Communication, Collaboration, Consistency

Building Trust During Care Transitions

Michelle Silva, M.A., Strategic Advisor of Consumer Experience, NRC Health

Have you ever thought about the effort that goes into ensuring a safe, seamless flight and arrival experience when traveling?

A smooth arrival relies on tight coordination between the cockpit and ground crew, who must stay in communication on details like gate assignments, jet bridge positioning, and cargo handling. If teamwork is fractured, passengers feel the effects immediately—whether through delays in deplaning, missed connections, or baggage issues. They can quickly feel frustrated, anxious, or even unsafe as they sit on the tarmac.

The same is true in healthcare. A patient’s transition from the ED to an inpatient unit, for example, depends on departments working in sync behind the scenes, from clinicians and admissions personnel to case managers and transport. If communication breaks down—whether about bed assignments, handoff instructions, or treatment plans—patients feel “stuck at the gate.” They may wait without clear updates, experience confusion, or fear about what comes next, or lose confidence that their care is well-planned. Just as travelers expect a safe and seamless airport arrival, patients want and expect their care journey to flow smoothly from one setting to the next. That only happens with reliable communication and collaboration across departments.

NRC Health data shows that reliability is a key driver of consumer and patient trust and a positive experience. Organizations with brand promises and marketing messaging that match actual experience have the highest trust, while those that are misaligned risk falling off a consumer and patient “trust cliff” that can be challenging to come back from. What drives reliability is consistency across all touchpoints. And consistency is fostered through clear, cross-functional communication and unwavering collaboration.

The 2025 HCAHPS survey features new care coordination questions that show how integral communication and teamwork are to patient experience, especially in the inpatient setting. Among all the new measures, how well staff work together stands out as the single biggest driver of confidence and trust in doctors and nurses:

NRC Health real-time data reveals that trust breaks down when collaboration is lacking, with care coordination scores consistently lower in ED and inpatient settings compared to other areas. In addition, a correlation analysis shows that the ED and inpatient care settings are where trust is most dependent on staff working together to meet needs. In other words, where the stakes are highest is exactly where hospitals are least likely to perform well.

Moreover, when patients are admitted to a hospital through the ED, their ratings drop even further. These patients report more frustration with communication, more confusion about next steps, and more concerns about whether their care teams are aligned.

The data is clear: care transitions, particularly between the ED and inpatient care, are where consistency and patient trust are at high risk. For some patients, these may also be the moments that matter most in shaping long-term trust.

“We win and lose together:” A culture change

NRC Health partner United Regional Healthcare System is successfully breaking down teamwork and communication silos between the ED and inpatient settings by providing care to patients boarded in the ED by inpatient nurses and nurse managers.

Communication and collaboration are key to consistently positive, seamless care transitions. Yet it’s no secret that most hospitals operate in silos, with departments like the ED, inpatient units, and ancillary services functioning as semi-autonomous groups, each with its own subcultures, workflows, and priorities. Their distinct identities—sometimes even “us versus them” sentiments—can create fragmented communication, disjointed processes, and inconsistent care, leaving patients feeling handed off rather than supported through a continuous journey.

Elevating communication and teamwork requires a commitment by leaders to developing effective interdepartmental communication, engagement, and information-sharing. This can include establishing interdepartmental workforce liaisons to break down silos and bridge department communication, developing a workflow resource hub on the intranet with workflow visuals and process mapping, and hosting cross-department workflow education and training sessions. Interdepartmental job shadowing and immersion can help employees experience workflows outside their usual roles and understand how their work impacts up- and downstream departments.

Finally, fostering camaraderie and interpersonal connections between departments and teams helps make collaboration and communication easier. Leaders should remind employees that how they communicate about and to each other can negatively impact teamwork and culture and reinforce silos. Managers can organize team lunches, cross-functional retreats, and/or informal Q&A sessions to build relationships.

Like air travel, healthcare requires all teams to be in sync to efficiently and seamlessly guide consumers and patients through every touchpoint. Data shows that inconsistencies in coordination erode trust, particularly between the ED and inpatient settings. To strengthen trust, healthcare organizations must focus on reliable handoffs through consistent teamwork and communication. Reliability is not built in a single interaction, but earned through consistency across the entire journey. Below are additional ways leaders can enhance communication and teamwork across departments: