I was taken aback by her response. I decided to talk with the nurses about the collaborative qualities of physicians at other hospitals where they worked. Many of the nurses at this hospital were seasonal because it was during the high season when the population swells. I asked about their experiences working in other states. The nurses told me that at other hospitals, where they worked during the summer months, physicians were much more collaborative—asking their opinions, listening to their comments and incorporating their recommendations.
However, at the hospital where my sister was being treated, they found it a stretch to label the physicians collaborative. During rounding, the hospitalists dictated to the nurses and others in the meeting; however, there was very little discussion from any of the participants, other than answering the doctors' questions.
In the middle of the night before my sister died, I heard her nurse whispering on the phone. After a few minutes she handed me the phone. My sister's doctor told me that “comfort care” was all that they could do for her. After I recovered from the shock, I asked the nurse what she had been whispering to the doctor. She told me that she had expected my sister to die the previous night, which floored me, because I had no idea that her condition had deteriorated so much based on previous conversations with her doctors.
Given she works in a hospital with little collaboration between doctors and other staffers, I applaud this nurse who had the courage to confront the doctor, who then prepared me for the next hours before my sister died.
I've spoken to caregivers around the country about the role of collaboration, the foundation of which is great communication. They know that communication skills are one of the most important drivers of a positive patient experience.
One example is Sound Physicians, based in Tacoma, Wash. The practice, whose 800-plus hospitalists partner with more than 80 hospitals around the country to provide inpatient services, is piloting physician-nurse team rounding that emphasizes communication. According to Dr. Mark Rudolph, vice president of patient experience and physician development, scores on the Hospital Consumer Assessment of Healthcare Providers and Systems survey have improved, often by sustained increases of more than 5%, on those floors where the communication and collaboration initiative was implemented. The rounding process also adds to the value of nursing staff surveys, which are conducted annually to provide physicians with feedback about their communication skills.