Communication in Healthcare

Deficient communication in healthcare can reduce the quality of care, increase wastage of resources, and cause high healthcare costs. Misunderstandings about medications and miscommunications about follow-up or discharge instructions can result in readmissions or a patient coming to harm. Hence, comprehensible and effective communication between patients and their doctors is vital for preventing poor patient health outcomes and malpractice lawsuits. CRICO Strategies medical safety experts found that of 23,000 malpractice suits investigated, 7,000 were attributed to failures in communication. These cases resulted in $1.7 billion in malpractice costs and around 2,000 preventable deaths. This document serves as a guide for best practices when faced with clinician-clinician and clinician-patient interaction.

Effective Communication in Healthcare

Clinician-Patient Communication

An essential piece of communication is taking the time to teach patients (and their families) about their medications, activities, follow-up appointments, and how to contact the physician if problems arise. Smooth and thorough communication takes much practice and is more than a poster on the wall with mechanized steps.

Part of communication with patients is listening effectively to both nonverbal and verbal information. Low health literacy is a communication barrier with patients that must not be overlooked. Using plain-language descriptions of diagnoses and treatments and communicating medical advice in layman’s terms are crucial abilities for clinicians to have or learn.

Clinician-Clinician Communication

Communication failures notoriously occur at the time of shift changes. When ambiguous or incomplete information is disseminated during the transition of care, the potential of medical errors occurring increases. The Joint Commission performed a study that found that about 80% of severe medical errors resulted from communication blunders between caregivers during shift changes. Miscommunications and providing incomplete information about patients’ conditions can lead to wrong decisions about treatment and impact the speed of treatment. Slow treatment speed not only causes health problems for the patient, but it can also lead to poor patient satisfaction ratings for the hospital.

Common Areas of Communication Problems: Ineffective Policies/Procedures, Language Difficulties, Poor Communication Skills, Workload Pressure, EHR Issues, Poor Documentation, Conflicts Between Staff Members, and Ineffective Communication Systems within the hospital. Hospital hierarchies can also lead to communication failures. If some clinicians have a power advantage, this can result in communication barriers.

Improving Communication in Healthcare

Several communication plans are available for implementation to improve communication within hospitals, particularly at shift changes. For example, the RELATE Model (Reassure, Explain, Listen/ Answer questions, Take action, and Express appreciation, the STICC Model (Situation, Task, Intent, Concern, Calibrate), and the BATHE Protocol (Background Affect, Troubles, Handling, Empathy). More information on these strategies and how they can be implemented can be found here. The blueprints for many of these plans require updated technology use within the hospital, such as mobile devices and communication technologies. Clinical Communication and Collaboration (CC&C) services have significantly improved information exchanges within hospitals. HIPAA-compliant messaging technologies can be used between a patient’s care team for updated and thorough communication. Support video and audio calls are also available on CC&C platforms for efficient consultations and effective communication with new caregivers at shift changes. CC&C handily operates with EHRs, allowing messages to be sent to any clinicians in the hospital from the EHR. The implementation of CC&C systems has shown improvement in several aspects of hospital care: patient safety, reduction in medical errors and patient wait times, greater productivity, and significant cost cuts.

These systems provide the opportunity for excellent communication between clinicians for better patient care, but what about the patient-clinician communication that comes with hospital visits?

Several effective patient-physician communication techniques can be followed to mitigate confusion and misunderstandings:

  • Avoid Medical Jargon When Communicating with Patients
  • Many physicians accidentally overestimated their patients’ health literacy, and Residents were found to overestimate their use of layman’s terms and teach-back by 50%. To some, medical jargon can sound like a foreign language.
  • Ask Patients Open-Ended Questions
  • Open-ended questions offer a chance for patients to engage in their appointments, uncover more information about their problems, and promote the asking of deeper “How” and “Why” questions rather than yes/no questions.
  • Listen to Your Patients and Slow Down
  • By listening, you ensure that all information is obtained while also conveying a sense of investment in your patient and their issues. Slow down your conversations with strategic silences and allow them to interrupt you to ask you questions about their health. This technique comes in handy, mainly when delivering bad news, as patients need time for information like this to sink in.
  • Use Eye Contact When Talking to Patients
  • Because of the increase in the use of EMR systems and technology in medical settings, it could be said that there has been a sense of depersonalization with doctor appointments. Along with this, the amount of eye contact with patients has decreased. This could, unfortunately, result in the patient feeling as if you are distracted from the visit. To mitigate this issue, try finishing your notes after leaving the room or use a scribe so you can focus your attention on the patient.
  • Summarize Patient Concerns
  • Reiterating a patient’s concerns reinforces that you have been actively engaged in the conversation and understand their issues. By summarizing your visit with the patient, you reassure them that their concerns are being heard and will be addressed.
  • Offer Patients Words of Encouragement
  • Address progress when you see it in your patients. Talk about it. Promoting these good behaviors will encourage them in the future. This is a fantastic way to build a deeper relationship with your patients. By portraying a “we are in this together” attitude, you are letting your patients know they are not alone.
  • The National Patient Safety Foundation created a tool called Ask Me 3, an effective way for patients to participate in their doctor appointments actively. The goal of this tool is for patients to understand the answers to the following questions:
    1. What is my main problem?
    2. What do I need to do?
    3. Why is it important for me to do this?