Learning how to speak up and when to listen can dramatically improve patient care and reduce the possibility of litigation. Research from 1995-2005 showed that poor team communication was the root cause in almost 66 percent of medical errors during the time frame. Patient care often suffers when team members do not possess the communication skills or work in a culture that discourages unsolicited contributions from members of their staff. Patients are also a part of the team as they are expected to understand and adhere to treatment and advise staff of any unusual concerns or changes. Huntington and Kuhn believe that the underlying reason for malpractice suits is a breakdown in communication between physician and patient. Fostering a culture of communication, such as when nurses are free to speak up to physicians and surgeons, clinicians speak to each other during shared patient care or patient changes, and all providers listen to their patients will promote an enhanced awareness of patient care management and delivery.
The Importance of Relationship-based Care
Michael Woods, MD, MMM, trains administrators, clinicians and board leaders on relationship-based care, specifically healthcare quality and patient safety measures. Communication is essential within healthcare due to the fact that team members may leave a patient midway through a treatment or other process. If details are not communicated either by keeping notes in the patient file or passing the information on verbally, patient’s experiences may not be satisfactory.
Dr. Woods related a personal story after going through sinus surgery. Within a week after the surgery he was experiencing acute pain. The performing physician went on vacation, and within the next two weeks, three more physicians he visited told him that the pain and bleeding he was experiencing were normal. After insisting on a culture, there was little follow-up by the surgeon’s ENT practice and only after repeated phone calls to the practice did a nurse tell him to come in. The culture showed that he had a staph infection. The downplay of patient pain and poor follow-up when a problem was found resulted in unnecessary patient discomfort and patient dissatisfaction. Dr. Woods believes that healthcare is a highly complex, adaptive system and communication within a culture of an organization is essential for patient safety and quality of care.
The Enterprise as a Team
If a healthcare organization lacks a culture where team members speak up and accountability is encouraged, quality of care suffers. Dr. Woods had statistics on wrong-site surgeries that could have been easily prevented with a more team-centered approach to patient care.
- 25 percent of professionals said that if they saw an issue, they would not communicate it
- In retrospective reviews, 60-80 percent of those interviewed said that they knew the site of the incision was incorrect but did not communicate this with the team
Dr. Woods believe that civility, or a safe environment where individuals are welcome to communicate openly, appropriate action is taken, and changes are made and information communicated, is necessary in a culture of safety.
Training is Only as Good as Communication
Caregiver and patient concerns are addressed in a culture of safety promoting civility. Healthcare institutions and teams must understand:
“Extensive research has shown that no matter how knowledgeable a clinician might be, if he or she is not able to open good communication with the patient, he or she may be of no help.”
Communication than become more important if not equal to the technical training and expertise of physicians and staff. Communication skills impact the patient’s ability to follow through with recommendations, self-manage treatment, and create new preventative health behaviors. Multiple studies show that the connection a patient has with their clinician can improve their health management and outcomes.
The Institute of Medicine Report on Health Professionals and Training calls upon licensing organizations and educators to strengthen health professional training requirements for patient-centered care delivery. They endorse a patient-centered care model that depends upon enhanced core communication skills between providers and patients.
It pays to listen. Communications throughout the team and with the client help to deliver improvements in healthcare quality and patient safety. Patients are already telling institutions where to improve in their plaintiff depositions in malpractice claims. In 71 percent of claims, the most litigious patients saw their attending physician as uncaring. 25 percent of plaintiffs reported poor delivery of medical information and 13 percent stated poor listening skills from the physician. Create a culture focused on open communications to promote better patient outcomes. Truly, the improvement to healthcare quality and patient safety starts with a few words.