What actions can you take while caring for this patient to communicate effectively?

A quick survey of your healthcare peers (or even a Google search) will tell you one thing almost certain about the importance of care team communication with patients: most healthcare quality experts agree that improving communication between patients and healthcare staff is the number one factor in improving patient experience. Medical staff communication is essential for providing quality care, reducing errors, increasing patient satisfaction, improving service recovery, and establishing strong patient relationships. Clear, precise, and timely communication is critical to improving health outcomes, decreasing risk, and maximizing overall performance. Our experience and data tell us that there are a handful of best practices that can help improve medical staff communication with patients.

If a patient is clearly unhappy with an aspect of their treatment, be polite and professional, and try not to act defensively. Be prepared to apologise if things have gone wrong.

Be transparent

Be clear about the possible costs when explaining the different treatment options, and whether treatment will be provided under the NHS or privately.

The GDC expects dental professionals to tell patients if treatment is guaranteed, under what circumstances and for how long. However, we would advise against offering a guarantee or warranty, which have specific legal meanings. It's acceptable to give an undertaking to refund fees or to repeat treatment free of charge if the treatment fails within a specified period.

DDU advice

• Surveys can be useful in asking patients about communication within the practice. Are the dental professionals providing their care approachable? Do patients understand the information provided? Do they feel they're being listened to?
• Give patients the chance to ask questions, and provide a cooling-off period before starting treatment plans.
• Tell patients how to contact you by their preferred method, and explain who to contact in an out-of-hours emergency.
• Put in place a system to identify patients with particular communication difficulties. Make reasonable arrangements to help - for example, through an interpreter, or an induction loop for those with hearing aids.

This page was correct at publication on 22/02/2022. Any guidance is intended as general guidance for members only. If you are a member and need specific advice relating to your own circumstances, please contact one of our advisers.

What the doctors wanted us to hear: “You CANNOT, under ANY circumstances, send your 83-year-old diabetic, dialysis-dependent father back to his house where your 78-year-old mother, who’s showing signs of dementia, is his primary caregiver.”

What my brothers and I heard: “You know, it might be time to think about considering the possibility that your dad should move to a facility where he can get better round-the-clock medical care.”

This conversation happened after my dad was hospitalized because his insulin pump was out of insulin for two days. His blood sugar rose to somewhere around 2,000 and his body dropped to the floor in the middle of the night. This was a dangerous diabetic coma.

Now, looking back, we realize the doctors knew what they were talking about. We know we should have found an assisted living facility or nursing home right away.

But here’s the thing. The doctors likely had that same conversation with hundreds of patients and their families over the years. They must have thought the message was clear and that we got it and would comply.

But for my family, it was the first time we ever had that conversation. We didn’t understand the seriousness of what they were saying. Besides, my dad seemed fine after their excellent treatment. So the message didn’t take.

And three days later, my dad was back in the hospital.

The question is, what could the doctors have done differently? How could they have helped us see how truly fragile my father’s condition was?

That question is what I want to cover in this article. And I hope healthcare leaders will read this and consider ways to improve the way clinicians communicate with patients and families.

Because I’m your customer. I’m not a clinician. I’m an observer who did in-depth research and thinking about my family’s hospital experience. I’m also an IT guy at a hospital, so I’m familiar with healthcare terminology. And I’m a systems guy who believes many problems can be fixed better by working on the system rather than individual behaviors of people.

So that’s what I’m going to do here. I’ll look at the patient communication system and offer six strategies for improving the system.

Thanks in advance for considering my ideas.

What is Patient Communication?

For this article, patient communication is:

• The sharing of information and messages related to the prevention, diagnosis, and treatment of diseases and injuries. We’re excluding your patients’ educational, scheduling, wayfinding, check-in, check-out, and billing interactions.
• A two-way dialogue. It’s giving and receiving information and messages. Listening is just as critical as speaking. And listening means using your ears, your eyes, and your heart.
• Limited to clinical staff on your side of the dialogue. Yes, patients interact with non-clinical staff, and those interactions impact the overall patient experience. Nevertheless, this article focuses on communication with clinical staff because they’re the ones with the perceived authority to discuss the prevention, diagnosis, and treatment plan.
• Not limited to the patient on the other side of the dialogue. It includes interactions with the patient’s family, friends, health advocates, and other visitors because they talk amongst themselves when clinicians are absent. Those conversations affect how patients perceive and receive messages from clinical staff.
• Not limited to written and spoken words. Patient communication includes nuance added by body language, facial expressions, eye contact, and voice tone.
• Not limited to face-to-face interactions. Prevention, diagnosis, and treatment discussions also occur through text messages, phone calls, and video conferences.

Why is Communication with Patients Important?

It’s no surprise that patients are unhappy with arrogant doctors who have the bedside manner of a sliver. But the tremendous benefits of consistent, effective patient communication seem disproportional to the financial cost and effort it requires.

We have studies going back 35 years that prove the power of excellent patient communication:

• Patient diagnoses are more accurate
• Patient satisfaction is higher
• Patient outcomes are improved
• Patient adherence to medical advice is higher
• Patient self-management of medical conditions is improved

“As an element of best practice, the effectiveness of patient-clinician communication can be as important as that of a diagnostic or treatment tool and should be the product of similarly systematic assessment and evaluation.” – Institute of Medicine

That quote from the Institute of Medicine is worth a second look. The Journal of the American Osteopathic Association said it this way: “Research has shown that effective patient-physician communication can improve a patient’s health as quantifiably as many drugs.”

Effective communication is as helpful as many drugs!

How do You Communicate Effectively with Patients?

Here’s a list of foundational tips for good communication with patients:

• Maintain eye contact
• Speak slowly and clearly but not loudly
• Practice active listening and do not interrupt
• Demonstrate compassion, patience, and empathy
• Unless you’re delivering bad news, smile frequently
• Be sensitive to age, gender, religious, and cultural differences
• Avoid medical jargon and slang
• Consider how your words could be interpreted – or misinterpreted – by the patient
• When speaking or listening, turn your face and your body toward the patient, and when possible sit next to them
• Ask fewer yes-or-no questions and more open-ended questions, such as, “now, what other questions do you have?”
• Pay attention to nonverbal communication, such as body language, posture, and gestures – both your and your patient’s

These are essential communication skills for every clinician to learn and practice.

But there’s also a system layer that can raise the quality and effectiveness of patient communications.

How can you Improve Communication with Patients?

This is where the systems approach comes in. I’m going to introduce several strategies that any organization can implement. You don’t have to use all of them, but there’s a dynamic synergy between them. They feed off each other and build on each other. The more strategies you implement, the stronger your organization’s communications system you’ll have.

Ask-Tell-Ask

I love this strategy because it’s easy to remember. Just three steps with two ingredients formed like a sandwich. Or an Oreo.

Ask-Tell-Ask works well when a patient or family member is ending their office visit or being discharged from the hospital. It allows you to make sure they understand what happened and what they should do after they leave.

There are variants of Ask-Tell-Ask, but in general, it works like this:

• Ask the patient or family members what they’ve already been told.
• Ask them if it’s ok to tell them what you know, then use “living-room language” to tell them new information that adds to what they know. Try to focus on the two or three most important things you want them to understand.
• Ask what questions they have and what they’re going to tell their loved ones about this conversation when they get home.

Empathic Listening – Covey’s Fifth Habit

Seek first to understand, then to be understood. That’s how Steven Covey summarizes empathic listening in his bestseller, The 7 Habits of Highly Effective People.

The strategy of empathic listening is especially useful when discussing a patient’s health care because it can be a highly emotional interaction. Empathic listening helps you deeply understand the patient and their unique challenges and goals. It can give you an insightful answer to the question, “how does this patient feel?”

Here’s a good summary of seeking first to understand, then to be understood, which is a perfect strategy to use during the Ask-Tell-Ask technique. We’re building our patient communication system.

Coach Your Patients

We expect patients and their families to respect healthcare workers. They depend on the care team to get and keep them healthy.

But patient outcomes improve in an atmosphere of mutual respect where patients feel like their care team members return the respect. Because if patients feel respected by their doctors and nurses, they’ll take a more active role in their health. Coaching increases patient engagement. Patients ask better questions and offer helpful suggestions. And you’ll get a truer picture of your patient’s perspectives.

Now, the idea of mutual respect is foreign to most patients. They believe their role is to listen to what the clinicians say and then do it. So how do you get them to expect mutual respect, and to act as if they are a valuable and respected member of their health care team?

Researchers at Tufts University discovered the answer in the 20-minute coaching session. While patients were waiting for their physician, a coach helped them figure out what they wanted to get from their time with the physician. The coach provided tips for overcoming anxiety, timidity, and embarrassment when talking with the physician.

The researchers reported these results:

• Coached patients were better at giving and getting information when interacting with their doctor
• Coached patients with hypertension showed a 15 percent drop in systolic blood pressure readings compared with earlier readings
• Coached patients with diabetes showed a 12 percent drop in blood glucose readings
• Coached patients were more assertive and, consequently, more likely to feel heard and understood – as if coaching greases the empathic listening process
• Coached patients left with a better understanding of the information they received from their doctor

Imagine how lively the Ask-Tell-Ask session will be after patients have been coached to expect mutual respect. Our system of communication strategies is growing stronger.

Telecommunications Technology

The last ten years gave us dramatic improvements in secure, HIPAA-compliant options for patient communication using mobile devices. An example is TigerConnect’s Patient Engagement system.

TigerConnect Patient Engagement allows patients to communicate with their physician and other care team members through an app on their smartphones. The app supports not only phone calls and text messages but also photo sharing and video conferencing.

Two common TigerConnect Patient Engagement workflows are pre-op preparation and post-discharge follow-up. They keep the patient engaged with their care team, which drives results like lower readmissions and quality patient care.

A telecommunications system like TigerConnect Patient Engagement is the perfect extension of a coaching program that trains patients to expect mutual respect. Coached patients will immediately see the value of telecommunications technology in their health journey. Our communications system is evolving into a long-term, comprehensive system now!

TigerConnect Patient Engagement is part of a suite of clinical communications software solutions. They support not only communications between care teams and patients but also bring substantial improvements to care team communications.

Measure Effectiveness of Patient Communication

Peter Drucker told us, “if you can’t measure it, you can’t improve it.”

We can also observe that “you get what you measure.” This means that if people know you’re monitoring something, they’re going to make an effort to get better scores.

Putting these two statements together makes the final strategy’s value leap out at us. You must measure the efforts and effectiveness of patient communication. Otherwise, four things will happen:

• You won’t improve patient communication, according to Peter Drucker
• Most clinicians won’t take steps to implement these strategies since nobody’s paying attention
• Your organization will not sustain the patient communication system architected in this article
• You’ll miss out on the benefits of effective patient communications, proven by 35 years of research

I suggest you add communication questions to your patient satisfaction survey AND your employee surveys. If clinicians know you measure it, they’ll know it matters to leadership, and they’ll adjust behavior to reflect the awareness.

Also, as you implement the other strategies, add questions to your surveys so you can measure how well your employees are adopting the strategies.

Steps for Mastering Patient Communication

Here, then, are my six simple strategies for mastering patient communication.

1. Institute a process to measure the effectiveness of patient communication. NOTE: This should be the first strategy you implement. If it’s not, all other strategies are at risk of failure until you begin measuring them.

You may implement the next five strategies in any sequence.

2. Encourage clinical staff to continuously improve the basics listed in the “How do you Communicate Effectively with Patients?” section above.

3. Roll out Ask-Tell-Ask throughout your organization. Develop a short training video to demonstrate and support the Ask-Tell-Ask strategy.

4. Roll out Empathic Listening as an organization-wide patient communication strategy. Develop a brief training video to demonstrate and support it.

5. Coach your patients to expect mutual respect. Identify clinical and non-clinical staff who are excited about this strategy. They will be your coaches.

6. Implement telecommunications technology so your patients can engage regularly with their care team. Consider a complete .

Your new patient communication system will benefit from any of these strategies you can implement. You don’t need them all. However, if you can implement all six throughout your organization, you’ll experience a strong synergy and can expect a lasting, effective patient communication system.

How can you ensure that you are communicating effectively with patients?

What are 3 ways that you can communicate with patients in a respectful manner?

What are some actions that you might take to improve communication in your hospital?