By Alisa Khan, MD, a pediatric hospitalist and health services research fellow at Boston Children’s Hospital and Christopher Landrigan, MD, MPH, director of Boston Children’s Inpatient Program, recently received the Community/Patient Empowerment Award at the National Pediatric Innovation Summit sponsored by the hospital.
Miscommunications are responsible for more than 70 percent of sentinel events in hospitals, according to The Joint Commission and the Department of Defense. A sentinel event happens when a patient has an injury related to medical care that wouldn’t normally be expected when treating that illness.
Boston Children’s has launched several successful projects to improve these communications. Its focus thus far has been on improving clinician-to-clinician communication during patient “handoffs”: the time when one doctor’s shift ends and another begins. These initiatives resulted in a 40 percent reduction in medical errors, and a 54 percent reduction in preventable adverse events (harmful, undesired events). Read more about it in this recent Vector post.
In today’s busy medical environment, doctors are asked to do a lot in a short amount of time. The average well visit clocks in at somewhere around 12 minutes these days, which means pediatricians need to screen children for several potential problems in a very finite amount of time.
Because of these time restrictions there simply isn’t enough time to do all the screenings recommended as part of general health care. One area that often gets overlooked is substance abuse among adolescent patients.
Data suggests that many physicians do not routinely broach the topic of alcohol and drug use with their teen patients because there isn’t enough time to bring the subject up, or they don’t always know what to do when a screen suggests a patient may have a problem.
To make the process easier on time starved doctors, the National Institute on Alcohol Abuse and Alcohol Addiction (NIAAA) and the American Academy of Pediatricians (AAP) have both released screening and brief intervention guidelines that will help physicians choose valid screening tools and clearly explain when to suggest appropriate interventions for their patients. …
A few weeks ago I sent out a tweet about something that I’d been noticing a lot in clinic that makes me sad. It’s remarkable, I said, how often patients don’t tell their doctors when they don’t understand, or when their instructions are impossible.
A tweet came back: It’s remarkable how often doctors don’t ask if we understand or if their instructions are possible.
The tweeter was the mom of a kid with special health care needs (actually, more than one kid). As we tweeted back and forth about her experiences, it hit me how crucial good communication is when there is medically complex stuff going on. So I asked her if she would help me write a blog post about the things parents like her wished doctors knew—or would ask.
Sure, she said. She talked with some of her friends who also have kids with special health care needs, and this is what they came up with: …