Physician–Physician Communication: What’s the Hang-up?

Dunn, Andrew; Markoff, Brian

doi:10.1007/s11606-009-0913-0

Cited by 27 publications

(23 citation statements)

References 16 publications

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“…Three major barriers to communication were identified: being too busy, perceiving a lack of benefit, and not knowing whom to contact [32,33]. The last of these cannot be considered in our study, because the pharmacy department was correctly identified on the BPMDL and the questionnaire.…”

Section: Discussionmentioning

confidence: 91%

Medication at discharge in an orthopaedic surgical ward: quality of information transmission and implementation of a medication reconciliation form

et al. 2016

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Background Medication reconciliation (MedRec) at discharge is a cumbersome but necessary process to reduce the risk of medication errors at transitions of care. The main barriers to implementing such a process are the large number of professionals involved and a lack of collaboration among caregivers. Objective This study was designed to assess the need for a medication reconciliation form at discharge in an orthopaedic surgical ward. Setting The study was conducted in the orthopaedic surgery ward among inpatients at a 407-bed French teaching hospital. Method We first performed a retrospective audit to evaluate the quality of discharge medication information in the medical record, after which a 5-week prospective study was conducted in 2013. All patients admitted to the orthopaedic surgery unit who had at least two chronic diseases and three medications underwent MedRec at discharge. We designed a Best Possible Medication at Discharge List (BPMDL) to be completed by hospital staff and transmitted to community caregivers. Mean outcome measures We assessed the completeness of medication information in the medical records, discrepancies between medications noted on the BPMDL and those prescribed on the discharge order, and the value of the BPMDL for stakeholders. Results Thirty patients were included in the study. Only 4 % of medical records contained a discharge summary with complete medication information. In 67 % of cases, treatment discontinuations at admission were justified, and medications were reintroduced before discharge, while 107 treatments (45 %) were added but not prescribed on discharge orders. Discontinuations prior to discharge were justified in 60 % of cases (treatments were ended or supportive treatment was required during hospitalization). An average of 2.1 treatments were prescribed on discharge orders (vs. 9.4 prescribed on the BPMDL). Patients, general practitioners (GP), and physicians in long-term care settings (PLTCS) rated the format, content, and readability of the BPMDL as satisfactory, and it was found to be of value for patients and PLTCS to support medication information. Because of the very low response rate among GP (10 %), we were unable to determine their satisfaction with the MedRec discharge process. Conclusion The transmission of patient medication information at discharge is often lacking. As such, the BPMDL appears to have value to both patients and community health providers. Because this study was conducted within a single surgical unit, further study in other surgical wards is needed to assess generalizability.

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Section: Discussionmentioning

confidence: 91%

Medication at discharge in an orthopaedic surgical ward: quality of information transmission and implementation of a medication reconciliation form

et al. 2016

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“…25,26 Although a third to half of respondents felt that HIV-infected patients were more likely to have poor performance status, more comorbidities, and be nonadherent to cancer treatment (items clustered together into factor 1, which we called provider perceptions), these views were not associated with delivery of standard cancer treatment on multivariable analysis. This finding is reassuring, because it suggests that the observed lack of cancer treatment is largely driven by concerns about toxicity and efficacy, which may be modifiable with policy change, guideline modification, and improved care coordination.…”

Section: 24mentioning

confidence: 99%

Cancer Treatment in Patients With HIV Infection and Non–AIDS-Defining Cancers: A Survey of US Oncologists

Suneja

Boyer

Yehia

et al. 2015

JOP

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Purpose: HIV-infected individuals with non-AIDS-defining cancers are less likely to receive cancer treatment compared with uninfected individuals. We sought to identify provider-level factors influencing the delivery of oncology care to HIV-infected patients. Methods:A survey was mailed to 500 randomly selected US medical and radiation oncologists. The primary outcome was delivery of standard treatment, assessed by responses to three specialty-specific management questions. We used the 2 test to evaluate associations between delivery of standard treatment, provider demographics, and perceptions of HIV-infected individuals. Multivariable logistic regression identified associations using factor analysis to combine several correlated survey questions.Results: Our response rate was 60%; 69% of respondents felt that available cancer management guidelines were insufficient for the care of HIV-infected patients with cancer; 45% never or rarely discussed their cancer management plan with an HIV specialist; 20% and 15% of providers were not comfortable discussing cancer treatment adverse effects and prognosis with their HIV-infected patients with cancer, respectively; 79% indicated that they would provide standard cancer treatment to HIV-infected patients. In multivariable analysis, physicians comfortable discussing adverse effects and prognosis were more likely to provide standard cancer treatment (adjusted odds ratio, 1.52; 95% CI, 1.12 to 2.07). Physicians with concerns about toxicity and efficacy of treatment were significantly less likely to provide standard cancer treatment (adjusted odds ratio, 0.67; 95% CI, 0.53 to 0.85). Conclusion:Provider-level factors are associated with delivery of nonstandard cancer treatment to HIV-infected patients. Policy change, provider education, and multidisciplinary collaboration are needed to improve access to cancer treatment.

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“…[2][3][4] Much of this communication has shifted mediums from handwritten notes and face-to-face conversations to mobile platforms such as email and text messaging. 5 These technologies offer ease, but their effect on clinical outcomes is unknown.…”

Section: Introductionmentioning

confidence: 99%

Change In Length of Stay and Readmissions among Hospitalized Medical Patients after Inpatient Medicine Service Adoption of Mobile Secure Text Messaging

Patel

Small

et al. 2016

J GEN INTERN MED

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Physician–Physician Communication: What’s the Hang-up?

Cited by 27 publications

References 16 publications

Medication at discharge in an orthopaedic surgical ward: quality of information transmission and implementation of a medication reconciliation form

Medication at discharge in an orthopaedic surgical ward: quality of information transmission and implementation of a medication reconciliation form

Cancer Treatment in Patients With HIV Infection and Non–AIDS-Defining Cancers: A Survey of US Oncologists

Change In Length of Stay and Readmissions among Hospitalized Medical Patients after Inpatient Medicine Service Adoption of Mobile Secure Text Messaging

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