“Hand holding and Chinese whispers..”

As part of my job as a clinical microbiologist, I am usually on the telephone 20-30 times per day.

That is a lot of telephone time for a man…

With regards to outgoing calls, a lot of these are simply information gathering. For example, is this patient with Gram negative bacteraemia on appropriate Gram negative cover? Has this patient with Clostridium difficile infection been isolated and treated? Has this patient with Staphylococcus aureus bacteraemia been investigated properly?

Gathering this information by telephone is of course always a little fraught with difficulty. Trying to get hold of the right person to speak to can take up a lot of valuable coffee drinking time. There is also no guarantee that the information you are given is accurate, and has not evolved along a chain of “Chinese whispers”. Sometimes you finish the phone call no more enlightened than when you started…

Many of these calls would not be necessary if the hospital/health network had a live, real time “Electronic Health Record”, along with an electronic/digital drug chart for each patient. These innovations simply cannot come soon enough to my neck of the woods. Objective, readily accessible clinical information is what microbiologists crave.

Incoming calls are generally from clinicians looking for advice on antibiotics, infection control, optimal samples, etc. Much of the information that I give out could easily be accessed from published clinical guidelines. There is often an element of “hand holding” here, of sharing the responsibility for the decision made, and sharing the blame if something goes wrong..

Personally I was never very good at hand-holding…

And then, once or twice a day, an interesting phone call comes along, one which stimulates the mind, and prompts further thought and reading, and reminds me that I do after all work in a microbiology laboratory, and not a call centre…


2 thoughts on ““Hand holding and Chinese whispers..”

  1. We use Whatsapp to instantly inform critical results to clinicians. We have been added to many groups that have been set up by a particular hospital, ward, firm or specialty, and all relevant clinicians are added to the group. We take a photo of the report and paste a standard comment asking the relevant clinician to contact us to discuss the result within the next hour. If we receive no response, we actively make telephonic communication. The benefits include: real-time dissemination of the result thereby reducing delays in clinical action, electronic paper trail (we can see who has seen the result and when), the most appropriate managing clinician will get the result and return the call with all the relevant information at hand, we waste less time trying to find the right clinician, etc. Uptake and satisfaction with the system has been highly favourable. Although there are concerns about confidentiality, the groups are private and “in-house”. We believe the benefits to the patient ethically outweigh this concern.

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