Inefficient Communication from the OR can Cost Thousands

Introduction

Effective communication in healthcare is crucial for providing quality care to patients. One area where communication is important, yet often overlooked, is between the operating room (OR) team and the patient’s family. Inefficient communication from the OR to the patient-family can result in significant costs in terms of time and resources. This whitepaper will explore how poor communication from the OR is an addressible problem for perioperative teams, and how the cost of running an OR every minute exacerbates the impact of inefficient communication.

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Identifying Inefficient (and Ineffective) Communication

Inefficiencies in provider-to-family communication can manifest in several ways. First, the inherent process to deliver an update to the family is often too input-intensive. To provide a simple progress update to the family, a provider in the OR may need to exit the OR, locate the family, and communicate with them face-to-face. Or similarly, the provider in the OR may need to pick up the phone and dial a registration staff-member or admitting clerk to relay a message to the family. This mechanism has drawbacks:

• Requires taking a provider away from their current responsibility
• Depending on if the message is delivered in person, it may welcome additional questions from the family, at a time where it is unrealistic for the provider to adress them at this time.
• Depending on if the message is delivered over the phone, a situation of phone-tennis may arise, leading to further distraction and time-waste.

Due to the high-input needed to deliver an update, staff may sometimes opt to disregard family communication in order to focus on patient-care. While this is understandable, this does leave the family in the dark. At which point, the family members will take it upon themselves to ask the admission staff for an update, who then needs to phone the OR. In these cases, proactive upfront communication saves time for the staff downstream.

It’s also worth noting that as inefficient as in-person and over-the-phone updates are, they also can lack in efficacy. Verbal communication, especially those littered with medical jargon, can be misinterpreted by family members. Patient experience teams are well aware that a common complaint about inaccurate communication from the medical staff, was actually just their own family sharing inaccurate information, without knowing it. Overall, it is important to acknowledge that verbal communication has an appreciable misinterpretation rate.

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Cost of Inefficient Communication

These high-effort communications, questions from family, and phone-tag can lead to delays in patient care and longer OR times. Inbound phone calls from the family or the admission desk can cause interruptions in the OR and divert the attention of the OR team away from the patient.

Another situation to note is when the physician is delayed entering the OR due to an extended communication with the prior surgical patient’s family. If a family didn’t recieve consistent communication throughout the perioperative process, they are more likely to take much more of the physician’s time in their post-surgery conversation. This can lead to a delay in getting the physician back into the OR to start on the next operation. This can lead to a domino effect of OR delays and decreased patient throughput.

Exacerbating all these losses of time and focus, is the large cost of maintaining an OR every minute. According to a 2015 study published in the Journal of Clinical Anesthesia, the cost of running an OR can range from $10 to $60 per minute, depending on various factors such as the type of surgery, the complexity of the procedure, and the staffing and equipment needs. This monetary impact makes clear the critical need to optimize the efficiency of OR operations.

As such, inefficient communication from the OR can have a significant financial impact on hospitals. In the OR, saving just 5 minutes can equate to savings of over $200. Depending on a hospital’s OR capacity, optimizing communication to shave off a few minutes during every procedure can save thousands of dollars per week, and hundreds of thousands annually.

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Recommendations for Improving Communication

To improve communication from the OR to the patient-family and optimize the efficiency of OR operations, hospitals should consider implementing the following strategies:

1. Develop a standard communication protocol: Hospitals should establish a standard communication protocol for the perioperative care team to follow when communicating with patients and their families. This protocol should include guidelines for when and how to communicate with the family, what information should be provided, and who is responsible for communicating with the family. This makes it clear at which points the staff should initiaite a communication to the family, and in time the protocol leads to habitual consistency and reliability.
2. Use technology to improve communication: Hospitals should leverage technology to improve communication with patients and their families. This can include using text messaging or secure messaging platforms to provide updates on the patient's progress. The nature of text-based messaging alleviates the potential misinterpretation that verbal methods encounter. Technology also works at scale — meaning every piece of communication can reach the entire patient-family at once, as to reduce the number of family members making phone calls into the hospital.
3. Assign a dedicated staff member to communicate with the family: Depending on the clinical context, care teams should consider assigning a dedicated staff member to communicate with the patient's family throughout the surgery. This can help ensure that the family is updated regularly on the patient's progress and can free up the surgeon and OR team to focus on patient care. This is often seen in the role of a Circulating Nurse.

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Familyfirst as a Proposed Solution

Concrete solutions to the problems outlined in this whitepaper may come in all different forms; new policy, protocols, workflows, or technology. But perhaps the most effective, would be a blend of these changes. Depending on your organizations prorities, Familyfirst’s own technology may be best positioned to optimize OR communication to the family.

• Text-based - Text is more digestable, and can be re-read many times by family members.
• Staff-friendly - Send an update in seconds, and return focus to the patient
• One-way - Only the medical staff can send messages. The family interface is read-only, in order to reduce distractions to the medical staff.
• Scale - As many family members as the patient consents, can join the conversation. So you can update the entire family with one message.
• Secure - The messages always stay within our enclosed and HIPAA compliant applications and cloud storage, unlike SMS-based solutions.
• Automatic Language Translation - For non-english speaking families, there is no longer the need to have a translator on the line.

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Conclusion

Inefficient communication from the OR to the patient-family can result in significant costs in terms of time and resources, especially when considering the high cost of running an OR every minute. Hospitals can reduce these costs by establishing a standard communication protocol, and leveraging capable technology to improve communication.

By improving communication from the OR, hospitals can provide better care to their patients and their families, all while reducing costs and increasing efficiency.