Seeking Guidance on Hospital Care Coordination
Subject: Request for Guidance on Managing Care Coordination for a Family Member in the Hospital My brother, who has schizophrenia, has been receiving treatment in the hospital since December. While he primarily stays in the inpatient psychiatric unit, he has been transferred to the ICU and medical units due to various health complications. The goal is to return him to the psychiatric unit for electroconvulsive therapy (ECT). I am finding it challenging to ensure proper coordination and communication between hospitals during his stays, especially when a new doctor takes over every twelve hours. It appears that the medical staff is often unaware of critical information regarding his treatment. For instance: 1) They lack knowledge of his transfer plan back to the psychiatric unit for ECT, 2) they are unaware of his need for regular physical and occupational therapy, leading to missed orders, 3) they do not realize the importance of monitoring his weight frequently due to malnourishment, 4) they have not recognized the requirement for an ENT specialist to manage his ongoing swallowing difficulties, which took my intervention to address by requesting a consultation. It seems crucial information fails to accompany him as he transitions between units, and unfortunately, he cannot convey these needs himself. Additionally, I am having difficulty ensuring that his psychiatrist from the inpatient unit remains engaged while he is hospitalized in medical care. Once he is in the ICU, his psychiatrist is no longer in charge, yet her involvement is essential for decision-making that affects his preparation for ECT. A different psychiatric team is responsible for the medical floors, and this creates a disconnect from his primary psychiatrist's oversight. Am I expected to navigate this complex situation on my own? Because that's how it feels. I would appreciate any advice on effectively managing these challenges. Thank you for your help.
Answers (1)
8/13/2025, 3:11:29 AM
OpenHealth AI
It sounds like you are facing a challenging situation coordinating care for your brother during his hospital stay, especially given his complex needs related to schizophrenia and accompanying medical conditions. Effective communication and care coordination are essential in such scenarios, and it's understandable to feel overwhelmed. Here are some essential points and actionable steps to help manage this situation better:
Key Points
- Care Coordination Challenges: Communication gaps often occur during transitions between units, which is affecting his treatment plan.
- Provider Engagement: Ensuring all relevant healthcare providers are engaged, especially his psychiatrist, is critical for cohesive care.
- Your Role: While it may feel that you're navigating this alone, there are steps you can take to advocate for your brother's care more effectively.
Next Steps
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Designate a Care Coordinator: Request a dedicated nurse or social worker to act as a liaison who can help facilitate communication between the medical and psychiatric teams. This person can help bridge the gap and ensure that everyone is on the same page regarding your brother's needs.
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Prepare a Care Summary: Create a concise document outlining your brother's key medical history, current treatment needs (including ECT plans and therapy requirements), and any special considerations such as weighing and ENT referrals. Share this document with all care teams upon admission and whenever he is transferred.
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Daily Check-Ins: Make it a priority to check in with the nursing staff or care providers at the start of each shift or daily. It's also beneficial to be physically present if possible, as personal interactions can help reinforce the importance of your brother's needs.
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Advocate for Psychiatrist Involvement: Communicate directly with your brother's psychiatrist to keep her engaged. Whether by phone, email, or in-person discussions, emphasize the importance of her involvement in his care decisions, particularly regarding ECT preparation. Encourage her to provide a written directive or notes that can accompany your brother during his transfer.
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Utilize Family Meetings: If the hospital has family meetings, participate actively. This can be an excellent opportunity to discuss your brother's comprehensive care plan with medical staff, ensuring all providers have the same information and goals.
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Track Progress: Keep a simple log of significant events, treatments, and missed communications regarding his care. This can help you identify patterns or recurring issues that you may discuss with hospital administration or the patient advocate team if needed.
Emotional Support
While it can be overwhelming to coordinate such detailed care, remember, you are advocating for your brother's well-being, which is already a significant support. It's understandable to feel lost in the process, but these practical steps should help ease some of that burden. Feel free to ask for additional resources or support from mental health advocacy organizations if you need more guidance.
Your efforts are critical, and it’s commendable that you’re seeking the best for your brother.
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