Inefficient communication: a £1BN+ problem for NHS hospitals in England

We are currently compiling an evidence centre for the devices4 website which will provide links to various information resources that support the devices4 mission: to improve patient care by placing modern technology in the hands of health care professionals.

In particular, we’re focusing on published evidence and commentary on communication issues within healthcare. What’s most surprising from our review of the literature is how little progress has been made in increasing the use of mobile devices despite mounting evidence and support from the health care community.

U.S. hospital communication: a $12 billion efficiency gap

One recent journal publication really caught our attention that we’d like to highlight.  Titled “Quantifying the economic impact of communication inefficiencies in U.S. hospitals” and published in the July 2010 edition of the Journal of Health Care Management, it suggests that the economic burden of communication inefficiency in U.S. hospitals is substantial, at over $12 billion.  (Full text)

The study draws upon existing academic research into health care communication, national statistics and primary research conducted by interviewing clinicians in seven different U.S. hospitals.  The authors constructed an economic model for the efficiency of resource utilisation, focusing on three areas where communication breakdown had an immediate economic impact:

  • Wasted physician time: $0.8 billion (6.7%)
  • Wasted nurse time: $5.0 billion (40%)
  • Increased length of stay for patients: $6.6 billion (53.3%)

In total, this puts the burden due to communication inefficiency at $12.4 billion, which is 1.97% of total U.S. hospital revenue.

Poor communication in hospitals is costing NHS England over £1 billion

This led us to think, what would a similar analysis show for the NHS?  Using readily available statistics for England and some simple assumptions, we calculated the following:

  • Wasted doctor time: £98 million (9.3%)
  • Wasted nurse time: £510 million (48.2%)
  • Increased length of stay for patients:  £450 million (42.5%)

Together this adds up to a total burden due to communication inefficiency of £1.1 billion, 3.44% of total income paid to hospital trusts.

Feel free to check our calculations and assumptions – we’ve published a spreadsheet for all to see. Please contact devices4 with your feedback and any changes you think we should make.

Connecting the right person, about the right patient, at the right time

The authors of the U.S. study state in their conclusion “greater and more effective infusion of communication technologies into the hospital context can address communication challenges and aid in connecting to the right person about the right patient at the right time in interpersonal interactions among care providers.”

This is why devices4 focus on increasing the acceptance and affordability of mobile phones for health care professionals.  We believe that mobile devices can deliver a step change in communication practices within health care, through their support of different communication media: voice, text and data. This would benefit the healthcare system as a whole: making health care professionals more productive, improving patient care, and saving taxpayer funds.

In an economic climate where the NHS is being asked for £20 billion ‘efficiency savings’ without sacrificing patient care, we think improving communication should be at the top of the healthcare reform agenda.

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