How can doctors be better at communicating? Let patients’ families join them on rounds

A recent Globe and Mail article highlights the issue of doctor and patient communication. Solution? Letting the patient’s family join them on medical rounds.

“In reality, the medical staff of most hospital units are usually pulled in a dizzying number of directions – continually investigating treatment options and reviewing medical procedures – all while trying to maintain effective communication with the patient and concerned family members. When emergencies arise, the necessary updating of worried family members can sometimes take a back seat. The addition of language barriers, or various cultural issues involving the relatives or friends of a cardiac patient in our care can further complicate what is already a difficult, emotionally-wrenching scenario.

When we have surveyed family members and patients regarding their experience in our Coronary Intensive Care Unit (CICU,) we sometimes hear that family members occasionally feel out-of-the-loop with regard to a patient’s treatment plan.

To address this, we recently introduced a novel pilot project using a family-centred approach to medical communication. Since the beginning of 2014, we have invited families of patients to accompany us – the medical team – on rounds so that these relatives can hear the health care teams’ detailed discussion about their loved one.

Here’s how it works: When a family first meets the medical team, they are briefed on how the process works, and how we will discuss their loved one’s condition. We invite willing family members to join us daily to listen in on the detailed medical discussion taking place. When running through a patient’s medical issues, we use typically use a “head-to-toe” format reviewing the condition of the brain, heart, lungs, intestines, kidneys, skin and the status of the lines used to monitor the patient and to introduce medications to them. Then, we let family members know what further investigation needs to be done, and describe the treatment plan for the day. When this plan changes, families are informed. During these “rounds,” at least 10 medical professionals are present, including a staff physician, four resident doctors, two nurses, a pharmacist, and a patient care co-ordinator.

Including family members in a patient’s medical briefing allows them to get a realistic perspective of their loved one’s condition, educates them about medical terms, provides them an opportunity to ask questions, keeps them abreast about updates and changes, and allows them to better understand the decisions that health care staff make while treating the patient.

It also affords family members the chance to share this information with the rest of their relatives, and even the patient themselves. Furthermore, if language is a barrier, medical briefings through a family-centred approach allow relatives to convey information directly to the patient in their native tongue. This approach also enables family members to develop relationships with the health care team, giving them the sense that the team is approachable in the care of their loved one.”

Read more about the Globe and Mail article here.

Merck & Co to buy Idenix to boost hepatitis C drugs portfolio

I recent Reuters article reported that Merck & Co Inc said it would buy Idenix Pharmaceuticals Inc IDIX.O for $3.85 billion and plans to combine the two companies’ most promising drugs to produce a faster, more effective cure for hepatitis C.

Merck said it would pay $24.50 per share, more than three times Idenix’s Friday closing price of $7.23.

The payoff for Merck could come from a triple therapy that may cure patients with all genotypes, or strains, of the hepatitis C virus in as little as four to six weeks, its research chief, Roger Perlmutter, said in an interview.

“An ideal therapy means something that works in every hepatitis C-infected patient, irrespective of which genotype,” Perlmutter said. “Our goal is to cure everyone quickly using an oral regimen.”

Read more on the article here.

Canadian hospitals see decline in overnight stays

“The CIHI annual Inpatient Hospitalizations, Surgeries and Childbirth Indicators report, released Tuesday, found that overall the number of hospitalizations across the country has declined steadily over the last five years, with approximately three million in-patient hospitalizations, including around one million surgeries, in Canada last year.”

Read more about this Globe and Mail article here.