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Communication Matters

For most of his adult life, David recalls experiencing random bouts of a racing heart.  However, it wasn’t until his late forties did he discover that the irregular activity in his chest was actually atrial fibrillation (irregular heart rhythm).  Although various treatment methods helped at first, his heart condition was never fully reversed. Because of this, David’s primary care physician explained that he could be at the risk of a stroke.  He was then placed on anticoagulants (blood thinners) in order to prevent the possibility of blood clots forming in his heart.  

David then started a daily exercise routine in an effort to lose weight.  However, as he increased the intensity of his exercise, he began to experience pressure in his chest.  When the discomfort continued, he did not hesitate to go and visit his primary care provider immediately.  His EKG rendered normal results, but due to a history of heart attacks in his family, his care provider referred him to a cardiologist for a cardiac catheterization. 

On his arrival to the cardiac unit, it was uncovered that David’s anticoagulation level was far too high to warrant catheterization without a serious risk of post-procedural bleeding.  It simply wasn’t safe. Because of this, the cardiologist deemed it best to delay the catheterization and send him home. Three nights later, David found himself in the local emergency department with terrible chest pain and a doctor explaining to him that he had just experienced a severe heart attack. 

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In regard to David’s story, how could his care have been revised so that his heart attack could have been avoided altogether?  In this case, the answer lies within the communication (or lack thereof) between his primary care provider and the nurse care manager that helped manage his heart arrhythmia and anticoagulation.  Although his primary care provider informed the cardiologist of David’s chest pain, they failed to relay their patient’s history of anticoagulation and atrial fibrillation. Because of this, neither the nurse care manager nor the cardiologist found it necessary to execute the standard, pre-catheterization protocol that was designed specifically for patients taking blood thinners.  Had the nurse care manager or cardiologist known of David’s full clinical situation, this would have been a different story. If proper communication would have taken place, the catheterization could have taken place, which would have revealed his extensive coronary vessel disease, leading to immediate treatment, thereby avoiding unnecessary costs and harm altogether.

Without highly effective communication and tools in place to keep ambiguity out of the picture, healthcare organizations are bound to face clinical complications, poor patient satisfaction rates, and unnecessary costs.  The truth of the matter is that communication is a critical piece to providing superior care for your patients. Without it, your business, as well as the lives of those entrusted in your care could be in jeopardy. 

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