Provider-patient communication in hospitals is more difficult today for a variety of reasons. First, the patient’s stay in the hospital is much shorter today, averaging just over 3 days. A few decades ago, patients would typically stay in the hospital for a week or more, providing plenty of time for daily interaction with doctors, nurses, and therapists. There was more time and more opportunity to achieve strong communication. Everything is rushed in today’s medicine. Nobody likes that, but it is reality. Medicare, Medicaid, and managed care organizations set strict limits on length-of-stay, and those limits are not going away any time soon.
Today’s medical care is also much more complex. There is simply more information for patients and families to understand now and more to comprehend. Combine the short length-of-stay with the complexity of care, and add in the fact that caregivers themselves are much busier than we were in the past, and you get the idea. It is harder to achieve mutual understanding with patients now.
We must achieve exactly that before we discharge the patient home or transfer them to another facility. Safe transitions to home, the nursing home, or to a rehabilitation center are so important. These transitions are also our greatest area of risk for patient safety. The history of U.S. health care has seen so many problems at the time of “handoff,” when one caregiver passes responsibility for the patient’s care to another. We must do better at these times of transition