The Royal Children's Hospital – Psychological Interventions PDF. Communicating about difficult issues is much easier if the small steps have been taken first. Raising your voice, publicly gossiping or arguing in front of patients or the public has no place in the workplace. Find The Royal Children’s Hospital Non-Pharmacological Methods of Pain Management at their website. All staff that comes into contact with patients has a role to play in the delivery of their healthcare. Before the end of the healthcare encounter, patient’s understanding should be gauged and any information discussed should be provided to the patient in a simplified format. If your patient is in a bed, crouch down to their level rather than towering over them. “I can understand why you feel that way,”, “It seems you have a different viewpoint on this situation. However, these assessments are very time-intensive and may be impractical to implement within a busy medical practice. Furthe… Explaining the procedure to a child can help to reduce anxiety and build the their confidence (Burke 2016). It conveys interest and respect for another’s point of view. It is important for you to be in a healthy mental state when working with a population of patients who are in the process of dying. Corresponding action plans should be created for each component in order to determine baseline capabilities and track improvements. If you are their nurse, and available for their concerns, they may be more willing to talk to you than to the doctor, who may only spend five minutes in the room. Patients at-risk for ineffective communication should be identified during the pre-visit chart review. If appropriate, don’t be afraid to insert your own assessment at this stage, such as you are worried about the patient, or that they don’t ‘look right’ to you. Avoid the use of negative words, such as ‘hurt’ and ‘sting’. Another challenge you may encounter when communicating with some older people is that they may not feel comfortable speaking openly with medical professionals, like doctors. This method involves: 1) performing an assessment of baseline capabilities, 2) setting benchmark goals, 3) implementation of interventions, 4) re-assessment of outcome metrics periodically and 5) augmentation of approach if necessary. 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. Communication is a key factor in the healthcare field. Milford, PC 2018, ‘3 Tips for Talking to Children about Traumatic Events’, PsychCentral, viewed 13 March 2019. For this reason, it is important for all staff to buy into health literacy improvement processes. 13, no. Current assessment tools readily used to assess health literacy include the Wide Range Achievement Test, Rapid Estimate of Adult Literacy in Medicine and the Test of Functional Health Literacy in Adults. Poor communication has been a factor in 1,744 patient deaths and over $1.7 billion in malpractice costs nationally in the past five years, according to a study published in FierceHealthcare. These language gambits can lead to an escalation. It’s a given that healthcare staff are busy. Currently, formal screening to assess barriers to cultural and language understanding do not exist. However, do not allow yourself to be overcome with emotions either. The field is gaining recognition in part because of its emphasis on combining theory and practice in understanding communication processes and changing human behaviour. Never lie and be sure to refer them to the right person if you don’t know the answer to a question. If you have misunderstood, this gives the person a chance to clarify their meaning and shows you are actively listening. Sudore RL, Schillinger D. Interventions to Improve Care for Patients with Limited Health Literacy. If, however you need to, it’s a good idea, out of respect to the patient, to let them know at the beginning of an interaction that you may need to take an urgent call, and apologise in advance if it is to happen. However, this strategy is not always feasible. Over the years, he has gained extensive experience in emergency and trauma, rural nursing, alcohol and other drug counselling, and psychiatric nursing across both the public and private sectors. ISBAR (Identify, Situation, Background, Assessment, Recommendation); SBAR (Situation, Background, Assessment, Recommendation); SHARED (Situation, History, Assessment, Risk, Expectation, Documentation); I PASS the BATON (Introduction, Patient, Assessment, Situation, Safety concerns, Background, Actions, Timing, Ownership, Next). In addition, all information should be provided in a format that patients can take home. Someone who is acting angry may simply be frightened, defensive or resistant to what is going on around them. If they don’t comply, it may be necessary to call a family meeting and explain the importance of a contact person. Avoid approaching someone when they are distracted, for example during a favourite television program, or if they are stressed about an unrelated procedure. If you have something important to talk to them about, and the time does not seem right, fire a ‘warning shot’ by saying, Be prepared for a wide range of reactions. Patient information materials are of the utmost importance during healthcare encounters since they routinely prompt patients to ask questions of their healthcare providers that they might not have otherwise. Many people associate the word ‘drug’ with illicit substances, whereas health professionals view the word ‘drug’ as any pharmaceutical. The knowledge to navigate all societal structures impacts health outcomes both directly and indirectly. In the end, she had her tests, however, doctors are still trying to determine the cause of her fainting spells. Being assertive involves expressing your own thoughts and feelings without dismissing or abusing the rights of others (which is aggression). Your This inadvertently influences the way they deliver healthcare. A variety of communication skills … Another good positive response is, active listening techniques, as you would for any other patient and their family. This can obviously have benefits such as accessing nursing apps to provide immediate medication information, for example. Keep your hands and arms in front of your body, not crossed. Avoid using an overly-familiar manner with older patients when first meeting them. With regards to patient-system interactions, communication is bidirectional: If any of the aforementioned steps of this process is compromised, healthcare delivery becomes ineffective. Break the ice by talking about the small things. For these reasons, the staff should be trained to utilize language services each time any language discrepancy occurs. Patients can identify themselves as being fluent in English but only have an incomplete understanding of the language. There are multiple components to effective communication in a healthcare setting: healthcare literacy, cultural competency and language barriers. Try to use the valuable time you have now to open discussion slowly. 1, pp. “I see what you are saying…” and “go on…”. It also increases patient utilization of inpatient and emergency care. Language barriers are not always immediately evident. Wake, D 2016, ‘Collaboration and Communication’, Ausmed, viewed 13 March 2019. As with older adults, avoid using complicated medical terminology, or ‘jargon’. Take a moment to consider your environment. You might find out something vital to the care and comfort of that patient just by spending a few extra minutes with them. However, a 2007 study concluded that grade level attainment is a poor predictor of patient health literacy. For instance, you could say, In addition to speaking and listening, don’t forget that there are other skills that you should work on, such as reading, writing and technology-based communication. When everyone works together to help the patient understand, you stand a much better chance of putting him or her at ease with all that is happening around them. Ask the patient if they are comfortable with their family and if they would like the family to have restricted access to them. Ineffective healthcare delivery increases the likelihood of negative patient outcomes. Schyve PM. Sleeman, KE & Collis, E 2013, ‘Caring for a Dying Patient’, BMJ, vol. (2006), patients had a higher likelihood of accurately interpreting single-step drug labels with low literacy scores than multi-step or higher literacy score labels.11. Effective communication is of the utmost importance when delivering healthcare. Active Listening. For example, did a patient syncopize before or after their fall? Be prepared to repeat yourself and express concepts in several different ways to make sure your message is understood. The same rights apply to patients who are in the next bed over. Update and discuss relevant medical and support information. As with most communication, careful listening, as well as showing your patient you are listening through positive body language, will serve you well in talking to children patients. For this reason, representative individuals from the target patient population should be involved in the creation of patient materials as an additional quality assurance measure. It is ok to admit that communicating with dying patients is extremely difficult, and taking care of yourself emotionally should always come first. Methods for assessing these three components should be integrated into healthcare systems on an individual and system-wide level.2 Merely performing assessments without integrating them into preexisting workflow processes leaves room for ineffective communication to take place in other areas of the organization. For example, a doctor may know the medicine best and you may know the patient best. Ideally, when engaging with a patient you should not be taking calls. Burke, N 2016, ‘Nursing Paediatric Patients - Effective Procedural Communication’, Ausmed, 29 July, viewed 13 March 2019. Your patient’s condition is deteriorating and you need to tell the doctor. Listening without interrupting is powerful. Throughout the second edition of Communication Skills for the Healthcare Professional, a broad range of examples, role plays, and scenarios from virtually every healthcare field help students master area-specific communication skills, while practical coverage of essential verbal and nonverbal communication skills … Carrying these feelings everywhere with you may make you susceptible to compassion fatigue - a syndrome that can lead to depression, anger and the breakdown of relationships. Use questions beginning with ‘why’, ‘what, ‘when’, ‘where’ and ‘how’. However, if they syncopized before, then you need to expand the differential diagnosis to include potential neurological and cardiovascular causes. A large part of communicating with children patients is the inclusion of their parents or guardians. Healthcare literacy is determined by the comprehending ability of the patient and the complexity of the healthcare system.3 The health care system has grown increasingly more complex and possesses a high barrier-of-entry with regards to knowledge base. Read the social cues. Lisa, not wanting to start an argument, has given it to her brothers and sisters, who in turn, gave it to a few grandchildren. This leads to negative patient outcomes, increased utilization of emergency and inpatient services and a greater cost burden on healthcare systems. If someone has a financial hardship, such as bankruptcy or foreclosure, it might cause them undue stress that may negatively affect their health. She wrote down all the key information in a system that she had developed to keep herself from forgetting important points. Be aware, however, that studies have shown the mere presence of your switched-off smart phone can be a drain on productivity (Ward et al. Begin to engage the person by using reflective statements, such as Addressing older patients can be slightly different to talking to other adult-aged patients. Comfort them and do not betray their trust in you. In its Health Literacy Universal Precautions Toolkit, the Agency for Healthcare Research & Quality describes the concept of “universal precautions” .4 Universal precautions imply that health care systems should approach all patients with the assumption that they are at risk for not understanding their health conditions or how to deal with them. Eye contact is important - it conveys honesty, openness and helps when being assertive. Although she is forgetful, she is still able to live a relatively independent life. First calm yourself and take stock of your own emotions. PBS Parents 2018, Talking with Kids, PBS, viewed 13 March 2019. Hodgkinson, K & Gilchrist, J 2008, Psychosocial Care of Cancer Patients: A Health Professional’s Guide to What to Say and Do, Ausmed Publications, Melbourne, Victoria. Speak softly and refrain from having a judgemental attitude. Cultural competency seeks to change the one-size-fits-all approach of the current medical practice and tailor healthcare delivery to the individual needs of a diverse patient population. The most likely scenario where this would arise is when taking the history of present illness (HPI) from the patient. Being in a loud, chaotic emergency department may require you to raise your voice. If you’re finding a particular patient especially difficult to speak with, simply being there, smiling, sharing meaningful eye contact and some human touch (with consent) can make all the difference. Let me explain our position.”. Duff, A, Gaskell, S, Jacobs, K, & Houghton, J 2012, ‘Management of Distressing Procedures in Children and Young People: Time to Adhere to the Guidelines’, Archives of Disease in Childhood, vol. Social distance: impersonal, social, casual. Communication is a two-way street. Supplemental information typically acts as an impetus for patients to initiate dialogue with their healthcare provider. 346, viewed 13 March 2019. Emergency department cubicles, and beds in multi-bedded rooms are often only separated by a curtain. Though the parents/guardians may be asking most of the questions, it is important to still include the child when talking about procedures and their health. Make it a point to be there for them, a presence of peace and understanding. Instead of being afraid, Daniel is now fascinated by the new toys in front of him and plays with them. However, patients often feel stigmatized due to their low health literacy. The first step in achieving cultural and linguistic competency is to perform a baseline community needs assessment of the organization’s patient service area to determine typical patient demographics. Interpersonal skills. This approach is pertinent at a time when many of the threats to global public health (through diseases and environmental calamities) are rooted in human behaviour. Lautrette, A, Darmon, M, Megarbane, B, Joly, LM, Chevret, S, Adrie, C, Barnoud, D, Bleichner, G, Bruel, C, Choukroun, G, Curtis, R, Fieux, F, Galliot, R, Garrouste-Orgeas, M, Georges, H, Goldgran-Toledano, D, Jourdain, M, Loubert, G, Reignier, J, Saidi, F, Souweine, B, Vincent, F, Barnes, NK, Pochard, F, Schlemmer, B & Azoulay, E 2007, ‘A Communication Strategy and Brochure for Relatives of Patients Dying in the ICU’, vol. These standards are divided into the following categories: 1) governance, leadership and workforce, 2) communication and language assistance and 3) engagement, continuous improvement and accountability.13. Approaching a patient in a busy, high-stimulus area with lots of people can hinder your communication. Remember to not stray from your scope of practice. Most organisations have their own policies regarding technology in the workplace, it may be worth finding out what yours is. Be curious. Health Literacy and Mortality Among Elderly Persons. If handing over, this offers the new team member a clear course of action to follow or opens up the lines of communication for further discussion. One of the nurses from the OR visits Daniel’s room the night before the operation with a bag of items. Let me explain our position.”. Honesty is, once again, very important, and you shouldn’t make empty promises to keep a relative calm. This way, the nurse only has to explain a situation once. Low Literacy Impairs Comprehension of Prescription Drug Warning Labels. Assessment of baseline patient literacy is crucial since it creates an impetus for initiating dialogue between patients and healthcare providers that would not have existed otherwise. Employ It may help to have a three-way conversation between the patient, their carer, and yourself. Quick Guide to Health Literacy – Fact Sheet. Trust in the skills of the interdisciplinary care team, and don’t make a recommendation if you aren’t comfortable doing so. It’s important to not be overwhelmed by the sheer amount of information you need to communicate to a potentially very busy member of the health team. Don’t send mix messages. You have their vitals, their chart, and a full head of information that you want to blurt out as soon as the doctor’s voice crackles across the phone line. taking care of yourself and allowing yourself time to disconnect from work. When you go home, you need to leave the sadness and emotion of the job at work. Lampert, L 2015, ‘Communicating with Children in Healthcare’, 26 March 2015, viewed 13 March 2019. The purpose of this review is to analyze the components of effective communication in a healthcare setting, cite current professional standards for each and propose solutions for improvement. Defining Effective Communication in Healthcare. However, it only focuses on nutritional matters and fails to comprehensively address all aspects of health literacy. It takes careful reminding to keep her from driving her car or performing other actions that may put her in danger. This is referred to as the ‘emotional contagion effect’, where your emotional state can affect how another person feels. This means By possessing these abilities, individuals are better equipped to make appropriate healthcare decisions and thus, improve their health outcomes. Most healthcare practitioners are not racists. Australian Commission on Safety and Quality in Health Care 2018, ‘6. Be mindful to put things so they are easy to understand, but without coming across as condescending. In a single day, healthcare workers can speak to people of varying educational, cultural and social backgrounds and they must do so in an effective, caring and professional manner. In short, healthcare systems should implement health literacy assessments that best suit the needs of their practice and are proven to be effective. Racial and Ethnic Differences in Patient Perceptions of Bias and Cultural Competence in Healthcare. To do this, one of the best-practice and most widely used handover tools is the It is most prominent among low-income, ethnic minorities and elderly populations. Any health literacy assessment a practice chooses to implement should be continuous and not simply be relegated to a single encounter. That is the best therapeutic gift you can give your patient. iSoBAR framework. Give plenty of space to families and friends and make sure they have everything they need, without intruding on their personal time. Effective communication can be defined as verbal speech or other methods of relaying information in order to get a point across.1 If either party does not understand the purpose of the information conveyed, communication cannot be effective. All patients possess different capacities for learning. “Maintain a sense of curiosity about your patient. There are several other examples of similar mnemonic tools used to structure handover, including: Among the most difficult scenarios that can arise for caregivers when communicating with patients is talking with a patient who is dying. Active listening, responding appropriately to patient’s needs and concerns, properly assessing body language, and possessing a non-judgmental attitude are all necessary skills that healthcare … Be aware of any patient privacy rights that may affect what information you give out to relatives and friends. The care coordination model employed by most healthcare systems is called the “Care Model.” After the implementation of the Affordable Care Act, this model was expanded to incorporate concepts from the Primary Care Medical Home. Explain that their behaviours are upsetting the patient and that a different approach is needed. There is no clear consensus with regards to the level of difficulty information patient populations are able to comprehend. If any one of these components is compromised, effective communication does not occur. This communication course for healthcare professionals will: Explore specific behaviors that convey a caring attitude. She experienced an episode of fainting at Church, that was witnessed by several people, and she was taken to her primary care physician. Consequently, the burden of cost on healthcare systems increases. Patients with race-concordant relationships with their healthcare provider tended to report greater satisfaction with the care than those who did not.12 Poorer health outcomes occur when socio-cultural differences between patients and staff are not reconciled during the healthcare encounter. A common mistake that many health professionals make is to use bigger and more complicated words. Although all of them are still nervous about the surgery, getting familiar with the process and tools for the procedure has helped calm Daniel so that he – and his parents – can get some much needed rest before his operation. Several standardized assessments for readability of patient materials currently exist. If relatives and friends are disturbing the patient’s rest, working them up or causing them unnecessary distress, the nurse has the right to step in and remove the family. Offering our older patients the extra time they may need when communicating is a dignity that should be put above all else. Minimal time and cost were needed to program an additional field for score entry into their preexisting electronic medical record. BusinessDictionary.com. Communication is pivotal to health care outcomes, which includes patient safety and patient satisfaction. Take a moment to relax and control your body before engaging in a situation you expect to be heated. Offer lots of reassurance, perhaps in the form of a small reward for their resilience and bravery. Communication can be about quietly projecting the energy that you are here, you are willing to listen, and you won’t judge. Communicating effectively with children and younger patients is one of the most difficult aspects of healthcare. However, they tend to assume that the aforementioned groups are less health literate due to an inability to relate to them on a cultural basis. http://www.businessdictionary.com/definition/effective-communication.html. This shows that better communication methods would Communication is the cornerstone of healthcare. Consequently, patients would be informed about healthcare processes and empowered to become active participants in decisions regarding their health.3. Every day on the unit, the nurse assigned to Mr Reed receives at least five phone calls about his status. Offer yourself as a sounding board for the relative. As a result, they are often less satisfied with their care.7 Poor patient health literacy is a universal problem. They are also more likely to be less satisfied with the care they receive and believe that they would have gotten better care if they belonged to a different race.12 Ethnic minorities of low socioeconomic status and elderly demographics tend to have more passive interactions with physicians and are not given the opportunity for shared decision-making in their healthcare. A culturally competent healthcare system provides high quality care regardless of race, ethnicity, culture or language proficiency for patients who are already members of the patient population. Ask yourself: ‘What’s going on with this … If you are going to be asking questions of a personal nature, environment is particularly important. The Gerontological Society of America n.d., Communicating with Older Adults, GSA, viewed 13 March 2019. Choose your words to fit the situation and the audience. When building rapport with a patient, you do not have only one chance. 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