Communication of critical information

Through the course of delivering health care, healthcare providers may learn critical information that may be relevant to other healthcare providers involved in a patient’s care. Sharing this information can lead to the best possible outcomes for patients and support multidisciplinary collaboration. Healthcare providers can use existing communication processes to convey critical information, alerts and risks in a timely way when they emerge and change, to:

• Relevant healthcare providers involved in the patient’s care
• Patients, carers and families, in accordance with the patient’s preferences. 

Identifying critical information

The identification of critical information or a risk to patient care depends on factors such as the type of service delivered and patient risks. Types of critical information could include:

• Changes to medicines or treatment
• Missed referrals or results
• Wrong diagnosis or results
• Change in patient goals, preferences or condition
• Allergies or adverse drug reactions
• Issues with equipment or medical supplies
• Information that requires follow-up with another healthcare provider (for example, the general practitioner) or the patient (or carer or family, where appropriate).

Communicating critical information 

Healthcare services should have established processes to communicate critical information, alerts and risks to:

• Relevant healthcare providers in the same healthcare service
• Relevant healthcare providers in a different healthcare service 
• Patients, carers and families.

The communication method adopted will depend on the information provided and the level of urgency involved. Examples include telephone call, referral, SMS or a combination of all.

Links to Actions 1.12 Healthcare records and 3.26 Processes for effective communication

• How does your healthcare service communicate critical information, alerts and risks to other healthcare providers within your healthcare service?
• How does your healthcare service communicate critical information, alerts and risks to healthcare providers in other healthcare services?   
• How is a patient’s preferences determined for sharing their health information within your service, with other services and to their carers and families? 

• Define ‘critical information’ and ‘risks to patient’s care’ for your service.
• Use standardised processes to communicate critical information, alerts or risks to relevant healthcare providers and patients, carers and families in a timely manner.

The type and comprehensiveness of evidence used is dependent on each healthcare service context. The content and complexity of the policies and processes will likely depend on the size of the healthcare service, but could include:

• A document describing the types of critical information likely to be received and actions taken in response 
• Processes for communicating critical information (for example, by telephone or secure electronic means) to the relevant healthcare providers including
  • method for communicating critical information to the patient, carer and family 
  • time frames for communicating critical information 
  • expectations for the healthcare provider and requirements for the patient’s care
• Standardised templates to support communication of critical information, such as referrals, templates or progress notes that are updated in line with identified risks, patient feedback and recommendations
• Observation of critical information being discussed, shared with the appropriate healthcare provider or the patient, and acted upon.

Commission resources

The principles and strategies outlined in these resources are broadly applicable.

• Communicating for safety resource portal – provides practical support for the implementation of the communicating for safety actions in the NSQHS Standards. 
• NSQHS Standards User Guide for health services providing care for people with mental health issues – provides practical support for healthcare services where specific efforts or additional attention is required to meet the health needs of this patient population, based on the NSQHS Standards.

New critical information that affects a patient’s health care comes from various sources, including patients, carers and families. 

For the right care to be delivered and action to occur, critical information must be timely. Healthcare services must ensure that patient, carers and families know how best to communicate critical information to the healthcare provider. These processes must be straightforward and easy to follow. 

The healthcare service should establish a process for patients, carers and families to communicate critical information:

• Before or at the initial appointment with the healthcare service
• At different points of care
• After the episode of care at the healthcare service.

This includes the patient’s, carer’s and family’s information on: 

• What could be considered critical information
• Their role in communicating this information 
• Resources or communication tools to support the communication of critical information to their healthcare providers
• Who they communicate critical information to.

Information such as key persons and their contact details, or an after-hours emergency contact number can be communicated to patients, carers and families in different forms. These include: 

• Displays in common areas of the healthcare service 
• Providing a phone number for patients, carers and families to call if they are concerned, particularly if it is after the episode or care at the healthcare service
• Providing written or verbal information during consultation or treatment. 

• How are patients, carers and families supported in communicating critical information to healthcare providers?
• What feedback processes are in place to let patients, carers and families know that they have been heard and any action that has been taken?

• Develop and implement processes that describe when and how critical information and risks about a patient’s health need to be communicated to healthcare providers.
• Support patients and carers to understand and use these processes.

The type and comprehensiveness of evidence used is dependent on each healthcare service context, but could include:

• Information provided to patients, carers and families about processes for communicating concerns to the healthcare providers
• Resources and information for patients, carers or families to use to communicate with healthcare providers, such as phone numbers or where to go for emergency assistance
• Patient notes that identify critical information provided by the patient or family and how this information was acted upon
• Results of a patient experience survey or patient, carer and family feedback about their communication with clinicians and, where necessary, how these results have informed improvement
• Information available online detailing the healthcare service’s communication processes or emergency contact processes (for example, on the healthcare service’s website or social media platform).

The principles and strategies outlined in these resources are broadly applicable.

Commission resources

• Communicating for safety resource portal – provides practical support for the implementation of the communicating for safety actions in the NSQHS Standards. 
• NSQHS Standards User Guide for health service organisations providing care for patients with cognitive impairment or at risk of delirium – provides practical support for healthcare services where specific efforts or additional attention is required to meet the health needs of this patient population, based on the NSQHS Standards. 
• NSQHS Standards User Guide for health services providing care for people with mental health issues – provides practical support for healthcare services where specific efforts or additional attention is required to meet the health needs of this patient population, based on the NSQHS Standards.