Have you ever been to the hospital and were seen by a myriad of providers, including ER physicians, nurses, specialists, and assistants? Did they seem to be working together or did the transition process seem disjointed? When you left the hospital, were you given clear instructions for what medications you need to take and the dosage, and symptoms to watch out for? It’s critical for health care providers to treat patients with dignity and respect, work as a team, and help them transition to the next phase of their recovery.
According to the Agency for Healthcare Research and Quality (AHRQ), “care coordination involves deliberately organizing patient care activities and sharing information among all of the participants concerned with a patient’s care to achieve safer and more effective care.” The goal is to the meet the patient’s needs and preferences and communicate that to the right people in order to deliver high-quality, high-value health care.
Why is coordinated care important? Without good coordination of care, risks for medical error rise significantly. The patient and providers are confused or lack information about a health situation which can make a bad situation worse. Use these five Consumer Reports tips to make sure your doctors are doing the right thing:
1. Have a primary care doctor
If you have more than one chronic condition, you’re likely to see more than one doctor. The more complicated your health, the more health care providers enter the mix. A primary care physician (PCP) can help facilitate the sometimes choppy communication among your specialists. You can ensure that your PCP is in the loop by asking each specialist to send your records and visit notes to him or her.
2. Pick a care coordinator
As of January, doctors can bill Medicare for time spent coordinating care for patients with multiple chronic conditions. The doctor most involved with your care may be the right choice (you can choose only one), but it’s up to you. Your doctor may bring up the subject, but if not, simply ask whether he or she will serve as your designated medical-care coordinator.
3. Keep copies of your medical records
If you are prescribed medications by more than one health care provider or through more than one physician network, keep a folder of your medical information and take it to all appointments. If a provider isn’t up to speed, you can quickly share important facts on tests, treatments, and more. What to keep in the folder: a current list of your medications and supplements, and any allergies, major illnesses, hospitalizations, and surgeries you’ve had. If possible, double-check your doctor’s patient portal after visits to make sure your information is correct.
4. Get and share test results
When my patients don’t get the results of medical tests quickly, they often assume all is fine. Don’t make that error. Every doctor’s office has had organizational systems fail. In fact, in a 2013 study, almost a third of PCPs reported having personally missed test results that led to delays in care. So when you have a test or procedure, ask when you can expect results. If you’ve heard nothing within the expected time, call the office. If you can’t access results online, request a hard copy of the report and add it to your health folder. And ask that your PCP and other doctors—as needed—receive the results, too.
5. Know when communication is most critical
At hospital discharge, patients are especially vulnerable to adverse drug events, misunderstandings about care instructions, and preventable readmissions. That’s why you should have a clear discharge plan, which notes which medications to continue and discontinue and when and with whom to schedule your follow-up visits, how wound or incision dressings will be cared for at home, and when a catheter needs to be removed. That information should be relayed to you and family members before you leave the hospital, and to your PCP (who may not be in charge of your care while you’re hospitalized) and specialists in as timely a manner as possible.
Make coordinated care your goal! Watch this IHI Open School video for proof that coordinated care can lead to the best outcome for a patient.