In the evolution of medicine, effective communication has been of crucial importance. There is plenty of evidence of the negative consequences of poor communication. This is along with inadequate information during a caregiver and care seeker interaction. There are various components to effective communication in a healthcare system. Effective communication is a two-way activity between patients and healthcare systems. If either the care seeker or care provider lacks a clear understanding of the information conveyed, the delivery of care is compromised.
Care seekers should be able to convey information about their health complaints to healthcare workers. Caregivers must be able to adequately understand and deduce the information to treat health complaints appropriately. In any case, if the aforementioned process is compromised, healthcare delivery becomes ineffective. Therefore, it increases the likelihood of negative patient outcomes and also patient utilization of in-patient and emergency care. Parallely, the burden of cost on healthcare systems increases. Communication is a very crucial aspect of the health care process. Hospitals with strong communication policies can enrich their patients’ health. Health care professionals need to recognize the importance of communication in health care to thrive.
The care seeker’s perspective on the treatment they receive is dependent on the quality of communication with their caregiver. Research states that the benefits of effective communication in the healthcare industry brings a positive patient outcome. Previously, due to the negligence of communicating the seriousness of certain diseases or the importance of medications in a few health conditions, led to serious consequences. Decades ago, physicians were presumed to hone their communication skills at patients’ bedsides, in their residency. This was as students working under senior clinicians. In a modern era like today, effective communication is a matter of ethics. It is estimated that at least 1/3rd of the adults with chronic illness underuse their prescriptions due to the cost concerns and still fail to escalate the issue to their physician. It is important that a care seeker feels a sense of connection with their caregiver to improve patient health.
Communication and interpersonal skills of the doctor-in-training are now considered as a set of measurable and modifiable behaviors that can evolve with training. Over 65% of medical schools now teach communication skills. Training in patient-physician communication is now tangibly assessed as a core competency in various accreditation settings. The evidence accordingly indicates the average length of the caregiver and care seeker encounter has not changed significantly in recent years. The specific results of the analysis indicate a correlation between patient participation in proper health plans and shorter hospital visits.
The caregivers' perspective – Why interact with patients?
Right from obtaining patient history to conveying a treatment plan, communicating effectively is a must. The basic relation of a physician and a care seeker is entirely built on communication which includes both verbal and written. Most of the communication is related to the diagnosis and the treatment provisions and options. Sometimes the caregivers notice that the care seekers are searching for psychological healing, a safe place for the care seeker to express. The patient’s contact with their physician is often the first step toward reconnection. Hence, the caregiver needs to listen to patient concerns, provide comfort and healing, and foster the relationship in general. The aspect of the care seeker and caregiver relationship is hard to define and, yet, with little doubt, can be a therapeutic relationship. This aspect also forms the basis for quality health care delivery.
In settings involving the delivery of bad news, a caregiver who can communicate bad news directly and compassionately will help the patient cope. In addition, it will strengthen the quality of the relationship to endure and further extend the healing process. Specific communication skills that involve preparing in advance include validating emotions, dealing with family members and new demise have been described for this difficult setting. Undoubtedly, each physician must cultivate his or her style of communication. Many professional and academic organizations have defined key elements of communication skills needed by physicians.
How to improve communication with patients?
To help caregivers gain and strengthen effective and personal communication flair, a few methods have been assembled with a list of practical steps.
- Understand the level of patient education-
Before providing any information or educating a patient, understand what the patient knows about one’s condition. A few times, healthcare providers have initially communicated information to the patient which can confuse when new information is provided. In a few scenarios, the patients come to the doctor with some preconceived notions about a particular illness. Hence it is very necessary to understand what the patient knows.
- Understand what the patient wants to know-
Studies have acknowledged that not every patient wants to seek information in a detailed manner. Doctors/physicians, before giving any new information to the patient, should assess whether the patient desires, or will be able to comprehend, additional information. Educate the patient about the risks and benefits of the procedure and then allow the patient to choose how much additional information he or she wants.
- Empathy is the key –
As a healthcare provider, empathy is the basic skill every doctor carries.It should be developed to recognize the unexpressed thoughts and emotions of the care seeker. Once identified, these sentiments/ reactions need to be recognized and further explored during the patient-physician encounter.
- Keep things simple –
An easy explanation works best. Caregivers should always remember to avoid long conversations about the illness while interacting with a care seeker. A simple and educative talk will inspire the patient to work with the physician on the treatment plan and avoid any distress.
- Be honest –
It is important to be truthful. Moreover, physicians mustn’t minimize the impact of what they are saying. Educate the care seeker on what could be the possible options for any certain illness. Sometimes euphemisms may soften the delivery of bad news but it can be extremely misleading.
- Prepare for a reaction-
Most caregivers/ doctors quickly grow a sense of the various coping styles of patients, a range of human reactions that have been characterized in several specific clinical settings. In response to any of the patient reactions, it is important to be prepared. The basic first step would be to recognize the response, allowing sufficient time for a full display of emotions and reactions.
The Care seeker perspective -
Being a good doctor requires not only knowledge and technical skills, but also effective communication skills. It is the basic moral duty of the doctor and the right of the patient when it comes to communication with the patient’s disease. The treatment he is to receive, the complications and alternative treatments if any. It has been recognized and understood that difficulties in the effective delivery of health care can arise from problems in communication between patient and provider rather than from any failing in the technical aspects of medical care. Trust is thought of as a fundamental characteristic of the doctor –patient relationship.
Patients must trust that their caregivers will work in their best interests to achieve optimal health outcomes. Patients’ trust has been demonstrated to be more important than treatment satisfaction. Studies have demonstrated that trust is additionally a strong predictor of a patient continuing with their provider. Trust extends to many different aspects of the caregiver/ careseeker relationships including, but not limited to the doctor’s willingness to listen to the patients. But also, patients’ believing that the doctor values patient autonomy and ability to make informed decisions, and patients feeling comfortable enough to express and engage in dialogue related to their health concerns.
Fortunately, the modern perspective emphasizes that the caregivers (and generally all health professionals) and the patient need to work together as a team. The whole procedure, from diagnosis to treatment—even until the end of life, is actually a result of teamwork. The physician/ caregiver will reach a diagnosis and explain the patient about the illness, the treatment options, the available resources, etc. The physician will ask the patient whether he or she has any questions, needs, or any clarifications. It is also necessary that the physician takes into consideration the patient’s beliefs, values, expectations, culture, and personality traits. Patients may have different points of view and thoughts about a particular illness.
At times and in cases, some patients may not be allowed to consider different treatment options owing to their cultural or religious beliefs and the doctor needs to respect that. Some of the patients may decide not to use a specific treatment plan because they cannot deal with the current treatment’s side effects. The necessity of the available choices is crucial as is the treatment and education about the disease. This will help the patient know that he or she is being informed about every little thing and make a decision.
Patient safety and satisfaction:
- Patient Satisfaction- in order to determine if the communication is running smoothly between the caregiver and the seeker, a few things have to be taken into consideration. The most important factors include patient satisfaction and safety.
The core elements comprising patient satisfaction include:
- To provide an upscale opportunity or a chance for the patient to tell their story and express.
- Patient satisfaction increases with the knowledge that the doctors can solve their problem. Reassurance that their illness can be taken care of in a setting in addition to treatment options helps the patient feel secured.
- In any case, the patients should be encouraged to express their ideas, concerns and expectations and know that their decision is in control.
- Patient satisfaction increases when the importance of their social and mental functioning is acknowledged in addition to letting them understand the illness. .
- When the patient receives continuing care from a specific healthcare provider, he seeks for mental healing as well. This enhances the patient’s satisfaction.
- When a patient understands one’s disease and is invited to partner in their healthcare decisions, they are reported to have greater satisfaction.
2. Patient Safety- While bearing in mind the importance of communication in health care, patient safety is one of the most important reasons to create an effective communication structure in any health care institute. Inadequate or ineffective communication is often the leading cause of in-hospital deaths. A study conducted in Australia in 2006 states that “In a retrospective review of 14,000 in-hospital deaths, communication errors were found to be the lead cause, twice as frequent as errors due to inadequate clinical skill”. Even though the communication errors can cause severe consequences, these issues are often relatively easy to fix i.e. many patient deaths caused by miscommunication are preventable.
- A survey suggests that an estimated one-third of adverse events are attributed to human error and system errors.
- A study conducted during 1995-2005 has demonstrated that ineffective communication between the caregivers team is the root cause for nearly 66 percent of all medical errors during that period.
- This brings to light that when the caregivers do not communicate effectively and efficiently, patient centered care often suffers.
- Medical error vulnerability is also increased when the caregivers are stressed and are overburdened with work which is why they fail to communicate clearly or effectively.
The outcome of good communication:
The practice of effective communication is integral in the medical profession for the development of a therapeutic relationship between doctors and patients. The diagnosing capability of the doctor is enhanced for the reason that there is a better understanding of the patient’s problems. Additionally, it is also useful in the management of difficult medical encounters that occur in the clinic and decreases the frustration of both the caregiver and the care seeker.
A few outcomes that are enhanced because of effective communication include:
- It is shown to decrease work stress and increase job satisfaction in doctors.
- Patient’s level of satisfaction is improved in addition to a better understanding of their ailment and the treatment available.
- It enhances the positive impact on a patient’s psychology, mental health, tolerance power, and quality of life.
- Good doctor-patient communication has the potential to help regulate various patient-related requirements.
- Patients with a therapeutic relationship with their physicians are more likely to be satisfied with their care in addition to sharing pertinent information for accurate diagnosis and treatment plans.
- The care seekers’ agreement with their physician about the nature of the treatment and requirement to follow-up is strongly associated with their recovery.
- A more patient-centered encounter results in decreased lodging of malpractice complaints.
- Satisfied patients are a boon to doctors in terms of greater job satisfaction, less work-related stress, and reduced burnout.
Research suggests that a clinician’s ability to explain, listen and empathize can have a profound effect on the health outcomes of a patient. Ineffective communication reverses any attempt at care provision. Additionally, barriers in communication in the team of the healthcare professional impacts the quality of working relationships, job satisfaction and has an impact on patient safety. Given the wealth of evidence that links the ineffective caregiver and care seeker communication, the necessity of addressing the discrepancies in communication skill is of the utmost importance. Effective communication must include health literacy and the knowledge provided to the patient, the cultural competency and some language and society barriers. Interventions to acknowledge each component should be incorporated into every level of healthcare organizations workflows. Enhancing all mechanisms of effective communication will improve patient outcomes and lead to better monetary savings and reinvestments.
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