Importance of Teamwork and Collaboration in Nursing for Improving Patient Care

02.06.20 TigerConnect Healthcare
Importance of Teamwork and Collaboration in Nursing for Improving Patient Care

Healthcare is supposed to be a team effort in which physicians, nurses, nursing assistants, social workers, and other care team members work collaboratively to address patient needs. But that’s not always the case in hospitals, especially given the current talent shortage. Instead, the burden often falls on overworked nurses to track down physicians and get the information they need to care for patients. That’s a waste of clinical time when hospitals don’t have time to spare.

Inefficient communication impedes teamwork and collaboration in nursing, which is frustrating for nurses, who are already bogged down with paperwork and worried they’re not spending enough time with patients. When asked whether they have adequate time with patients, 40 percent of registered nurses said no, and another 20 percent answered ambivalently, according to a 2017 survey by AMN Healthcare.

If only those nurses could pull out the smartphones they’re supposed to leave in their lockers. Then they could text doctors with questions or start a video chat for a quick patient consultation, rather than beeping physicians and playing phone tag. And the next time a patient needs help going to the bathroom, they could text a nursing assistant rather than tracking one down (or deciding it would be faster to do it themselves).

Of course, texting patient information from a personal device is a HIPAA violation, and most nurses know better. To work collaboratively (and securely), they need a clinical communication and collaboration solution that enables HIPAA-compliant, multichannel communication.

3 Barriers to Teamwork and Collaboration in Nursing

Most nurses get into the profession to help people, and 73.7 percent say they genuinely care about the success of their hospitals, according to the PRC National Nursing Engagement Report. Yet, only 45.1 percent of registered nurses report being fully engaged (36.8 percent of millennials), and 18 percent are looking for another job. Worse yet, nearly half (49 percent) of nurses have considered leaving the profession altogether over the past two years, according to travel nurse staffing agency, RNnetwork.

Why are so many hospital nurses dissatisfied, disengaged, and daydreaming about early retirement? Because they’re outnumbered, overloaded, and overwhelmed.

1. Outnumbered by Patients

The healthcare industry is now experiencing the talent shortage that experts have long predicted, and it will only get worse in the coming years. By 2032, the population will have grown 10 percent, and a third of currently active doctors will reach retirement age, leaving the U.S. short 122,000 physicians, according to the Association of American Medical Colleges. At the same time, patients are getting older and more dependent on healthcare professionals. By 2030, seniors will account for 35 percent of the population, versus 28 percent in 2020, according to the last census.

With more sick patients and fewer doctors to treat them, the burden will increasingly fall on nurses to pick up the slack, but there aren’t enough of them either. As patient populations grow and Boomer nurses retire, the U.S. will need an additional 203,700 new registered nurses each year through 2026 to meet the increased demand, according to the American Association of Colleges of Nursing.

As hospitals increasingly operate with short staff, they’ll need remaining healthcare professionals to be more productive and more collaborative than ever — which means they’ll need better communication tools.

2. Overloaded with Communications

Traditional analog communication tools such as beepers and landline phones can make it hard for nurses to reach physicians, but while they’re trying to get a message through to doctors, a plethora of messages are coming their way. The overhead paging system directs them from one room to the next, while the landline phones at the nurses’ station ring and ring. Meanwhile, alarms from nurse call systems and bedside telemetry sound off tens of thousands of times a day throughout the average hospital, according to the Joint Commission.

Between 85 to 99 percent of those alarms don’t require medical intervention, but some need the nurse’s attention immediately. Yet, without digital communication tools, the nurses don’t always know the difference until they get to the room, and the sheer volume of alarms can have a desensitizing effect which leads to care delays that threaten patient safety.

A clinical communication and collaboration solution can be integrated with bedside equipment and nurse call systems to filter out false alarms and prioritize patient requests. It can also reroute requests the nurse doesn’t need to handle — for example, tasks that could be done by nursing assistants or another care team member.

3. Overwhelmed by It All

Nurses are overwhelmed by the workload, the communications, and the paperwork. Not only does this affect performance, but it can also affect their mental health. In the PRC study, 15.6 percent of nurses reported burnout, while 41 percent of unengaged nurses reported feeling that way. In a 2017 survey of registered nurses by Kronos Incorporated:

  • 85 percent said their jobs make them fatigued overall
  • 63 percent had experienced nurse burnout
  • 44 percent worried that their tiredness could compromise patient care
  • 41 percent had considered changing hospitals in the past year due to burnout

Nurse burnout and disengagement isn’t just a problem for nurses; it’s bad news for hospitals and patient safety.

The High Cost of Poor Communication

Hospitals have two major communication challenges — communication overload and communication gaps. Both make it hard for healthcare teams to work collaboratively on improving patient care. That makes work harder for nurses, who are usually tasked with coordinating communication between physicians, specialists, radiology, social workers, and everyone else involved in treating any given patient.

Without implementing technology to address communication challenges, hospitals risk the following:

  • Nurse turnover: Replacing a single nurse costs between $37,700 to $58,400, according to the 2016 National Healthcare Retention & RN Staffing Report. Overall, nurse turnover costs hospitals $5.2 million to $8.1 million a year. Faced with a nursing shortage, many hospitals must fill the gaps with temporary nurses, who cost considerably more than full-time employees.
  • Medical errors: Communication delays and mistakes account for 30 percent of malpractice claims made against U.S. healthcare organizations, according to a CRICO review of nearly 24,000 cases. Among the 30 percent of errors that were communication-related, 7,149 patients were harmed, 1,744 died, and organizations paid $1.7 billion in malpractice costs. Nurse burnout also takes a high toll on patient safety and is associated with higher rates of both patient mortality and more frequent dissemination of hospital-acquired infections.
  • Higher readmissions: Nurses are responsible for patient education and for ensuring that patients have all the information and resources they need to heal at home. If nurses don’t have the resources they need from other healthcare team members, and if they don’t have time to provide thorough disease management education, patients are more likely to end up back in the hospital. That’s a problem, considering that CMS’s Hospital Readmission Reduction Program penalizes hospitals up to three percent of all Medicare reimbursement for the following year if they readmit too many patients. On the other hand, at least one-quarter of hospital readmissions could be prevented if hospitals “improved communication among health care teams and between health care professionals and patients, [paid] greater attention to patients’ readiness for discharge, enhanced disease monitoring, and [provided] better support for patient self-management,” according to a study conducted by 12 leading academic medical centers.
  • Lower HCAHPS scores: The Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey also ties CMS reimbursement to patient satisfaction and engagement. Low HCAHPS scores can cost hospitals up to 2 percent of all CMS reimbursements. So, if a hospital discharge takes too long or patients don’t get what they need as quickly as they think they should have it, HCAHPS scores go down (and so does revenue). If patients don’t feel prepared for discharge or don’t think they got enough facetime with physicians and nurses, HCAHPS scores go down. On the other hand, improving patient engagement and satisfaction leads to higher HCAHPS scores, which can earn hospitals additional incentive funds.
  • Costly inefficiencies: Communication gaps and delays cost the average 500-bed hospital more than $4 million per year in lost productivity, according to the University of Maryland.

The cost of using outdated communication tools is too high. How can hospitals improve teamwork and collaboration in nursing?

Calling for Backup: How Clinical Communication & Collaboration Solutions Bridge Gaps

Studies show that successful inter-professional collaboration helps hospitals increase patient satisfaction, improve patient outcomes, reduce medical errors, expedite treatment, reduce inefficiencies and costs, and improve staff relationships and job satisfaction. That collaboration happens seamlessly when clinicians have smartphone-based clinical communication solutions that are integrated with the EHR and other key hospital information systems. Physicians can access lab results and other relevant information on the go, and nurses can get in touch with them using whatever channel makes the most sense for the situation.

Yet, in most hospitals, healthcare teams still communicate via analog technology such as landlines, pagers, and fax machines. According to TigerConnect’s State of Healthcare Communications 2019 Report, nearly 90 percent of healthcare organizations use fax machines, and 39 percent use pagers for physician communication. It’s not surprising that the majority of healthcare organizations – 52 percent – experience communication breakdowns that affect patients daily or multiple times a week. On the other hand, hospitals using clinical communication and collaboration solutions organization-wide are 50 percent less likely to have regular communication disconnects.

Inter-professional collaboration shouldn’t be so hard, and nurses shouldn’t be getting burned out because they don’t have the resources they need. With a clinical communication and collaboration solution in place, the rest of the care team is just a text message or video chat away.

The State of Healthcare Communications Report

State of Healthcare Communications Report

 

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