The Pharmaceutical Journal Vol 267 No 7174 710-713
17 November 2001

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Letters to the Editor

Communication

Pharmacists must advertise themselves

From Ms K. Åström, Dr C. A. Duggan, MRPharmS, Mr I. P. Bates, MRPharmS

Sally-Anne Francis and colleagues have called for research evidence on aspects of communication between health care professionals (PJ, 6 October, p460). We recently completed a funded study over the years 1998–2001 measuring communication between health care professionals on a general medical ward. Throughout the study (which has yet to be published), evidence and feedback was contributed by all health care professionals, including interviews, observations, questionnaires and focus groups. The professionals themselves validated the intervention: a multidisciplinary ward-based communication record named the "joint communication note" (JCN).

We agree with Francis et al that medical notes do not encourage discussion because of their format and location. Since the drug chart is used daily by doctors, nurses, pharmacists and occasionally by other health care professionals, a conjoint communication record (eg, the JCN) can fill the communication gap.

The JCN provided a means whereby professionals could transfer messages of low urgency and up to moderate importance to each other concerning the patient. It also gave information on who was caring for the patient. The JCN was located with the drug chart in the end-of-bed note folder. The introduction of the JCN decreased the total number of communication devices relied on and health care professionals found it easier to find another professional's contact number. The JCN also replaced the "sticky notes".

In particular, the pharmacists found the JCN record helpful during their ward rounds, and wrote up to 65 per cent of the messages in the JCN. Pharmacists sent twice as many messages as they received and more often gave information rather than requesting actions from others. There is a message here about pharmacists in hospitals: they are independent, specialised and informative professionals. Their heavy use of the JCN supports the need for a convenient multidisciplinary record.

The provision of a multidisciplinary communication record could also make the pharmacists more "heard and seen", breaking their professional isolation and conveniently "advertising" their skills and services.

Our study concluded that among all health care professionals there was a widely recognised urge for improvement in interprofessional communication, with an emphasis on the acknowledgement of each others' messages. Furthermore, pharmacists need a record where they can formally communicate with other professionals.

Kristina Åström
Catherine Duggan
Ian Bates
Centre for Practice and Policy,
School of Pharmacy,
University of London

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