IntroductionResearch evidence indicates that there are strong positive relationships between a healthcare team member’s communication skills and a patient’s capacity to follow through with medical recommendations, self-manage a chronic medical condition, and adopt preventive health behaviors. Studies conducted during the past three decades show that the clinician’s ability to explain, listen and empathize can have a profound effect on biological and functional health outcomes as well as patient satisfaction and experience of care. BackgroundPatients’ perceptions of the quality of the healthcare they received are highly dependent on the quality of their interactions with their healthcare clinician and team 2,3. There is a wealth of research data that supports the benefits of effective communication and health outcomes for patients and healthcare teams. The connection that a patient feels with his or her clinician can ultimately improve their health mediated through participation in their care, adherence to treatment, and patient self-management. 4, 5, 6, 7,8, 9 Yet, it is estimated that one-third of adults with chronic illnesses underused their prescription medication due to cost concerns; yet they fail to communicate this information to their physician 10. Another study found that less than half of hospitalized patients could identify their diagnoses or the names of their medication(s) at discharge, an indication of ineffective communication with their physicians. 11 The Institute of Medicine (IOM) Report on Health Professions and Training 12 has identified that doctors and other health professionals lack adequate training in providing high quality healthcare to patients. The IOM 12called upon educators and licensing organizations to strengthen health professional training requirements in the delivery of patient-centered care. The patient-centered care model 13 underscores the essential features of healthcare communication which relies heavily on core communication skills, such as open-ended inquiry, reflective listening and empathy, as a way to respond to the unique needs, values and preference of individual patients 14. Healthcare Communication OutcomesA clinician may conduct as many as 150,000 patient interviews during a typical career. If viewed as a healthcare procedure, the patient interview is the most commonly used procedure that the clinician will employ. Yet communication training for clinicians and other healthcare professionals historically has received far less attention throughout the training process than have other clinical tasks. This is so even as evidence continues to mount that a structured approach to communication measurably improves healthcare delivery. Diagnostic Accuracy
AdherenceAdherence is defined as the extent to which a patient’s behavior corresponds with agreed upon recommendations from a healthcare provider 16. Certainly, we are all aware of the huge problem of non-adherence in health care. For instance, a Health Care Quality Survey 17conducted by the Commonwealth fund found that 25% of Americans report they did not follow their clinician’s advice and provides the reasons cited in this survey:
Patient SatisfactionThe core elements comprising patient satisfaction 18 include:
Patient Safety
Team SatisfactionWhy is team satisfaction important?
What are the elements that contribute to healthcare team satisfaction: Feeling supported, e.g., administratively and inter-personally, respected, valued, understood, listened to, having a clear understanding of role, work equity and fair compensation. Malpractice Risk
SummaryResearch evidence indicates that there are strong positive relationships between a healthcare team member’s communication skills and a patient’s capacity to follow through with medical recommendations, self-manage a chronic medical condition, and adopt preventive health behaviors. Studies show that the clinician’s ability to explain, listen and empathize can have a profound effect on biological and functional health outcomes as well as patient satisfaction and experience of care. Further, communication among healthcare team members influences the quality of working relationships, job satisfaction and has a profound impact on patient safety. Clinicians and other members of the healthcare team conduct thousands of patient interactions during their career. The call to action from the Institute of Medicine (IOM) Report on Health Professions and Training 12underscores the importance of communication training for clinicians and members of the healthcare team. Similar to other healthcare procedures, communication skills can be learned and improved upon. Improvement in communication skills requires commitment and practice. Given the wealth of evidence linking ineffective clinician-patient communication with increased malpractice risk, nonadherence, patient and clinician dissatisfaction, and poor patient health outcomes, the necessity of addressing communication skill deficits is of the utmost importance. References1. Asnani MR. (2009). Patient-physician communication. WestIndian Med J, 58(4):357-61. pubmed 2. Clark PA. (2003). Medical practices’ sensitivity to patients’ needs: Opportunities and practices for improvement. Journal of Ambulatory Care Management, 26(2), 110-123. pubmed 3. Wanzer MB, Booth-Butterfield M & Gruber K. (2004). Perceptions of health care providers’ communication: Relationships between patient-centered communication and satisfaction. Health Care Communication, 16(3), 363-384. pubmed 4. Duffy FD, Gordon GH, Whelan G, Cole-Kelly K, & Frankel R. (2004). Assessing competence in communication and interpersonal skills: The Kalamazoo II report. Academic Medicine, 79, 495-507. pubmed 5. Heisler M, Bouknight RR, Hayward RA, Smith DM, & Kerr EA. (2002). The relative importance of physician communication, participatory decision-making, and patient understanding in diabetes self-management. Journal of General Internal Medicine, 17, 243-252. pubmed 6. Renzi C, Abeni D, Picardi A, Agostini E, Melchi CF, Pasquini P, Prudu P, & Braga M. (2001). Factors associated with patient satisfaction with care among dermatological outpatients. British Journal of Dermatology, 145, 617-623. pubmed 7. Safran DG, Taira D, Rogers WH, Kosinski M, Ware JE, & Tarlov AR. (1998). Linking primary care performance to outcomes of care. Journal of Family Practice, 47(3), 213-220. pubmed 8. Sullivan LM, Stein MD, Savetsky JB, & Samet JH.. (2000) The doctor-patient relationship and HIV-infected patients’ satisfaction with primary care physicians. Journal of General Internal Medicine, 15, 462-469. pubmed 9. Zachariae R, Pederson CG, Jensen AB, Ehrnrooth E, Rossen PB, Von der Maase H. (2003). Association of perceived physician communication style with patient satisfaction, distress, cancer-related self-efficacy, and perceived control over the disease. British Journal of Cancer, 88, 658-665. pubmed 10. Piette JD, Heisler M, & Wagner TH. (2004). Cost-related medication underuse among chronically ill adults: The treatments people forgo, how often, and who is at risk. American Journal of Public Health, 94(10), 1782-1787. pubmed 11. Makaryus AN & Friedman EA. (2005). Patients’ understanding of their treatment plans and diagnosis at discharge. Mayo Clinic Proceedings, 80(8), 991-994. pubmed 12. Institute of Medicine. (2003). Health professions education: A bridge to quality. Washington, D.C.: National Academies Press 13. Stewart MA. (1995). Effective physician-patient communication and health outcomes: A review. Canadian Medical Association Journal. 152:1423-1433. pubmed 14. Stewart M, Brown J, Donner A, et al. (2000). The impact of patient-centered care on outcomes. J Fam Pract.;49:805-807. pubmed 15. Peterson MC, Holbrook J, Von Hales D, Smith NL, & Staker LV. (1992). Contributions of the history, physical examination and laboratory investigation in making medical diagnoses. Western Journal of Medicine, 156, 163-165. pubmed 16. World Health Organization. (2003). Adherence to long-term therapies: Evidence for action. Switzerland: WHO Library Cataloguing. World Health Organization 17. Davis K, Schoenbaum SC, Collins KS, Tenney K, Hughes DL, & Audet AM. (2002). Room for improvement: Patients report on the quality of their health care. New York: Commonwealth Fund 18. Thiedke CC. (January 2007). What do we really know about patient satisfaction? Family Practice Management, 33-36. pubmed 19. Team strategies and tools to enhance performance and patient safety (TeamSTEPPS), Department of Defense and Agency for Healthcare Research and Quality http://www.ahrq.gov/qual/teamstepps/ 20. Lein C & Wills CE. (2007). Using patient-centered interviewing skills to manage complex patient encounters in primary care. American Academy of Nurse Practitioners, 19:215-220. pubmed 21. DiMeglio K, Lucas S & Padula C. (2005). Group Cohesion and Nurse Satisfaction. Journal of Nursing Administration. 35:3 , 110-120. pubmed 22. Larson EB & Yao X. (2005). Clinical empathy as emotional labor in the patient-physician relationship. Journal of American Medical Association, 293(9), 100-1106. pubmed 23. Huntington B & Kuhn N. (2003). Communication gaffes: A root cause of malpractice claims. Baylor University Medical Center Proceedings, 16, 157-161. pubmed 24. Beckman HB, Markakis KM, Suchman AL, & Frankel, RM. (1994). The doctor-patient relationship and malpractice. Lessons from plaintiff depositions. Archives of Internal Medicine, 154(12) 1365-1370. pubmed July 2011 Why is communication important in healthcare for patients?Skillful communication is essential to health care. Clear, honest communication between patient and provider paves the way for accurate diagnoses and treatment decisions.
Why is communication important between patient and nurse?Communication assists in the performance of accurate, consistent and easy nursing work, ensuring both the satisfaction of the patient and the protection of the health professional.
How can you ensure that you are communicating effectively with patients?Be attentive. “Listen completely and attentively. ... . Ask open questions. ... . Be curious. ... . Summarise throughout. ... . Involve friends and family. ... . Use the right tone. ... . Be aware of your patient's situation. ... . Get help from colleagues.. |