How do you engage patients and families in care transition communication?

While I’m constantly assessing in my mind, I find changing the word ‘assess’ to ‘ask’ helps to bring the patient and family into the planning of care, which provides a sense of control on their part. Another aspect is helping them to adapt the disease process TO their lives, not exchanging it FOR their lives.This helps to build confidence as they learn the steps of transition into THEIR lives, instead of fear, when taken out of their own routine of life. The healthcare professionals across the spectrum in a patient’s care, become the resources for answers and application, not to do for them, but the who, what, where, when, why, how, and how much, to help them carry on with their lives.

As the client and family begin to cross the trust bridge, the conveyance of information becomes much easier. In addition to the conveyance becoming easier, the acceptance and implementation becomes easier as well. When the client finally realized that you are there to help, you have won a major motivational battle. Now, instead of having to push and use dark tones, power moves, etc., the client sees his own interests being benefited and includes his own motivation to comply. That is a much easier client to manage, lead, and benefit.

One thing I've found helpful is to ask the question, "Who needs to know this information". With coordinated efforts, it is important when one of the team has new information that they ask who needs this information. Doing this can make the transition smoother as well as eliminate duplication of service and actions. The people closest to the client should have as much information as possible. More information can reduce anxiety and increase the effectiveness of implementing plans as well as reducing errors and neglect.

In my experience, meeting one-on-one with the patient and primary support/caregiver is paramount. 2-way pickup of body language is crucial to understanding what is trying to be conveyed. A written booklet that reinforces what is covered gives an immediate backup in hand. Providing name and phone number to call allows them to follow-up for anything not understood. Within 48 hours, if you haven’t heard from them, call or text them to inquire how they are doing. They don’t want a black abyss to be floating in without contact. Sometimes, we are the only ones that will check up on them.