Problem:
Early and consistent communication between medical staff and patients’ families is essential in subacute geriatric units, where patients often have complex needs and may lack capacity. Inconsistent or delayed communication can lead to unrealistic expectations and misaligned care goals. Prior to this audit, documented communication with patients’ next of kin in our geriatric evaluation and management (GEM) unit was variable.
Design/methods:
A clinical audit was conducted in a 16-bed subacute geriatric unit within Metro North Health Service, Queensland. Medical records of new admissions were reviewed to determine whether next of kin were contacted on the day of, or the next working day after, admission and whether the GEM service was explained. Three 30-day audit cycles were completed. Patients who declined family contact or had no identifiable next of kin were excluded.
Practice change:
Two interventions were implemented. First, medical staffing was improved by appointing a full-time Principal House Officer, increasing clinician availability for communication. Second, targeted education was delivered to the medical team, emphasising timely family contact and clear explanation of the GEM process.
Re-audit:
Each cycle included 12 eligible patients. Documented family contact improved from 33% at baseline to 50% in Cycle 1 and 67% in Cycle 2. Documentation that both contact occurred and the GEM service was explained increased from 0% to 42% and 50%, respectively.
Conclusions:
Enhanced staffing and increased team awareness improved early communication with families in a subacute geriatric unit. Further improvements may be achieved through standardised admission prompts, multidisciplinary involvement, and ongoing monitoring.