6 Key Interpersonal Skills Required for Communicating Effectively with Patients, Families/Advocates
A key strategy to support your learning about patient safety is to reflect on basic concepts and how you can apply these concepts in your daily practice. This article is the seventh in a series highlighting a key patient safety topic.
In article four in this series, the concept of “patients as partners” was reviewed. We pointed out that engaging patients is at the foundation of safe care. Engaging patients can improve their healthcare experience, their health outcomes, and can reduce patient harm. Engaging patients leads to improvements in various aspects of the care experience, such as length of stay, re-admissions, communication between team members, and in understanding family strengths for future care-giving.
If patient engagement is at the foundation of safe care, what is at the foundation of patient engagement? One pillar is communication. Communication breakdowns can occur without a common basis of understanding, and communication breakdowns are considered to be the leading factor that influences patient harm.
“The single biggest problem in communication is the illusion that it has taken place.”
George Bernard Shaw
What is “communication”? Communication is information transmission. Communication requires that all parties understand a common language that is exchanged, be it by verbal, written or other means. Between parties, communication includes acts that confer knowledge and experiences, give advice and recommendations, and ask questions. It is through communication that collaboration and co-operation in healthcare partnerships occur.
We have every good intention of making our intended meaning understood. However, there will be many interpretations of the meaning of a person’s communications. Sometimes healthcare providers need additional tools to help others understand what they are attempting to communicate.
Communication can be challenging for many reasons. These include physical factors such as hearing loss, and emotional factors such as anxiety and stress. Communication can be impacted by the way in which healthcare providers elicit the patient's story, and interruptions that occur before the patient's full description of their situation is heard[1]. In addition, health literacy is an issue for a significant number of Canadians. It has been estimated that 60% of Canadians have low health literacy, meaning that they have challenges finding, reviewing, analyzing and communicating information they need to make health decisions[2].
The public is often faced with complex health information and treatment decisions. They need to have skills to:
These skills are important to individuals being involved in their healthcare and partnering with healthcare providers to improve safety. However, people with low health literacy have challenges in these areas that can compromise safety.
Even if patients hear and understand what is said, it is estimated that up to 80% of information shared in a primary care visit is immediately forgotten by patients[3]. This means that despite efforts to inform patients about their health situation, they will only retain a small part with memory alone.
Here are some communication tips for healthcare providers to enhance communication and improve health literacy with patients and families/advocates.
Learn to be safe!!
A key strategy to support your learning about patient safety is to reflect on basic concepts and how you can apply these concepts in your daily practice. This article is the seventh in a series highlighting a key patient safety topic.
In article four in this series, the concept of “patients as partners” was reviewed. We pointed out that engaging patients is at the foundation of safe care. Engaging patients can improve their healthcare experience, their health outcomes, and can reduce patient harm. Engaging patients leads to improvements in various aspects of the care experience, such as length of stay, re-admissions, communication between team members, and in understanding family strengths for future care-giving.
If patient engagement is at the foundation of safe care, what is at the foundation of patient engagement? One pillar is communication. Communication breakdowns can occur without a common basis of understanding, and communication breakdowns are considered to be the leading factor that influences patient harm.
“The single biggest problem in communication is the illusion that it has taken place.”
George Bernard Shaw
What is “communication”? Communication is information transmission. Communication requires that all parties understand a common language that is exchanged, be it by verbal, written or other means. Between parties, communication includes acts that confer knowledge and experiences, give advice and recommendations, and ask questions. It is through communication that collaboration and co-operation in healthcare partnerships occur.
We have every good intention of making our intended meaning understood. However, there will be many interpretations of the meaning of a person’s communications. Sometimes healthcare providers need additional tools to help others understand what they are attempting to communicate.
Communication can be challenging for many reasons. These include physical factors such as hearing loss, and emotional factors such as anxiety and stress. Communication can be impacted by the way in which healthcare providers elicit the patient's story, and interruptions that occur before the patient's full description of their situation is heard[1]. In addition, health literacy is an issue for a significant number of Canadians. It has been estimated that 60% of Canadians have low health literacy, meaning that they have challenges finding, reviewing, analyzing and communicating information they need to make health decisions[2].
The public is often faced with complex health information and treatment decisions. They need to have skills to:
- access health care services
- analyze relative risks and benefits
- calculate dosages
- communicate with healthcare providers
- evaluate information for credibility and quality
- interpret test results
These skills are important to individuals being involved in their healthcare and partnering with healthcare providers to improve safety. However, people with low health literacy have challenges in these areas that can compromise safety.
Even if patients hear and understand what is said, it is estimated that up to 80% of information shared in a primary care visit is immediately forgotten by patients[3]. This means that despite efforts to inform patients about their health situation, they will only retain a small part with memory alone.
Here are some communication tips for healthcare providers to enhance communication and improve health literacy with patients and families/advocates.
- Use plain language.
- Use visual models.
- Use 2-way communication. Ask patients/advocates to “teach back” information and instructions by telling you what they heard you say.
- Encourage patients to ask questions and use the “It’s Safe to Ask” brochure to write them down to bring to appointments. Make it Safe to Ask! Suggest that patients/advocates write down the answers.
- Ask “What matters to you?”[4]. Listen actively and respond to what matters to patients.
- Be mindful of non-verbal communication and use it to enhance communication.
Effective communication will help patients and families understand the information they need to make decisions. It also helps healthcare providers get the information they need to understand the patient’s situation and to provide advise and recommendations.
Below are additional resources and references for further study on effective communication in healthcare.
Learn to be safe!!
Manitoba Institute for Patient Safety Make it Safe to Ask
Using Family-Centered Rounds to Improve Care and Communication ABC Life Literacy Canada. Health Literacy
Skills in Canada: First Results from the Programme for the International Assessment of Adult Competencies (PIAAC) 2013
Videos:
BC Patient Safety and Quality Council. What Matter’s to You? (1:32 mins)
American Medical Association. Health Literacy and Patient Safety (23:18 mins)
Dr. Abraham Verghese: A Doctor's Touch (18:32 mins)
[1] Ospina, Naykky Sing et al. Eliciting the patient’s agenda – Secondary Analysis of Recorded Clinical Encounters. Journal of General Internal Medicine, 2019 Volume 34: 36 – 40. Accessed June 11, 2020 at https://link.springer.com/article/10.1007/s11606-018-4540-5#Tab2[2] Health Literacy in Canada. Accessed June 5, 2020 http://www.en.copian.ca/library/research/ccl/health/health.pdf
[3] Kessels, R. Patients memory for medical information. J R Soc Med. 2003 May; 96(5): 219–222.
[4] What Matters to You – BC Patient Safety and Quality Council
https://bcpsqc.ca/advance-the-patient-voice/what-matters-to-you/ Accessed June 5, 2020
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