Structure as communication vehicles

Another way to view structure is to consider the means in which different roles in a practice communicate.

What are the structures for communication?

This of chapter does not apply only to care management, but all roles in a practice that need to communicate to get work done. It is especially important in care management, however, because the care manager is usually not working independently, but in coordination with others to make sure patient care needs are met. There is really no right or wrong here either in terms of how communication can occur; however, consider the need for documentation, how to reduce burden, and how to make sure important parts of communication do not “fall between the cracks” and get lost. We have found that flexible and multiple types of communication are useful. Here are some things to consider having in place:

  • Meetings – Once a week or once a month meetings are useful for considering the big picture, studying data/results, getting broad input, and making decisions together. If there are regular Patient-Centered Medical Home or Quality Improvement meetings, the care manager should be included. Meetings are a great way for key members of the team to consider
    bigger or process issues with care management.
  • Huddles – Huddles are shorter, mini-meetings to address issues coming up that day. Often they are at the beginning of the day with the mini-team(provider, care manager, medical assistant) to discuss what is happening that day and to make everyone aware and on the “same page.” This is also a good time to identify potential patients coming in that day who may benefit from care management.
  • Patient team conferences – “Sit down” meetings in which the provider, care manager, and other key care team members discuss quality metrics associated with the population, utilization metrics, patients’ treat-to-target status, and where the patients are in the care management process.
  • Hallway talks – Brief exchanges usually between two team members about a specific patient care issue. Often they are to follow-up and make quick decisions or refer back and forth.
  • EMR messaging – Sending communication through the EMR. Key advantage: documentation. You can also attach a patient chart so it provides the context of the patient in question.
  • Structured communication that is efficient and effective. Consider using a tool such as SBAR (situation, background, assessment, recommendation). This aids in knowing the direction the care management is going.
  • Good ol’ post-it notes – Much like hallway talks, but when you can’t reach each other

By Complete Care Management, Inc.