As the model of medical care in nursing homes evolves, it’s becoming increasingly common for multiple providers to be involved in a patient’s care. Whether it’s an attending physician, one or more advanced practice providers (APPs), or a mix of both, the need for regular, effective communication is more important than ever.

This shift in care structure reminded me of my residency years. At the end of each shift, we would receive detailed sign-outs from our colleagues — a structured handoff that covered each patient’s active issues, care plans, and any pending concerns. That simple routine kept the entire team aligned and ensured that no details slipped through the cracks.

Bringing Back the Sign-Out Model

Inspired by that practice, our team has adopted a similar version of the sign-out:

• Quick joint calls are held daily or every other day

• All providers involved join to briefly review patients and address updates or concerns

• Focus on efficiency:  most calls take just a few minutes

This approach has been a game-changer in keeping our team coordinated and proactive.

Supplementing with Shared Digital Tools

In addition to regular calls, we also use a shared Google Sheet to document key updates on our patients. This living document allows any provider to jump in and immediately understand what’s going on, a helpful backup when schedules get busy. While maintaining it can be time-consuming, it has proved beneficial for many practices seeking better transparency.

The Risks of Poor Communication

Recently, we encountered a challenging situation involving a patient with a history of opioid use disorder. The care plan involved transitioning the patient to buprenorphine (Suboxone). Due to a lapse in provider-to-provider communication, the patient’s responsible party received two conflicting messages from two members of our own team. Each provider based their message on personal experience with Suboxone, but the lack of coordination resulted in confusion and mistrust.

This incident underscored the importance of having a structured, reliable communication system among providers,  not just for clinical accuracy, but to maintain the confidence of our patients and their families.

Conclusion: A Small Shift, Big Impact

Whether through brief calls, shared documents, or both, building regular communication into your practice’s workflow can significantly improve coordination and outcomes in the nursing home setting. As teams grow and care becomes more complex, this simple shift can ensure everyone is moving forward together,  with clarity, confidence, and patient safety at the center.