ev822

Physicians and staff work well together.

Survey Domain: Organization

Survey Theme: Organizational Alignment

Understanding the Issue: The first step is to understand the issues behind the survey performance scores. Unless you are absolutely sure that you understand the issues related to a particular survey item, the best place to start is identifying them, and the section Understanding Issues can help you do so. The activities described in Understanding Issues can be used for any of the survey items.

Breakdowns in communication and work processes often contribute to a low score on this item. The quality of the healthcare service provided also impacts how well physicians and staff work together.

Improvement ideas:

Perceptions of what has, or has not, improved will often be unit-based. When assessing results, employees' perceptions will be based on their understanding of what improvement goals were set and what the expectations are for specific outcomes. Therefore, goals and expectations must be clearly communicated.

1. When planning interventions on this item that involve physicians, get a physician advocate to partner with you in your communications. Physician response tends to be much more positive when a colleague is a part of communication with them.

2. Improve communication with physicians. When communications are inaccurate or incomplete, relationships between physicians and staff are greatly impacted and may suffer as a result.

   1. Encourage staff to be sure that they have fully understood a physician's directions and instructions. Advise your staff to ask the physician to confirm any part of the instruction they may have misunderstood.

   2. Be sure that communications to physicians are timely and accurate. This action will instill confidence among the physician group in general while improving their relationships with staff.

   3. Provide physicians (staff physicians) with a pocket card that lists key phone numbers (laboratory, radiology, etc.) that they may need to access while treating patients at your facility. This contact list will reduce the assistance that staff must provide to physicians and create a more efficient means of communication for the physician.

   4. Provide phone lists to referring physicians periodically so that they may easily reach key departments in your organization. This action will ease communication barriers and create a good sense of working relationships between physicians and staff.

3. Consider having an outside facilitator meet with your employees to help you learn more about your low score. Since this topic can be sensitive, begin with separate focus groups, one for physicians and one for your unit's staff, with the following agenda:

   1. Create a list of accidents, mistakes, and performance problems related to patient treatment.

   2. Talk about how communication breakdowns may contribute to the problem.

   3. Create a goal for the top one or two communication issues identified.

   4. Ask for help from physician and patient care leaders in bringing the two groups together to make specific plans for creating improvement on the goal.

4. Consider using an outside facilitator and a physician advocate to help you design and implement team-building activities.

5. Be sure that physicians and staff understand the quality improvement efforts your organization is pursuing.

6. Research shows that physicians and staff work much more harmoniously in environments that encourage error-free and compassionate care. Be sure that physicians understand the ways through which your organization attempts to eliminate errors and provide compassionate care to all customer groups. Be sure that staff understand and practice the same initiatives.

(MI 822)