Saving Lives: Communication in Anesthesia

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Dr. Skidmore

Dr. Kimberly Skidmore [right] and Randi Domingue [left]

When trading information in the high-stakes world of anesthesia, speed is essential. Anesthesia is the field of medicine that involves putting patients “to sleep” during surgery. Therefore, important details must often be sent in an emergency. However, as expected in such a field, complete records and legal documents must also be kept up to date at all times. Dr. Kimberly Skidmore, Medical Director of Anesthesia Services, met with me to discuss some forms of communication in her work.

Dr. Skidmore works at Glenwood Regional Medical Center in West Monroe. She has not always worked here, though. She recently moved from the University of California in San Francisco hospital, where she is still the Associate Clinical Professor at the medical school. While communication did differ in these two places, she tells me that the essentials are mostly the same. Two types of communication we discussed were patient “pre-op” forms and texting.

A pre-operation packet is a series of standardized documents for every patient, including medical history checklists, insurance papers, legal documents, and preprinted order sets. These leave little room for additional notes but manage to keep all those in contact with a patient on the same page. Dr. Skidmore admits that this helps prevent errors. Still, she prefers a more flexible design so that any issues not covered by the documents can be written in.

When asked whether written or verbal communication was more important, Dr. Skidmore says “it has to be a mixture,” but admits that verbal is probably more useful in anesthesia. In addition to conversing with coworkers, she also sits with patients and listens to their problems in their own words. These are then hand written into notes on her standard patient chart. She then uses all of this to build a “checklist”. This is a simple, bullet-point list of each problem she needs to tackle. It helps keep her organized and focused: “In anesthesia we’re all about making it safer for the patient.”

While she enjoys the freedom of handwritten notes, Dr. Skidmore says that she would prefer the information be digitized for better organization. However, she says there are downsides to using electronic medical records (EMR): “getting locked out [of the system], difficult learning it, it’s different in every hospital” and that it takes lots of time away from patient-doctor interaction. Dr. Skidmore values the personal time she gets to really hear each person’s problems, and her patients appreciate it as well.

Another important form of communication in her job is texting. Dr. Skidmore says that she and her coworkers “do a ton of text messaging, in group format.” She uses this for a number of reasons, from updating others on patient statuses to receiving details about which cases she will work in a week. She says that this easy, efficient form of communicating has really helped her in her job.

Before texting, doctors were only called over hospital speakers or found in person. Pagers, cell phones, and now texting have each had important roles in improving medical communication, but each also has its own flaws. Dr. Skidmore believes the next step is something she experienced at her job in California. While also carrying cellphones at all times, doctors would use texting pagers. Each nurse or doctor could then receive or send full messages more reliably, while also leaving a “track record for when you called a consultant,” Dr. Skidmore says.

While communication in medicine has changed throughout the years, Dr. Skidmore maintains that face to face interaction is best for patients, while quick electronic contact is best between doctors. This differs greatly from other jobs, where long charts and texting may be discouraged. In this environment, though, each form of communication is meant to reduce errors, move information efficiently, and ultimately save lives.

Randi Domingue, guest blogger

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