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Interpersonal communication in the hospital is an essential part of providing care to patients. It is such an important part of patient care that medical schools and medical training programs consider it to be a core competency on par with medical knowledge and medical care. Every nurse, doctor, physician assistant, and nurse practitioner can distinctly remember sitting through lectures with titles like “Breaking Bad News” and attending in-person training sessions with medical actors with whom we would have to disclose major medical events like a cancer diagnosis. This type of training is and should be a standard part of learning the art of medicine and has remained a focal point of provider-patient communication training. 

What I have realized though, as a practicing emergency physician, is that while this type of training is extremely useful to draw from during rare episodic events – such as a disclosure of major medical illness or family member death – the formality of these discussions is not necessarily instructive or relevant during the day-to-day communications we have with patients and their families. Providing patients and their loved ones with frequent, small pieces of information over the course of an illness, if done well, can be ameliorating, build trust, and improve the overall patient care experience for everyone: families, patients and providers. I would argue that the sum total of the small frequent conversations we have with patients and their families rival the big, formal, summative conversations which occur at the end of a hospital or emergency visit. An example of this type of communication would be: “I wanted to call and let you know that your mom just went down for her CT scan”.  This type of message, while at face value may seem benign and relatively inconsequential, can, as part of an intentional system of frequent communication, bring the family members who are either not present (or as has been the case during the COVID era not allowed to be present) into the care team. This feeling of participation and of having an internal locus of control can be immeasurably valuable.

Improve the patient, family, and clinician experience

The problem of course is time. Doctors and nurses are busy. I will be the first to admit that one of the primary responsibilities I have to triage on very hectic days in the ED is the frequency of my patient and family updates. It’s not that I consider them to be expendable, but I have to prioritize patient care. However, doing so comes at a cost because it’s precisely on busy days – when patient wait times are long and frustrations can mount – that providing those frequent experiential updates carry the most value. Patients deserve to be kept in the loop.They deserve minute-to-minute updates like informing them right away when an important blood test has come back or when their bed is ready.

This is exactly where Vital’s family sharing feature shines. It automatically shares status changes, lab and imaging completions, pertinent ED information, and treatment team communication with the patient and their loved ones. This is a seamless process that over half of the patients in the ED and a quarter of their family members use. The staff don’t have to lift a finger, which is especially nice when things are busy. The experience of having this feature is reassuring for patients, and it decreases the customer/patient experience burden from hospital staff.

Alleviate uncertainty with family sharing

I wanted to share a couple anecdotes from the ED to give you an idea of how the sharing feature is used. The first story happened shortly after we created the family sharing feature. Around this time I was taking care of a young man with a chronic medical condition that unfortunately caused him to have semi-frequent hospitalizations and ED visits. When I went into the room to perform my history and physical, I noticed that he was using Vital. After performing my initial assessment, and seeing that he was stable with the appropriate management in place, I took a moment to ask him if he was using the new family sharing feature. He said that he was using it, and he liked it. I asked him why, and (to paraphrase), he felt that coming to the hospital frequently was hard for him, because he felt the stress and pressure of keeping his family updated at home. He felt like he was always on the phone texting everyone whenever anything important was happening. What he liked about the software automatically updating his family was that he didn’t have to and he could share with as many of them as he wanted. He said: “I can just chill out and try to feel better, and they can see what’s going on without me having to do it”. In essence, the family sharing feature had taken some of the burden of communication off his shoulders, allowing him to focus on himself and healing.  

The second patient story happened one month ago. I was taking care of an elderly woman in the ED. She arrived by ambulance from a nursing home but was stable enough to log in and use the sharing feature to keep her family members updated (although I didn’t know this yet). As is often the case with older patients, I call their family members early in the visit to give them an update and try to get more collateral information about their illness. When I rang the patient’s home phone, her daughter picked up and the conversation basically went like this: Me: “Hello, may I please speak with (patient’s daughter)?” Her: “Is this Dr. Schrager?” Me: “Uh yes, how did you know?” Her: “My phone told me you were her doctor. I mean I got a text message from the ED. Is mom ok?” This was of course just a snippet of the conversation that I had with her, but a great example of the unexpected ways this feature has enhanced and deepened our relationships with our patients. My patient’s family was reassured to know where she was and that a medical doctor was already taking care of her. Personally, I felt like I had skipped forward a step in my conversation with her daughter.  It made my conversation efficient and served as a foundation of trust between us. 

Provide instant updates, automatically

It seems like almost every day I am getting feedback from patient experience leaders in hospitals with quotes about Vital in their patient satisfaction surveys. Like this one: “The website with information about wait times and test results was amazing!!!! It was nice to be able to share it with family to help keep them informed. It was the primary way that I was updated on my treatment throughout the day. Knowing what to expect from the website meant that I didn't need to bother the nurses for updates.” 

Vital provides patients and families with real-time, powerful touch points throughout the course of an ED visit. These frequent updates – such as predicted wait times, lab and imaging status, and follow-up care reminders – provide a tangible, meaningful way for patients and families to stay connected during and after a healthcare emergency. While I typically cannot physically relay these updates to each and every patient who visits the ED, knowing Vital is running in the background ensures my patients are informed, and ultimately, confident and satisfied in their care experience. 

 

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