Individual communication performance has long been identified as a major risk factor for patient action against a doctor.
Increasingly analysis from the literature, expert opinion, patient complaints management bodies and Cognitive Institute has identified inter-professional communication between doctors as a significant source of risk to patients and doctors.
The risk concentrates into two major areas – when care of a patient is passed over to another doctor or when there is significant disagreement between doctors about the diagnosis and/or management of a patient. In addition, some professional interactions between doctors carry higher risk and this needs to be accounted for in the time and effort allocated to this communication.
This workshop addresses these two areas of risk by:
- exploring the nature of the risk to patients and doctors
- providing opportunity for reflection on personal attitudes and behaviours
- examining strategies to reduce the risk.
Modern healthcare requires effective passing over of patient care between doctors whether it be:
- formal referral to a colleague from a different specialty
- handing patient care back to a referring doctor
- involving a colleague in the care of a patient while remaining the treating doctor
- referral to a colleague for a radiological or pathological investigation
- handing over and taking back the care of a patient from a colleague in the same
- specialty who has been providing cover.
The workshop explores how poor inter-professional communication when passing the care of a patient to another doctor translates to patient risk including:
- abnormal investigations not acted on
- wrong diagnosis made or wrong investigation/treatment undertaken
- high risk treatments not effectively monitored
- predictable complications not recognised
- significant co-morbidities not taken into account regarding investigation and treatment
- unnecessary investigation and treatment
- increased hospital length of stay.
The barriers to effective communication between colleagues are explored and opportunities to reflect on strategies participants might use to assist in overcoming these barriers are presented.
Participants are introduced to the Cognitive Institute’s Referring Over© and Referring Back© checklists to assist them to effectively manage formal referral processes.
Participants are also introduced to the Cognitive Institute’s S.H.I.F.T.© model to assist them to effectively undertake clinical handover to a colleague in the same specialty providing cover.
The workshop examines techniques to reduce risk when doctors are in disagreement about aspects of patient care. Common areas of potential disagreement between doctors include:
- acceptable risk and perceived benefits of proposed treatments
- interpretation of investigations
- degree to which investigations/treatments should be pursued
- boundaries around provision of care.