J Clin Outcomes Manage
Communication amidst chaos: challenges to patient communication in the emergency department
Engel KG, Buckley BA, McCarthy DM, Forth VE, Adams JG
Abstract Objective: To examine the critical stages within the emergency department (ED) care process that require effective patient engagement and offer suggestions for enhancing communication. Methods: Review of the literature and a description of techniques for improving communication. Results: There are 4 main junctures during the ED care process that have critical communication requirements: (1) at intake, when the patient first enters the ED from home or as a transfer from another facility; (2) during assessment; (3) at the point of development of the treatment plan; and (4) at discharge or admission to the hospital from the ED. Transitions in care, such as discharge from the ED, are especially high-risk times for communication failure and, in turn, adverse patient events. To improve communication with patients at discharge, we need to define the information they need to care for their condition at home and consider how this information can best be provided. Our research group has created diagnosis-specific discharge instructions for several common diagnoses based on input from emergency providers, relevant subspecialty providers, and communication and literacy experts. Conclusion: Identifying and addressing problems with communication are essential to providing safe, high-quality patient care in the ED. An enriched dis-charge process may lead to positive downstream effects on ED recidivism and patient outcomes.
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