Intended for healthcare professionals

Rapid response to:

Practice What Your Patient is Thinking

Sibling and family caregivers

BMJ 2018; 362 doi: (Published 01 August 2018) Cite this as: BMJ 2018;362:k3158

Rapid Response:

Re: Sibling and family caregivers

With health care organisations’ commitment to providing patient-centred care, it is critical that clinicians have an understanding of the social constructs that support each patient. Social determinants of health are powerful influencers of patient outcomes yet there exists a real gap between provision of care in acute settings and in comprehensive care that considers such factors. With multi morbidity, increasing patient complexity and funding constraints, it is essential that such determinants of health be integrated into mainstream clinical practice. Failure to do so results in greater health care costs and utilisation, increased re-admissions, morbidity and less true patient centered care.

Involving family and carers into everyday routine work and ward rounds is often challenging for reasons that include time constraints, competing priorities and high patient numbers. It is however absolutely essential if we are to make a real difference in providing optimal patient care. It is well accepted that patients are often unclear about their admission diagnosis, treatment and management plans. It is their family that can assist greatly in providing an objective and independent assessment on the patient’s response and progress. The family serves as a valuable extension of the clinical workforce, affording much needed reinforcement of clinical information and support to the patient, long after the staff has completed ward rounds.

Clinical care encounters need to be much more than providing the required medical treatment in an acute setting to a patient. They must encompass a greater understanding of patients’ social needs and their individual support mechanisms. Bedside communication boards, planned family meetings and greater clarity around clinician ward round timings can help maximise opportunities for effective and meaningful interactions between clinical staff and relatives. This in turn should lead to improved prospects for early and important discussions on care delivery and enhance the likelihood for better patient outcomes.

Competing interests: No competing interests

08 August 2018
Vikas Wadhwa
Clinical Director of Integrated Services
Kylie Hall, Nurse Unit Manager
Eastern Health & Monash University
Arnold Street, Box Hill, Victoria, 3128, Australia