Communicating with Staff

Communicating about a Patient's Condition

Any communication or handover regarding any unwell patients must be verbal: either face to face or over the telephone. The use of text messaging or other electronic means of communication for handover of unwell patients is not permitted

Communicating with SMOs

Always communicate any concerns about patients to Senior Staff. They can only accept responsibility for patients if they are kept informed.

Communicating with RMOs

When going off duty, brief the RMOs taking over about any seriously ill or recent acute cases in their wards. You must also make arrangements with them for carrying out any treatment which has been ordered.

Before you leave a ward, check with the senior nurse to see if there are any other patient problems that need addressing, for example:

• To ensure sufficient IV fluids for overnight are charted before you depart.
• To assist your colleagues on evening and night duties.

Otherwise you may be called back to the ward.

Never, under any circumstances, remove items of equipment from the wards.

Always leave your pager in the hospital for relief staff covering your duties while you are on planned or unplanned leave.

Communicating with General Practitioners

Contacting General Practitioners

Hospital admissions are a moment in people's lives - but general practitioners and general practice nurses have often known their patients for many years, and it is easy and worthwhile to communicate with them. You can contribute positively to the care of your patients and possibly shorten their stay in hospital by communicating well with the general practice team.

• Together with the nursing team and your consultant, plan the date of discharge early in the patient's admission.
• Call the patient's general practitioner when you need further information, when there are difficult decisions to make about the patient's care, and when discharge is planned - especially if there are elements of ongoing care to transfer on to the general practitioner.
• When making the call, tell the receptionist who you are and who you are calling about - that way the general practitioner can have the patient's record ready when your call is put through.
• If the general practitioner is not available, ask to speak to the practice nurse, who will have a knowledge of most patients and can either take the necessary actions or pass a message to the general practitioner.
• Share the information you get from the general practitioner with the full team.

"You will find patients feel more comfortable and secure in your care when they know you have spoken to their general practitioner."

Receiving Enquiries from General Practitioners

• RMOs are expected to answer and return calls as soon as practicable.
• Always be courteous when you receive a phone call from a general practice and be aware that the doctor or nurse on the other end of the phone probably has an acutely ill patient with them and other patients waiting to be seen.
• Most GPs in Canterbury are using HealthPathways to manage patient conditions. It can be helpful to look up the relevant pathway when a general practitioner phones, to talk through further management options for a patient.

"Most registrars are pleasant to deal with... most of us are not admitting on a whim but because we have gone as far as we can with management... and all of us have been in their position at some point so we do understand the difficulties."

The GP Phone and Fax Lines

• The GP Phone Line provides a convenient link for general practitioners wishing to contact hospital patient services. It operates from the Referrals Centre, Monday to Friday, between 8.30 am to 4.30 pm. The staff operating this service can transfer all calls to the appropriate hospital contact and also take messages until the intended recipient is available. In some instances the Phone Line staff may take referral details that need to be faxed urgently to ED on behalf of a GP. This allows the GP to continue in their role and avoid unnecessary delays before contact is made with the appropriate team.
• The GP Fax Advice service allows general practitioners to seek brief and timely advice from a consultant, while retaining the responsibility and management of the patient. It is intended to enhance the quality of care by the GP and possibly avert the need for an outpatient referral. The service works well as an option for less acute clinical situations where the GP retains the duty of care and would benefit from generic specialist advice.
• Most departments receive faxed GP requests for advice, or from internal departments requesting advice from another department. The usual time taken to answer these queries is 3 days, however at times this may be extended.
• The phone and fax lines are listed on HealthPathways.
• Please feel free to call the Referral Centre ext 80208 or the GP Phone Line ext 80210, for help with GP contact numbers or other information.

Consultations Between Specialists

It is vitally important for the standard of patient care that consultation between specialists occurs regularly. The principle governing consultations is that consultations should be between specialists, not RMOs.

Registrars may initially assess consults, then discuss them with the consultant for a subsequent review.

If a consultant is not available for a second opinion, you may be asked. These 'consultations' are expedient rather than desirable, and require you to accept full responsibility for your decisions until you have discussed it with the consultant. You should discuss these cases with the consultant as soon as possible.

Some departments have one staff member available for acute or consultation work. In this case, the on call specialist will deal with all consultations on a particular day.

Request consultations in writing, but make sure you also phone the consultant/registrar to ensure that the patient is reviewed as soon as possible.

See form QMR003C.

Relations with other Departments

When expert advice or consultation is needed with allied health professionals, i.e., Occupational Therapy, Physiotherapy, and Pharmacy, the Senior Clinician must also be consulted.

Topic Code: 11793