Deficiencies in communication are the major cause of complaints involving the Department of Emergency Medicine. Communication includes both verbal, non verbal and written communication.
Documentation is vital and must be dated, named and signed for each input.
Communication with patients:
It is important for both medical reasons and medico legal reasons that patients are made aware of any treatments, investigations and in particular any potential complications of treatment or investigations, as well as instructions on appropriate care. Professional interpreters should be used in the non English speaking patients to obtain histories and gain consent rather than family members and friends.
Where possible, written information sheets should be given to patients, particularity prior to discharge. Many of these re available on the DEM Wiki page or the RCH website for children’s handouts.
Communication with GPs:
Any patients discharged back to nursing homes or for GP review must be given a letter to accompany them so that the appropriate care and follow-up can occur. If within hours, a phone call to the GP to explain the need for urgent review within a few days is common courtesy.
It is hospital policy that when a GP sends in a patient with a written or telephoned request for admission, then the patient must not be discharged without prior consultation with the GP. If the GP does not agree with the decision to discharge the patient, then the appropriate speciality registrar must review the patient and discuss it with the GP.
Nursing home patients:
Medications including minor analgesics cannot be dispensed without a doctor’s orders and therefore the patient must have medications dispensed from the Emergency Department and a Drug Chart needs to be done to prescribe new medications or to write modifications to existing ones.