Deconstructing the Tower of Babel

I’ve spent the week immersed in this communication dilemma in healthcare.   As I’ve said before, I’m amazed that any communication occurs in healthcare – a constant unfolding Tower of Babel. Way too big of a topic. Let’s narrow (as the solar system is a narrowing of the universe) to communication across thresholds and boundaries. Some examples:

1. Between clinicians (same profession, same agency, same department): such as nurse to nurse, doctor to doctor, shift to shift, day-to-day
2. Between professionals (different profession, same agency, same department): such as nurse to doctor, therapist to doctor, counselor to nurse, paramedic to nurse)
3. Between clinician and patient or family caregiver (within a hospital stay or clinic visit or community setting)
4. Across departments or levels of care (inpatient, rehab, home, clinic, emergency, intensive and long-term care,  are all levels of care) within a hospital, clinic, or system: such as clinician to clinician, direct care or support staff to anyone
5. Across levels of care (everything in 4. above plus jail, homeless shelter, community residence, supported living)  sometimes called discharge planning, care management, consultations, questions involving just about anyone in the center of care.

OMG, my head’s about to explode. This solar system is HUGE. Why would anyone think this could work smoothly?  But it has to. This is my life and well-being , yours, my honey’s. It’s at the root of overuse, underuse, misuse of health resources, variation in treatment (called compliance or adherence by some),  harm, waste, burnout, stress, and frustration. In emergency management (disaster planning), communication is key. Communication has an infrastructure for planning, operations, and learning. Yet disasters, by their nature, happen rarely, albeit with great impact on lives, communities, suffering, and resources. Healthcare communication across thresholds and boundaries happens billions of time a day with even greater cumulative impact on lives, communities, suffering and resources.  How can this not have an infrastructure for planning, operations, and learning? Phew, more to come. Hang on.