Donna Ron MD (is Clinical Research Fellow, Department of Community and Family Medicine, and Department of Anesthesiology and Perioperative Medicine, Dartmouth Health and Geisel School of Medicine at Dartmouth.), Christine M. Gunn PhD (is Assistant Professor, Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine at Dartmouth.), Jeana E. Havidich MD, MS (is Pediatric Anesthesiologist and Associate Professor, Department of Anesthesiology and Perioperative Medicine, Dartmouth Hitchcock Medical Center and Geisel School of Medicine at Dartmouth.), Madison M. Ballacchino (is Medical Student, Jacobs School of Medicine and Biomedical Sciences, University of Buffalo.), Timothy E. Burdick MD, MBA, MSc (is Associate Professor, Department of Community and Family Medicine, Dartmouth Health and Geisel School of Medicine at Dartmouth, and Associate Professor, Dartmouth Institute for Health Policy and Clinical Practice.), Stacie G. Deiner MD, MS (is Anesthesiologist and Professor, Department of Anesthesiology and Perioperative Medicine, Dartmouth Hitchcock Medical Center and Geisel School of Medicine at Dartmouth. Please address correspondence to Donna Ron)
{"title":"Preoperative Communication Between Anesthesia, Surgery, and Primary Care Providers for Older Surgical Patients","authors":"Donna Ron MD (is Clinical Research Fellow, Department of Community and Family Medicine, and Department of Anesthesiology and Perioperative Medicine, Dartmouth Health and Geisel School of Medicine at Dartmouth.), Christine M. Gunn PhD (is Assistant Professor, Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine at Dartmouth.), Jeana E. Havidich MD, MS (is Pediatric Anesthesiologist and Associate Professor, Department of Anesthesiology and Perioperative Medicine, Dartmouth Hitchcock Medical Center and Geisel School of Medicine at Dartmouth.), Madison M. Ballacchino (is Medical Student, Jacobs School of Medicine and Biomedical Sciences, University of Buffalo.), Timothy E. Burdick MD, MBA, MSc (is Associate Professor, Department of Community and Family Medicine, Dartmouth Health and Geisel School of Medicine at Dartmouth, and Associate Professor, Dartmouth Institute for Health Policy and Clinical Practice.), Stacie G. Deiner MD, MS (is Anesthesiologist and Professor, Department of Anesthesiology and Perioperative Medicine, Dartmouth Hitchcock Medical Center and Geisel School of Medicine at Dartmouth. Please address correspondence to Donna Ron)","doi":"10.1016/j.jcjq.2024.01.006","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><p>Suboptimal communication between clinicians remains a frequent driver of preventable adverse health care–related events, increased costs, and patient and physician dissatisfaction.</p></div><div><h3>Methods</h3><p>Cross-sectional surveys on preoperative interspecialty communication, tailored by stakeholder type, were administered to (1) primary care providers in northern New England, (2) anesthesia providers working in the perioperative clinic of a tertiary rural academic medical center, (3) surgeons from the same center, and (4) older surgical patients who underwent preoperative assessment at the same center.</p></div><div><h3>Results</h3><p>In total, 107/249 (43.0%) providers and 103/265 (39.9%) patients completed the survey. Preoperative communication was perceived as logistically challenging (59.8%), particularly across health systems. More than 77% of anesthesia and surgery providers indicated that they communicate frequently or sometimes, but 92.5% of primary care providers indicated that they rarely or never communicate with anesthesia providers. Some of the most common reasons for preoperative communication were discussion of complex patients, perioperative medication management, and optimization of comorbidities. Although 96.1% of older surgical patients reported that preoperative communication between providers is important, only 40.4% felt that their providers communicate very or extremely well. Many patients emphasized the importance of preoperative communication between providers to ensure transfer of critical clinical information.</p></div><div><h3>Conclusion</h3><p>Surgeons and anesthesiologists infrequently communicate with primary care providers in one rural tertiary center, in contrast to patient expectations and values. These study results will help identify priorities and potentially resolvable barriers to bridging the gap between the inpatient perioperative and outpatient primary care teams. Future studies should focus on strategies to improve communication between hospital and community providers to prevent complications and readmission.</p></div>","PeriodicalId":14835,"journal":{"name":"Joint Commission journal on quality and patient safety","volume":null,"pages":null},"PeriodicalIF":2.3000,"publicationDate":"2024-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Joint Commission journal on quality and patient safety","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1553725024000321","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"HEALTH CARE SCIENCES & SERVICES","Score":null,"Total":0}
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Abstract
Background
Suboptimal communication between clinicians remains a frequent driver of preventable adverse health care–related events, increased costs, and patient and physician dissatisfaction.
Methods
Cross-sectional surveys on preoperative interspecialty communication, tailored by stakeholder type, were administered to (1) primary care providers in northern New England, (2) anesthesia providers working in the perioperative clinic of a tertiary rural academic medical center, (3) surgeons from the same center, and (4) older surgical patients who underwent preoperative assessment at the same center.
Results
In total, 107/249 (43.0%) providers and 103/265 (39.9%) patients completed the survey. Preoperative communication was perceived as logistically challenging (59.8%), particularly across health systems. More than 77% of anesthesia and surgery providers indicated that they communicate frequently or sometimes, but 92.5% of primary care providers indicated that they rarely or never communicate with anesthesia providers. Some of the most common reasons for preoperative communication were discussion of complex patients, perioperative medication management, and optimization of comorbidities. Although 96.1% of older surgical patients reported that preoperative communication between providers is important, only 40.4% felt that their providers communicate very or extremely well. Many patients emphasized the importance of preoperative communication between providers to ensure transfer of critical clinical information.
Conclusion
Surgeons and anesthesiologists infrequently communicate with primary care providers in one rural tertiary center, in contrast to patient expectations and values. These study results will help identify priorities and potentially resolvable barriers to bridging the gap between the inpatient perioperative and outpatient primary care teams. Future studies should focus on strategies to improve communication between hospital and community providers to prevent complications and readmission.
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