients judge quality of care by their own personal interaction with their healthcare team. We need to see improved relationships within this industry, and effective communication is the starting point. The discussion would likely include standards of care and how such standards and regulations are enforced. The resident’s quality-of- rights should also be identified, along with a plan of care. Everyone involved should then come to a basic educated or informed consent of care.

Preadmission screening is imperative for effective counseling and care to be carried out as the resident and family embark on such an important decision. Listed below are a few recommended areas to explore within the residents background information:

• Cognitive patterns
• Hearing/vision impairments
• Disease Diagnosis
• Mood/behavior patterns
• Physical function
• Family/resident goals and outcomes
• Identify resident’s acuity level
• Establish estimated length of stay and discharge potential
• Identify family member for ongoing communication
• Discuss medication and how it is administered
• Discuss facility and staffing

Admission to the facility continues the process with the resident and family, and listed below you will find further suggestions to help facilitate better communication:

• Complete History & Physical
• Care plan that involves medical, nursing, and psychosocial needs
• Complete assessment of all systems
• Educate family/resident of assessment and potential problems and changes
• Introduce policies & procedures
• Activities, both physical and social
• Review fall, elopement, skin, nutrition, safety, and incontinence assessments
• Review informed consent, privacy and confidentiality, resident choice in medical treatment, and restraints
• Review documents of living will, power of attorney, and do not resuscitate status
• Provide staff and facility orientation

The next step of critical communication surrounds the change in resident condition. This involves timely notification to the physician and family followed by complete and thorough documentation. Based on the resident’s change of condition, care plans are reviewed and revised by the healthcare team. Treatment is determined and a new care plan is discussed with the resident/family, implemented, and documented. It seems that by improving communication among the residents healthcare team, we may also see potential liability claims be reduced.

As a healthcare provider we must remember, kindness, understanding, patience, and respect work to build trust. In turn, trust builds confidence and a professionalism that is needed in this ever growing industry. Let’s get back to the basics and focus on the importance of effective communication and see the results of an improved quality of care.