Running head: Scenario 3
Fundamentally, communication problems cause various challenges for any given organization as well as the entire society. Current trends indicate that incidences of missing or inaccurate information and data and inability to relay vital information in an effective and timely manner are the main causes of problems in health institutions. In order to enhance quality healthcare, health professionals need to bridge the inherent gaps. Essentially, this entails improving communication between employees, supervisors, nurses, physicians, social workers and so on. Most importantly, there is dire need to inculcate a culture of safety and cost effectiveness in such institutions. This is instrumental in guiding professional behavior in various ways.
Moreover, it would influence adoption of vital and timely intervention measures in a bit to counter the scenario. This paper provides an in depth evaluation of communication intricacies inherent in scenario three. To enhance a harmonic consideration, it begins by providing an over view of the scenario. It then proceeds to the analysis of each key player’s perspective and role in communication with the patient scenario. Then, it underscores the communication implications and finally proposes viable methods through which the problems can be resolved.
After receiving written notes from the doctor, the billing office translates them in to codes and forwards to the billing health insurance for relevant action. Notably, the notes are illegible and this has culminated in inaccurate translation that has led to patients being denied their claims by Medicare and private health insurance. This has made the patients to be billed directly by the office. The occurrence of this problem has been quite often and as such, complaining patients have raised their concerns to the billing office. Since Mr. and Mrs. Johnson are some of the patients that have called three times to complain about incorrect billing, they decide to meet someone in order to discuss the scenario.
The first person they met is Rose, a medical assistant who is aware of the problem. In a bit to explain the problems, she informs the Johnsons that the billing department is challenged by the illegible handwriting of the doctors. She further cites that the respective doctors are proud and have not been able o respond to any inquiries. Further, she informs them that the medical director is aware of the problem but is equally unsupportive. She then apologies and reassures them that she would take necessary measures to fix the problem. After a few days, the Johnsons request a transfer of their medical records to another medical facility.
Notably, the scenario is compounded by various communication issues that have far reaching implications on the holistic functioning of the institution. At a primary level, there is a communication breakdown between the patients and the doctors. The doctors presume that the patients understand the financial implications of their medical care. Furthermore, they presume that the patients have a clear understanding of all the medical procedures. On the other hand, the patients do not bother to request for clarification of critical information regarding the billing notes as well as important medical procedures. If the patients could request for such information upfront, the problem of illegibility could have been noted and hopefully, relevant action would have been undertaken.
The billing department has also not been persistent with following up the doctors. In their research, Hansten and Jackson (2008) indicate that incorrect misinterpretation of medical information amounts to unethical practice. This is particularly so because medical information tends to be very sensitive in nature. In addition, relative medical costs are reportedly huge and financing them can be costly if mistakes are made. The failure of the billing department to take a firm stand in this regard can be attributed to communication gaps between institutional departments.
Further, the billing department has failed to inform the patients of the current scenario. This can be used to explain why the Johnsons decided to meet face to face with any personnel. It implies that they are not convinced or satisfied with the information that they are provided with by the billing department. The fact that the problem has been recurring for some time indicates that minimal measures have been undertaken to resolve it. Arguably, the arrogant nature of the physicians has been a major impediment to resolution of the issue. Partly, the Medicare and private insurance companies have also not been keen with resolving the issue. The fact that this has been recurring for some time needs to have prompted them in to pressuring the hospital administration to take relevant measures. In this respect, Servellen (1997) posits that in order to optimize the quality of healthcare, all relevant institutions need to be responsible with regard to addressing inherent inconsistencies. Clearly, the lack of collaboration between these institutions has culminated in persistence of the problem.
The approach that the patients took in an attempt to resolve the issue is also faulty. Rather than confronting any person in the institution, they would have consulted the billing department. Although their roles are interconnected, it is worth noting that health care professionals specialize in different fields. Therefore, they may not be fully informed about the functioning of different sectors. In this consideration, the Johnsons would have sought help from the billing department, as opposed to from the medical assistant. Apparently, the billing department would have provided them with factual information regarding the problem at hand that are unknown to the medical assistant. Despite being aware of the issue being discussed, the medical assistant could have refrained form providing this information to the patients. Usually, such instances require sensitive handling especially presuming that the patients could have been angry. From an ethical point of view, the information provided needs to be factual and based on informed thought. From the scenario, it is certain that the medical assistant was subjective in her reporting. This implies that she was not conversant with the facts on the ground, simply wanted to portray a positive image in order to win the confidence of the patients or she honestly wanted to reassure them that problem would be fixed.
Nevertheless, she should not have told them that she would do anything within her means to ensure that the problem was resolved. This is because the problem was already beyond her means. It amounts to lying that is immoral from an ethical perception. Moreover, she had not taken any practical steps to resolve it irrespective of the fact that she clearly understood the complexity and dynamics of the problem. Then the decision of the patients to transfer their medical records to another facility was also not informed by objective and credible sources. In this respect, they failed to exercise their responsibility with regards to contributing to the reformation of healthcare institutions.
Also worth mentioning is the recognition that they did not have a clear understanding of the functioning of this institution. This implies that they had not taken time to establish sustainable relationships with the medical personnel of this institution. Finally, the medical director can be blamed for the current state of affairs. Seemingly, s/he has failed to enhance information flow within the organization. His or her silence about the problem shows that either s/he has not been given sufficient credible information to warrant action or s/he lacks relevant skills to enhance open communication systems in the institution.
Seemingly, the communication disconnect in the institution has had diverse implications on service delivery, employee relationships and employee-client relationships. To begin with, it has led to inaccurate billing of medical costs. This has made the clients to use alternative means of payment that they would not have planned for initially. Then, it has compromised employee relationships in the institution. The doctors have been cited to be proud and the director unsupportive. Such a work environment triggers unnecessary tension that undermines effective service delivery. This can be used to explain why the medical assistant took the initiative to explain to the patients the state of affairs instead of referring them to the relevant department. Finally, the communication gap has led to loss of clients by the institution. The loss impacts not only on its reputation but also on its financial wellbeing.
Certainly, viable intervention measures need to be undertaken to counter the scenario. Effective communication is important as it also assures the patients of safety and quality service. On an institutional level, it influences good interpersonal relationships that boost productivity. Most importantly, it eliminates unnecessary medical costs that affect the quality of life of the patients. The main problem is lack of effective communication in the institution. To curb incidences of illegibility, the institution can introduce technological initiatives. Compared to individual handwritings, Northouse and Northouse (1997) indicate that computer generated information is legible. Besides, this would also streamline information flow and sharing. In the long run, it would enhance performance and productivity as the relevant persons would be informed of all procedures.
Another sustainable solution to the problem would be to carry out education and awareness creation especially pertaining to client doctor relationships. Basically, clients need to be aware of the notes that doctors make about them regarding several issues. The doctors are also obligated to provide this information to the patients and make clarifications accordingly. Seemingly, the root cause of this case lies in lack of viable .patient physician relationships. Regardless of their busy schedules, doctors need to take the initiative of establishing and maintaining these relationships. Patients on the other hand need to be conversant with hospital procedures as this enables them to get timely and effective help whenever need occur. From a professional point of view, they are better informed of effective communication than their patients. Nevertheless, effective execution of this would need the support of the patients.
Finally, all professionals at the hospital need to be trained on the importance of performing their roles. Boundaries also need to be placed with respect to the roles that the personnel are expected to play. This would aid in eliminating such cases related to providing false, inaccurate or unnecessary information to the clients as witnessed in the case. Factors relating to maintaining good interpersonal relationships and respecting their colleagues should also be clarified. In most cases, implication of such misbehavior is usually indicated in the institutional policy covering work ethics. From the scenario, it can be deduced that these are neither implemented nor enforced. Otherwise, necessary action to address client needs would have already been undertaken.
Communication gaps in healthcare institutions culminate in poor delivery of services and ruin vital relationships. In the scenario under review, poor communication has led to patients being billed inaccurately. The responsible parties are not only proud but also unsupportive of any intervention measures. The patients are not conversant with institutional procedures and have approached the wrong person for consultation. The medical assistant on the other hand fails to refer them to the relevant department and promises to do what is beyond her means to help them. Ultimately, the patients request that their records be transferred to another facility.
The intrinsic communication breakdown culminates in poor employee relationships. In addition, it affects the quality of service delivery and minimal measures are undertaken to address the issue. Introduction of technology can aid in curbing the problem as it eases information flow and sharing. To enhance output, the institution also needs to carry out training and awareness creation. This should aim at informing the patients about the procedures as well as initiating and maintaining viable relationships with patients. Moreover, employees need to be trained on how to deal with such matters in future.
Hansten, R. & Jackson, M. (2008). Clinical Delegation Skills: Handbook for Professional Practice. USA: Jones & Barlett Publishers
Northouse, P. & Northouse, L. (1997). Health Communication: Strategies for Health Professionals. New York: Prentice Hall
Servellen, G. (1997). Communication Skills for the Healthcare Professional: Concepts and Techniques. USA: Aspen Publishers.