Face-to-face meetings improve communications

Keep meetings meaningful and short

Case conferences can be an excellent way to improve communications between staff members and ensure that the plan of care is up to date. The challenge presented by case conferences for hospice and home health agencies is the staff's perception that time spent in meetings is not time well spent for patient care.

"We call our weekly meetings multidisciplinary team meetings, but they are case conferences during which each team discusses plans of care for patients who are cared for by team members," says Patricia Burke, RN, director of clinical services and operations for Caritas Home Care in Norwood, MA. "We limit the meeting to one hour, and each case is presented by the admitting clinician or the primary clinician," she says. There are nine clinical teams, each with a heavy caseload, so the presentations are limited to new admissions, recertifications, and medically complex patients who require extra attention.

Because weekly team meetings represent a change in practice for the agency, there was some resistance, admits Burke. "Everyone uses a point-of-care system, so staff members do not regularly come into the office," she says. The biggest concern of most staff members was that the meetings would be a waste of their time, Burke says. To alleviate that concern, the one-hour limit was established, and housekeeping items such as announcements of training opportunities or other administrative items is limited to no more than 10 minutes at the beginning of the meeting.

"We also built in a 10-minute period at the end of the meeting to allow staff members to bring up any issues that they want to discuss," Burke says. Those 10 minutes might be used to ask for suggestions that could help the clinician with a patient not discussed in the case conference or to ask about other clinician's experience with certain equipment or patients, she explains.

In addition to the team meetings, Caritas Home Care staff members meet individually with their case manager on a weekly basis. "This gives staff members a chance to review all of their patients," she explains. Case managers also use that time to review documentation requirements with staff members and point out ways that the clinician can improve his or her documentation. "These meetings are also kept to a minimum time so that the clinician has time to see patients," she adds.

Attendance at meetings and participation in case conferences now are part of each clinician's job description, but there is little resistance these days, says Burke. "New clinicians find both the team meetings and the weekly meeting with the case manager a great learning experience," she says.

Communications have improved because team members get a chance to talk face to face each week and get questions answered quickly, points out Burke. Even though experienced staff members initially viewed the meetings as a waste of time, one employee recently told Burke, "I didn't think I'd like these meetings, but I never realized how much time they really save me."