Communication in the Hospice Setting Among Health Care Workers - Research Paper Example

For these purposes, two methodologies will be applied:  IOM Aims for quality care framework and clinical microsystem analysis.

Using IOM Aims for quality care as a framework for communication issues it is possible to understand more clearly what the real impact of communication on both the quality and safety of hospice patients is. The Quality Chasm’s framework is comprised of 6 primary aims, which are crucial for providing safe medical care on a high level. These aims include the following: to provide safe, timely, effective, efficient, equitable, and patient-centered care (Bingham et al, 2005). Referring to the specifics of hospice patients, let us review each of the IOM separately and adjust it to our case.

Safe care

Palliative care is neither primarily concerned with life prolongation nor producing long-term remission of disease (IAHPC, 2008). However, it is not concerned with the shortening of a patient’s life as well. In order not to jeopardize the patient’s safety, all relative team members need to be fully apprised of the patient’s condition (Bingham et al, 2005).

 Timely care

The main focus in hospice falls on the quality of life of the patients. To be able to improve the quality of the life remaining to the patient, medical staff needs to provide timely care. Here timely care is especially crucial when the patient needs relief from both physical pain and psychological fits (IAHPC, 2008). In the cases, when the nurse is a link between patient and doctor, it is crucial to inform the doctor about the patient’s pains timely. Lack of operative communication between patient, nurse, and doctor makes timely care almost impossible.

Effective care

Effective care for hospice patients suggests the provision of high-quality care during the last days of a patient’s life (IAHPC, 2008). Therefore, the effectiveness of pain relief and quelling psychological fears depends on effective communication between clinical team members. For example, if the nurse has given a certain drug to the patient, not having confirmed this with a doctor, the effectiveness of care can be significantly impaired.

Efficient care

Efficient care at the hospice cannot be provided to the patients when their pain is unrelieved. As has been mentioned previously, one of the causes of unrelieved pain is lack or ineffective communication among medical staff. Doctors need to coordinate continuously with nurses what drugs can be given, what drugs are forbidden, periodicity, frequency, etc.

Equitable care

Personality, ethnic origin, intellect, religion, and any other individual factors should not be prejudice for delivering optimal care to the patient (IAHPC, 2008). Communication among doctors and nurses and sharing some personal information might be very helpful in developing an approach to each patient.

Patient-centered care

Palliative care is not disease-oriented, but it is person-oriented. To increase the patient’s comfort at the hospice, it is preclinical staff members must communicate and not be too lazy to talk about the patient’s psychological features (IAHPC, 2008). While planning palliative care for individual patients, doctors need to communicate with nurses about the unique characteristics of the patients, which can greatly influence the suffering of the individual patient (IAHPC, 2008).

The 5P’s framework

Purpose: to provide relief from pain and other distressing symptoms (Godfrey et al., 2004).

Patients: patients, facing life-threatening illness

Professionals: palliative care consultants, physicians, social workers, psych, palliati MDsare MD’s, palliative care NP’s, chaplaincy, physical therapist.

Processes:

• Entry/assignment
• Orientation
• Patient evaluation/Chart review (PC-NP & PC-MD)
• Request input from chaplaincy, social worker, psych, physical therapy, financial debt
• Communication of goals and plan of care to inpatient, family, attending, house staff, nursing (Godfrey et al, 2004).

Patterns