Poor communication between physicians is the No. 1 issue hurting patient transitions between hospitals and nursing homes, according to a recent survey of long-term care professionals.
Researchers with the University of Missouri Sinclair School of Nursing devised a survey to gauge problems with care transitions. They received responses from care teams at 178 nursing homes in Missouri. The teams included a variety of workers, including nurses, physicians, Minimum Data Set coordinators and administrators.
The most common problem identified was “no communication between hospital physician and accepting physician,” the researchers found. The respondents also reported issues with written communications from hospital physicians, particularly with medication orders. Many said that “unclear” orders are a problem and trying to “decipher” or “figure out” orders is challenging. About one-third of these respondents said they spend one to two hours making calls to clarify orders, and 13% spend two to three hours.
“It is challenging for a nursing home to call back to a discharging hospital and get orders clarified; the physician who initiated the order may be gone, as is the nurse who had knowledge of the resident,” the researchers wrote.
Generally problematic communications with hospitals are compounded because patients often transition late in the day or on Friday afternoons, according to the respondents.
About half of the respondents said having a single hospital contact with thorough knowledge of the incoming resident would improve communications, the investigators reported. Social workers were singled out as good candidates for this role.
The findings appear in the Journal of Nursing Care Quality.