A Study on Hospital Communication Practices for Improving

Patient Discharge Process with Reference to Bangalore Baptist

Hospital

Dissertation Synopsis submitted

To

BANGALORE UNIVERSITY

By

HEMALATHA S
Register Number: 151GCMD050

Under the guidance of

Mrs. RASHMI SHETTY

Assistant Professor

RV INSTITUTE OF MANAGEMENT
CA-17, 36th Cross, 26th Main, 4thT Block,
Jayanagar, Bangalore-560041
2016-2017

TITLE OF THE STUDY

A Study on Hospital Communication Practices for improving patient discharge process with
reference to Bangalore Baptist Hospital

INTRODUCTION

Background to the industry:

Healthcare sector is seeing a rapid growth due to services provided, expenditure made by the
public as well as private players in the market. Healthcare industry mainly comprises of
hospitals, diagnostic centres, medical equipments, pharmaceuticals, medical tourism and
health insurance. Recent technology advancement has introduced telemedicine concept which
also has been a part of healthcare industry. 60% of the total revenue of the healthcare is from
hospitals, diagnostic centres and pharmaceuticals. Healthcare industry is one of the growing
sector which provides high revenue and employment opportunities to the people.

In India, Healthcare is delivered at two main systems called public and private healthcare
system. Public healthcare system usually consists of Primary Healthcare System (PHC) in
both rural and urban areas which is maintained and operated by government. Private
healthcare system consists of tertiary and quaternary care institutions mainly concentred in
metros, tier I and II cities and operated by major private players in the market.

The healthcare market in India is expected to reach US$ 280 Billion by the year 2020 and IT
market in the health sector is going to increase 1.5 times by 2020. In Indian healthcare, more
number of well trained doctors, professionals, managers and work force helps in gaining cost
competitive advantage compared to other countries. Government of India, has been a major
taking a major steps regarding to improve the health of people my making investments in
their budgets.

Hospital Communication Practices:

Communication is a process of exchanging information either by sending or receiving

between 2 or more healthcare providers and patients. In any business growth relies on the
effective communication between the workers, team members who express themselves and
work to accomplish task. Effective internal communication is a vital and critical element in
order to achieve the best outcomes and increase the organizations fame.

In healthcare communication plays a significant role and one of the foundations. Majority of
the hospitals suffers from massive inefficiencies due to poor communication practices. 70%

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of the accident and serious cases are due to poor communication or miscommunication in the
hospitals. Hospital communication practices can be both verbal and non verbal
communication. In verbal communication doctors, nurses and other staff members sends
information to other either by calling or face to face where as in non verbal communication
the information is being sent without speaking. Hospitals use both verbal and non verbal
communication in order to interact among doctors, nurses, other staff and patients. In hospital
every interaction starting from the entry of the patients and till the patients discharge effective
communication is very much important. Sometimes good communication practices acts as a
tool for improving the patients satisfaction and health outcomes.

In the past, the focus on communication was not much given, but today but to advancement
in technology multiple means of communication is being practised. But in hospital, verbal
communication- face to face yields an effective result. In case of internal communication in
the hospital which consists of doctors, nurses, housekeeping staff, and admission staff etc;
one needs to be effective in their communication and time sensitive.

In hospital, during a period of diseases a patient will be treated by a number of specialists

which includes outpatient care, emergency care, surgical and rehabilitation. Patient will also
be shifting between areas of diagnosis, treatment and care, where number of different staff
comes across and the communication with the each and every department will be
interconnected. The staff member of the particular department needs to have an valuable
communication with the staff members of other department. The team of discharge
department needs to communicate with laboratory, pharmaceuticals, billing department etc, in
order to have an early discharge of the patient. Communication of the nurses with the house
keeping staff is very much important in order to keep the wards clean. Today hospital is
considered as the most important service providing industry and every one are concern with
the term Quality in healthcare. In order to attain this quality the hospitals needs to optimize
the resources to the fullest in each and every process. One such process that makes the
attention of the patients is delay in the discharge process. Therefore the success of the
hospital purely depends on the effective communication among the healthcare providers at
hospitals.

LITERATURE REVIEW

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A Tool for Improving Patient Discharge Process and Hospital Communication
Practices: the Patient Tracker

Christopher G. Maloney et al (2007)

Speaks about the strategies needs to be followed during discharge process and also a software
tool called patient tracker was developed and implemented in order to minimize delays in
discharge and admission process and facilitate timely discharge of the patients. Overall from
the above study it was observed that patient tracker software gave an effective result in bed
management and solves the problem by adopting hospital information technology.

Deficits in Communication and Information Transfer between Hospital-Based and

Primary Care Physicians

Sunil Kripalani, MD, MSc et al (2007)

In their study, they found out that inaccurate communication between primary care physician
and hospital based physicians at hospital discharge. The study was done based on the sample
size of 55 respondents. From their study it was found that defects in the communication and
information transfer during discharge may adversely affect the patient care and some
recommendations were made to primary care physicians in order to make discharge
summaries more consistently available during follow up care.

Communication: A Dynamic between Nurses and Physicians

Cassandra Lee Flicek (2012)

The study mainly focused on the communication between the nurses and the physicians.
From the research it was found that communication between the nurses and the physicians
can affect the health outcome of the patients and major challenges lies in the effective
communication between the care providers. The overall study revealed that healthcare
providers are the main responsible in improving the communication practices which is vital
aspect in the hospital and mandatory beside round practice allows the patients to witness
effective communication by reducing errors.

Influence of communication between nurses and physicians on patient outcome in

hospital settings

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Ali Hakami et al (2013)

The study was made in order to describe how communication between the doctor and the
nurses will influence the patient outcome at hospital setting. A model called SBAR was used
in order to share patients information between the nurses and the doctors. SBAR model was
mainly depending on the verbal communication. The main objective of the study was to
identify that communication has a very important link between the caregivers in order to
decrease medication errors and also to improve patient satisfaction.

Reducing and optimizing the cycle time of patients discharge process in a hospital using
six sigma DMAIC approach

S. Arun Vijay (2014)

In his study, he focused on how to reduce discharge process by using six sigma tool. The
main objective of this study was to analyse the discharge procedure by using DMAIC tool of
six sigma and find out the gaps in the discharge procedure. Overall from the above study it
was observed that positive impact was obtained on reducing the time in the discharge process
due to recommendations made for 2 months.

A Study of Discharge Process with A Special Focus on Reducing the Waiting Time in A
Tertiary Care Teaching Hospital

Dr. N. Lakshmi Bhaskar et al (2016)

The study was made to know the flow of discharge process which is resulting in delays with
reference to Narayana Hospitals. The data for this study was collected from the discharge
summaries and feedback from the patients and staff of various departments through
questionnaire method. The findings from this study show that 70% of the patients were
satisfied and recommended the hospital administration to address the activities causing delays
in order to bring 100% of the patients to feel satisfaction.

NEED FOR THE STUDY

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Communication practices are very important in any of the field. An effective communication
between the workers makes the organization to achieve its goals. In hospitals, internal
communication plays a major role in the decision making. The communication time gap
between the doctors, nurses, staffs at other department leads to increases in the time duration
of the patient staying at the hospital. If the poor communication practises has not been
addressed properly at required time, then the hospital may end up with the high cost for the
facility and may face medicare reimbursement if the satisfaction level of the patient is not
reached

With respect to hospital, discharge process is a major problem when compared to other.
Discharge process is the last patient contact and it is more important stage which depicts the
patients satisfaction. During the discharge of the patient, the communication between the
medical providers must be effective which makes the discharge duration less and patient feels
satisfied. If the patients feel dissatisfaction regarding long time, it may not be beneficial to
the hospital. Today due to population outburst, the ratio of bed is approximately less than one
that is 0.84 beds for every 1000 population. If the hospitals make discharge process late the
admission process also gets late which leads to the shortage of beds. Over recent decades,
hospital discharge processes have gained an importance across the world, but evidence shows
that hospital discharge process continues to be the major problem.

Prolonged stay of patients at hospital may poses a significant problem regarding hospital
acquired infection and depression/frustration. Healthcare providers must examine each and
every step in order to reduce the discharge process. If the communication between the
doctors, nurses, billing department, housekeeping staff etc, is going effectively without any
gaps, the discharge process also will take place quickly. The communication between the
nurses and the patients is very important, where majority of the patients shares their actual
problems with the nurses. The communication between healthcare providers and patients also
plays an significant role in discharge process. The present investigation is to find whether
communication practices are good enough and is there any problem with delay in discharge
of the patient at Baptist hospital.

STATEMENT OF THE PROBLEM

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Sometimes the communication practices followed in the hospitals may not be yielding good
results. In healthcare industry, particularly in hospitals gaining the patients satisfaction is very
difficult. Delays in discharge have become a topic of increased interest in every hospital. A
key factor to these issues comes from the ineffective communication between the discharge
team. The delay in discharge process leads to delay in the admission process and vice versa.

In India, due to shortage of beds, the discharge process need to be happen in a timely manner
in order to synchronize the supply and demand of beds. Usually delay in discharge process
happens through miscommunication or gaps in communication between doctors and nurses or
nurses and billing department or nurses and pharmacist or nurses and patients.
Communication process does not stop as soon as the patient discharge form is written by the
doctor, it also continues with guiding the patient regarding the proper timely checkups and
also regarding medicine consumption. Patients are the best source of information to tell how
effectively communication happens between the discharge team in order to reduce their
staying time at the hospital.

In the backdrop of the explanation given above, the problem is stated as A study on hospital
communication practices for improving patient discharge process with reference to Bangalore
Baptist Hospital

OBJECTIVES OF THE STUDY

To study the communication practices in the hospitals are effective or not

To study the flow of discharge process
To study the bottlenecks in the discharge process which are the main causes of delay
To analyse the patients perception regarding communication between the discharge
team
To provide suggestion, in improving the discharge time and communication practices.

RESEARCH METHODOLODY

Sampling is a mode of selecting representative portion from the entire population of interest
for the study. It is an integral part of research methodology

Sampling unit: Here the sampling units are both patients and staff members of the
organization.

Sample size: For the resolution of the study, data will be collected from 100 respondents.

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Sampling method/ technique: The sampling method used is "convenient sampling method".

Convenient sampling:

Convenient sampling is a non-probability sampling method, which the interviewer will

decide the choice of sampling units on his/her convenience.

SOURCE OF DATA
For any study the source from where we collect the data counts a lot. The data collected for
the above study is by
Primary source
Secondary source

Primary Data: primary data is raw data which is collected for the first time, and thus happen
to be original in character. The primary data for the study will be collected by using
questionnaire method and this will help to analyse the problem regarding the study.

Secondary data: The secondary data on the other hand, are those which have already been
collected by someone else. The secondary data is the data which already exists. Common
sources of secondary data for social science include censuses, information collected by
government departments, organizational records and data that was originally collected for
other research purposes.

Secondary data sources for this study are:

Reference books
Website sources, internet
Journals, magazines, research books for review of literature

TOOLS FOR DATA COLLECTION

Data collection is the process of gathering and measuring information on targeted variables in
an established systematic fashion, which then enables one to answer relevant questions and
evaluate outcomes. The goal for all data collection is to capture quality evidence that then
translates to rich data analysis and allows the building of a convincing and credible answer to
questions that have been posed.

Structured Questionnaire method

The set of questions had been given to respondents to fill up the Questions. The 100
respondents were given the questionnaire form and were requested to fill the questionnaire

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form. Structured questionnaire has several advantages as compared to other survey and are
very economical and do not require much effort.

PLAN OF ANALYSIS
Analysis of data is a process of inspecting, cleaning, transforming, and modelling data with
the goal of discovering useful information, suggesting conclusions, and supporting decision-
making. For calculation the simple percentage the following formula used. Based on the
collected data from the respondents, it will be analyzed through percentage analysis method
and the same will be depicted in tables and graphs along with appropriate analysis and
interpretation.

Percentage analysis: Simple percentage can also be used for better understanding of the
collected data.
Number of respondents/Total respondent100
In this study Pie Chart is used for questionnaire which is collected from the customers.

The data collected is analysed and shown in the form of:

Tables
Charts
Graphs
Comparative diagrams/figures.

CHAPTER SCHEME

CHAPTER 1: Introduction

This chapter covers the industry background, theoretical background of the topic-introduction
to the topic.

CHAPTER 2: Review of the literature and Design of the study

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 This chapter covers the plan of the study stating the problem, review of literature, scope and
objectives of the study, methodology to undertake study, finally limitations of the study.

CHAPTER 3: Industry and company profile

It covers the industry profile, a detail explanation of the Bangalore Baptist Hospital.

CHAPTER 4: Results, Analysis and Discussions

It covers data analysis and interpretation. Analysis is made from the data obtained through
questionnaires as well as the secondary data collected.

CHAPTER 5: Summary of Finding, Conclusion and Suggestions

It gives the summary of findings, suggestions and conclusions based on analysis and
interpretation of data.

Bibliography:
The various books, magazines, journals, articles and websites used for the study are stated
here.
Questionnaire:
It includes questionnaires used for the study.

REFERENCES

Journals:

1. Flick, C. L. (2012). Communication: A dynamic between nurses and physicians.

Medsurg nursing .

2. Maloney, C. G., Wolfe, D., & Hales, J. W. (2007). A tool for improving patient
discharge process and hospital communication practices: the patient tracker.
International Healthcare .

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Websites:

1. (2017). https://www.ibef.org.

2. (2016). https://www.ncbi.nlm.nih.gov.

Books:

1. Goel, S., & Gupta, A. K. (2014). Hospital Administration: A problem solving

approach. Elsevier Health.

2. Mohapatra, M., & Mohapatra, S. (2016). A treatise on health management. The health
science publisher.

Name: Hemalatha S Guide Name: Ms. Rashmi Shetty

Reg No: 151GCMD050 Assistant Professor

Date: 13/04/2017

Student Signature: Guide Signature:

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