Good Communicaton Will Solve Many of the Problems at Your Healthcare Site
You may think that you know what your patients heard when you spoke to them, but in many cases you are only partially correct. Sometimes in healthcare, communication is like the childhood game of passing a message from one person to another by whispering in a person’s ear. I hope that you remember that game. What may have started out as Amos has a green shirt on could end up by the seventh or eighth person as A mouse had a spleen out. Communication is extremely important in healthcare. Communicating poorly can have serious consequences.
I was recently reminded of the nature of communication while reading an article by Dr. Benjamin Brewer in the online edition of the Wall Street Journal (November 1, 2006). He was describing several episodes of treating patients who had recently come from Mexico to his area of practice in Illinois. In the satellite office where he encountered these patients there was very little sophisticated equipment, nothing much beyond a microscope and an X-ray machine. So, he had to rely on his wits and experience to diagnose patients. In the incident he was relating, there was a male patient who had a serious cough and muscle aches and was not getting any better. He later found out from his office assistant, who was of Mexican descent, that the patient thought he had caught the Aire, an illness caught when moving from a cold area to a warm one; it is a common folk diagnosis in parts of Mexico.
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In contrast to the leisurely pace of my canoe trips the world of healthcare is fast-paced and sometimes quite changeable. Currently, there is a demand for significant change in the delivery of healthcare in the United States. There are numerous articles in medical journals, a plenitude of surveys and even political campaigns that tell the medical profession that change is urgently needed to ensure delivery of quality healthcare to all citizens. The Institute of Medicine in its Crossing the Quality Chasm lists ten important principles that a healthcare provider should follow to fully meet the patient’s needs; the principles are based upon patient-centered care. A recently completed survey by the Commonwealth Fund indicated that 9 out of 10 surveyed indicated they thought it important that a primary care physician should be responsible for the coordination and delivery of all medical care to a patient. As we know, this seldom happens in healthcare in the U.S.
Fortunately, many healthcare sites are responding to these pressures, even though funders are not very supportive in general. Hospitals are adopting the techniques of Lean Quality and Six Sigma to improve at their sites. The capacity to deliver coordinated care at the primary site is being established as the Patient Centered Medical Home. If funders and purchasers of healthcare adequately support this movement it seems that there may be a significant improvement in the delivery of healthcare in the U.S.
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