Internal Medicine (East Africa)
Introduction: Palliative care aims at ameliorating patients and families suffering when they are faced with life-limiting illnesses. It involves symptoms management as well as psychosocial, spiritual support. As such, proper communication between clinicians taking care of the patient is an important aspect of this care. Studies have shown that errors in communication are common and relevant in palliative care as they negatively impact on the quality of care provided. The service at Aga Khan University Hospital, Nairobi (AKUHN) provides both in and out patient consult services. Primary physicians to patients consult the palliative care team via telephone models as well as face to face talks. There is a lot of literature regarding patient/family member consultation with a doctor but little has been done on understanding the efficacy of doctor to doctor telephone discussion on a patient being referred from one service provider to another. Objective: The aim was to assess the adequacy of information regarding the patient given in telephone consults versus face to face consults during the referral process.
Methodology: This was a cross-sectional study. 60 consults to the palliative care team were assessed, these were consults received over a period of 4 months; 36 were telephone consults and the rest face to face. The information was assessed for inclusion of the following details: I) name II) age, III) gender, IV) longevity of illness, V) ward/clinic location, VI) Patient’s diagnosis, VII) reasons for referral, VIII) current treatments, IX) patient’s knowledge of their diagnosis and prognosis, X) family’s knowledge of diagnosis and prognosis and XI) patient’s and family’s knowledge of referral to palliative care.
Results: Overall, there are more missed characteristics of a patient in a telephone consult compared to a face to face consult. The most missed characteristics in both types of consults were name, patient and family knowledge of referral, patients’ and families knowledge of diagnosis.
Conclusion: It is evident that a telephone consult is less informative than a face to face consult. It is therefore important to have a face to face discussion on a patient after telephone consultation. It is also evident from these findings that doctors are still poor in the aspects of communicating with patients, their families and also among themselves and more need to be done to improve this.
Palliative medicine and Hospice care
(2016). Telephone versus Face to Face Palliative Care Consults during Referral. Palliative medicine and Hospice care, 2(1), 17-20.
Available at: http://ecommons.aku.edu/eastafrica_fhs_mc_intern_med/37