Can We Talk? Priorities for Patient Care Differed Among Health Care Providers

Objective: Poor communication and collaboration between members of a patient’s health care team can result in medical errors and poor quality of care. The purpose of this study was to assess communication and consensus regarding patient care goals between members of the health care team (physicians, registered nurses [RNs], and patient care technicians [PCTs]) caring for the same patient on a given day. Methods: Frequency of communication and agreement on priorities for patient care were measured among team members. Four hundred thirty-seven inpatients were randomly selected from six nursing divisions in an acute care tertiary hospital, and the responsible physician, RN, and PCT were identified. Each health care provider was interviewed midmorning and midafternoon. Each provider was asked to identify other team members and to describe the top three priorities for the care of the individual patient. Results: Midmorning, 23 percent of physicians could name the RN caring for their patient and 42 percent of RNs could name the physician responsible for the same patient. Midafternoon, approximately 50 percent of physicians and RNs reported discussing the patient with each other, while over 90 percent of RNs and PCTs had discussed patient care with each other. There was full agreement on patient priorities between the physician and RN in 17 percent of cases, partial agreement in 53 percent of cases, and no agreement in 30 percent of cases. Agreement between physicians and RNs was higher than the agreement between RNs and PCTs. Conclusion: Our findings show that the priorities of patient care differed between members of the health care team, and that verbal communication between team members was inconsistent.