Inter-Specialty Communication for Older and High-Risk Surgical Patients: "A Huge Opportunity to Really Impact Our Patients' Care"

Older adults benefit from a multidisciplinary approach to perioperative care, with reductions in length of stay and postoperative readmission. To explore perioperative communication, we conducted in-depth, semi-structured interviews with anesthesia, surgery, and primary care providers caring for older patients in northern New England. Communication barriers included cumbersome health information exchange with system fragmentation across and within electronic health records resulting in clinician and administrative burden and unnecessary duplication of services. Clinicians expressed the value of preoperative communication across specialties but described a lack of timely communication with colleagues caring for shared patients and uncertainty about specialty roles and responsibilities. Preferences and use patterns of communication modalities varied across specialties, but the need for direct, secure communication linked to the patient chart was consistent. Clinicians emphasized the importance of communication for efficiency and patient safety and suggested strengthening perioperative care pathways through improvements in technological and organizational infrastructure and interprofessional relationships.