Jt Comm J Qual Patient Saf. 2024 May;50(5):326-337. doi: 10.1016/j.jcjq.2024.01.006. Epub 2024 Jan 18.
Suboptimal communication between clinicians remains a frequent driver of preventable adverse health care-related events, increased costs, and patient and physician dissatisfaction.
Cross-sectional surveys on preoperative interspecialty communication, tailored by stakeholder type, were administered to (1) primary care providers in northern New England, (2) anesthesia providers working in the perioperative clinic of a tertiary rural academic medical center, (3) surgeons from the same center, and (4) older surgical patients who underwent preoperative assessment at the same center.
In total, 107/249 (43.0%) providers and 103/265 (39.9%) patients completed the survey. Preoperative communication was perceived as logistically challenging (59.8%), particularly across health systems. More than 77% of anesthesia and surgery providers indicated that they communicate frequently or sometimes, but 92.5% of primary care providers indicated that they rarely or never communicate with anesthesia providers. Some of the most common reasons for preoperative communication were discussion of complex patients, perioperative medication management, and optimization of comorbidities. Although 96.1% of older surgical patients reported that preoperative communication between providers is important, only 40.4% felt that their providers communicate very or extremely well. Many patients emphasized the importance of preoperative communication between providers to ensure transfer of critical clinical information.
Surgeons and anesthesiologists infrequently communicate with primary care providers in one rural tertiary center, in contrast to patient expectations and values. These study results will help identify priorities and potentially resolvable barriers to bridging the gap between the inpatient perioperative and outpatient primary care teams. Future studies should focus on strategies to improve communication between hospital and community providers to prevent complications and readmission.
临床医生之间沟通不佳仍然是导致可预防的医疗保健相关不良事件、增加成本以及患者和医生不满的常见原因。
针对术前跨专科沟通，按利益相关者类型定制了横断面调查，并分发给（1）新英格兰北部的初级保健提供者，（2）在三级农村学术医疗中心围手术期诊所工作的麻醉提供者，（3）来自同一中心的外科医生，以及（4）在同一中心接受术前评估的老年外科患者。
共有 107/249（43.0%）名提供者和 103/265（39.9%）名患者完成了调查。术前沟通被认为在后勤方面具有挑战性（59.8%），特别是在跨医疗系统的情况下。超过 77%的麻醉和外科医生表示他们经常或有时进行沟通，但 92.5%的初级保健提供者表示他们很少或从不与麻醉提供者沟通。术前沟通的一些最常见原因是讨论复杂患者、围手术期药物管理和合并症的优化。尽管 96.1%的老年外科患者表示提供者之间的术前沟通很重要，但只有 40.4%的患者认为他们的提供者沟通得很好或非常好。许多患者强调提供者之间术前沟通的重要性，以确保关键临床信息的传递。
与患者的期望和价值观相反，在一个农村三级中心，外科医生和麻醉师与初级保健提供者很少沟通。这些研究结果将有助于确定优先事项和潜在的解决办法，以弥合住院围手术期和门诊初级保健团队之间的差距。未来的研究应侧重于改善医院和社区提供者之间沟通的策略，以预防并发症和再入院。
