B

efore you ever cared for a resident in your long-term care facility, you designed a strategy as to how best to deliver that care. The care plan becomes the map to guide those involved in the delivery process. Many people have a hand in the care of a resident. Information about a resident lives not only in charts and documents but also in the minds of the people who interact with the resident. No one person knows everything there is to know about any given resident. It is a community effort. But how can all of the relevant information about residents be gathered, synthesized, and communicated to their loved ones?
       Without an integrated communications strategy, information becomes locked up in silos or the individuals who come into contact with the resident (eg, social workers, nurses, dietitians, housekeepers). Sharing the wealth of information about a resident with his or her loved ones is important for everyone, including the facility staff, the resident, and the resident’s community of family and friends. Communication enhances trust and provides peace of mind. It is also a tool to educate loved ones on the resident’s health. Further, effective communication eases family dynamics, since more people are “in the know” about their loved one’s health.
       There are several elements of an effective communication system. First, the communication effort must reach multiple persons in the resident’s community of family and friends. Second, information must be easily understandable. Third, to comply with the Health Insurance Portability and Accountability Act (HIPAA) regulations, the system must be able to authenticate the person who is receiving the information about the resident. Finally, the communication that is delivered must be verified and a record of the message maintained for future reference.

Communication Challenges

       Of course, there are also challenges to executing a communication service. The first challenge that often arises is time. The process of communicating a significant amount of information to multiple persons is time-consuming. Additionally, when using the “gatekeeper” model, you rely solely on a single point of contact to understand all of the information shared and then adequately repeat it to other family members.

Table 1

       Studies on information retention reveal that, in spite of good intentions, we simply forget a large percentage of new information very soon after we hear it (see Table 1).¹ The gatekeeper’s effectiveness as a communication hub is further complicated by his or her health literacy as well as family dynamics.
       Learning about the aging process is a new experience for many people. Again, people do not easily retain new information. Providing information repeatedly and consistently stacks the information in a person’s mind and increases retention of the new information.
       Research shows that 66% of adults 60 years of age and older have marginal or inadequate health literacy.² Health literacy is defined as a person’s ability to obtain, process, and understand basic health information and services in order to make appropriate health decisions.
       There is a significant disconnect regarding health literacy in that most health materials are written at the 10th-grade level or higher. Nearly 2 out of 5 Americans 65 years of age and older read at or below the 5th-grade level.² There are implications for long-term care providers because there is a high probability that residents have marginal health literacy skills and an equally high probability that the resident’s family members do not have adequate health literacy skills.
       Another challenge facing effective communication is regulatory compliance. Clearly, HIPAA complicates sharing information with loved ones because it requires positive identification of the message recipient prior to delivering the information. This includes written and oral communication as well as sending a fax, e-mail, or telephone message.
       And, let us not forget about risk management. A breakdown in communication with a resident’s family and friends is the leading cause of legal claims. The cost of defending these claims is significant. Further, when a provider speaks to a family member over the phone, there is rarely an exact record of the exchange. Effective communication reduces the providers’ risk by regularly delivering information to loved ones as well as keeping specific records of what was communicated. More often than not, the family members who are not in touch with providers are the ones who file legal claims.

The Benefits of Effective Communication

       The case supporting the use of a communication service is evident. Families want to hear from you, and you want to share your good work with them. By implementing a communication strategy, you will create more time to focus on care delivery. You will increase health literacy rates and be able to enjoy conversations with residents’ loved ones because they know and understand more. Do not be afraid to communicate—be afraid not to.
       Further, an effective communication strategy will differentiate your services in the marketplace and expand your reach, thereby increasing your bottom line. By talking to your residents’ loved ones in a way that they understand and appreciate, you create a credible network of families that become your advocates. Touching 3, 4, or even 5 people with regular communication for each of your residents can expand your marketing efforts many times over. In an industry where word-of-mouth referrals are still the most potent marketing tool, an effective communication strategy makes good business sense.
       Once you have decided to incorporate a communication solution, consider the method by which you will deliver information. The advent of technology has offered more and more ways to communicate. However, the telephone is still the most widely used communication tool with many distinct advantages (see Table 2).

Conclusion

Table 2

       A communication strategy is a necessary accompaniment to your care delivery plan. Providing quality care is of primary importance, but quality can soar when you have the ability to effectively share information, educate, reduce risk, and improve everyone’s satisfaction. It is just a phone call away.