Article type
Year
Abstract
Background: Evidence-based health care (EBHC) has traditionally focussed on clinical care. The growth in publication of systematic reviews of interventions to improve communication with, and involve the participation of, patients and their families in health care provides an opportunity to extend the concepts and practices of EBHC to quality improvement on communication problems. A 1-year pilot project in Melbourne, Australia, was funded by the Victorian Quality Council to explore the feasibility of improving communication practices in hospitals.
Objectives: To develop a systematic approach to incorporating into quality improvement activities the evidence of effectiveness of interventions to improve communication with patients and their families.
Methods: Pilot study, involving university-hospital partnerships, quality improvement processes and analysis of systematic reviews and trials.
Results: Three large metropolitan hospitals (two general, one specialist women's) volunteered to participate, in collaboration with the Cochrane Consumers and Communication Review Group (CCCRG). Each site assembled a working group, gained support from senior managers and clinicians, and undertook a diagnostic analysis of data under direction from CCCRG project officer. Issues chosen for quality improvement were: communication issues in the preoperative stage of day surgery; decision making for vaginal birth after caesarean section; and communication with consumers from culturally and linguistically diverse backgrounds in the emergency department. The communication pathway for each issue was mapped. The CCCRG project officer then searched for, selected, appraised, and translated the evidence relevant to addressing the local problem. Each hospital is responsible for implementing the change strategies identified.
Conclusions: The project highlights the impact of effective communication to high quality and safe health services and has provided valuable insights into how evidence of effectiveness can be applied to quality improvement processes. Using an evidence-based approach to addressing communication issues is feasible. This project provided the basis for the development of a framework for applying evidence about effective communication in health care provision into practice.
Objectives: To develop a systematic approach to incorporating into quality improvement activities the evidence of effectiveness of interventions to improve communication with patients and their families.
Methods: Pilot study, involving university-hospital partnerships, quality improvement processes and analysis of systematic reviews and trials.
Results: Three large metropolitan hospitals (two general, one specialist women's) volunteered to participate, in collaboration with the Cochrane Consumers and Communication Review Group (CCCRG). Each site assembled a working group, gained support from senior managers and clinicians, and undertook a diagnostic analysis of data under direction from CCCRG project officer. Issues chosen for quality improvement were: communication issues in the preoperative stage of day surgery; decision making for vaginal birth after caesarean section; and communication with consumers from culturally and linguistically diverse backgrounds in the emergency department. The communication pathway for each issue was mapped. The CCCRG project officer then searched for, selected, appraised, and translated the evidence relevant to addressing the local problem. Each hospital is responsible for implementing the change strategies identified.
Conclusions: The project highlights the impact of effective communication to high quality and safe health services and has provided valuable insights into how evidence of effectiveness can be applied to quality improvement processes. Using an evidence-based approach to addressing communication issues is feasible. This project provided the basis for the development of a framework for applying evidence about effective communication in health care provision into practice.