Dr Anne Stephenson GP in Torquay , Victoria , and the GP liaison officer at Epworth Geelong Private Hospital .

COUPLE of weeks ago , I had the honour of being invited to a patient ’ s funeral .

I don ’ t usually attend the funerals of my patients , but in this case , her husband had got in touch and asked me to come . He said it would be a small private event for the family and friends who had been a big part of their lives . It seemed important to be there . The funeral was at my patient ’ s favourite beach , where her ashes would be scattered into the ocean . As we huddled and teared up on the sand , my patient ’ s son and brother spoke poignantly about their mother and sister and all the goodness she had brought to their lives .

My patient ’ s husband spoke of their many wild adventures and the amazing people they had met on their journeys and her uncanny ability to make lasting connections with people from all over the world .

Towards the end of his speech , he spoke of the care I had provided to her and how much that had meant to them .

I had mixed feelings about this praise , and I have since reflected on what I had done that meant so much .

We often forget what a difference we make to our patients ’ lives . I think this is especially true if clinicians work together across the primary and tertiary care divide .

At one time during her illness , my patient had been an inpatient at a big hospital , and her surgeon had taken the time to call me about

what had happened and what was planned .

Both of us respected our different roles in the care of our patient , and the surgeon and I worked together to look after our mutual patient .

My patient ’ s husband spoke of how much it had meant to my patient that we had communicated to look after her . We worked as a team , and such a simple thing had meant the world to her .

While our communication and respect worked well in this case , there are too many examples where communication has broken down between hospitals and primary care . The consequences can be traumatising for our patients and frustrating for clinicians . And they can often be avoided . A quick phone call , particularly when something significant has happened , or when we need to work together to care for our patients outside hospital , can make a huge difference to everyone involved .

In my experience , one of the key breakdowns in communication happens when a patient leaves hospital . ‘ Clinical handover ’ is the term GPs want hospitals to use when they talk about communication .

As was eloquently described in an MJA InSight + article : “ The words ‘ discharge summary ’ evoke feelings of an administrative process

at best and various unsavoury processes at worst .

“ The accidental discharge , the dishonourable discharge and the smelly discharge all come to mind . The words ‘ clinical handover ’ instantly sound more professional . They reflect the sort of interaction between clinicians of which we want to be part .”

Language can set the tone and

PICTURE CREDIT

expectations . ‘ Clinical handover ’ confirms that the care does not finish after leaving the hospital but instead is handed over to the community clinician .

Robust IT systems are integral to an effective clinical handover from hospitals to primary care . The systems need to be easy to use , and the information has to get to the right GP at the right time .

We often forget what a difference we make to our patients ’ lives .

I have never understood why hospitals and regional areas have different communication systems . In our region , we use ReferralNet to send , receive and share electronic referrals . In our nearest city , Argus is most commonly used . Other states use HealthLink .

Universal systems work better for everyone . Over the long term , we should ask for this kind of

investment in our health system . In the short term , while our IT systems are still unreliable , if there is important information to hand over , nothing beats one clinician making a simple phone call to another .

I willingly give my mobile number to any specialist who wishes to call me , and they often do .

If one of my patients dies or deteriorates in hospital , I want to know . A letter is good , but a phone call is much , much better .

Of course , this courtesy has to go both ways , and if significant things happen to our patient in primary care , it is in everyone ’ s interests to pass on the information to the treating team regardless of whether you are a GP or specialist .

We are always rushed , we never have enough time but the need for communication cannot be overemphasised . And it means the world to our patients .

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