1 ISSUE IN HEALTHCARE Identification of the problem: Ineffective communication is the main issue that had resulted many patients to go through severe levels of suffering in the healthcare organisation. Many of the family members of patients had complained that the patients were not asked for informed consents, their queries and concerns were not answered and they were not given proper education about maintenance of interventions. Ineffective communication was not only found between the service users and the providers but also among the professionals as well. There were sequences of medication error, improper delegation, long waiting times for patients as well. Lack of effective communication made the patients anxious as well as fearful, as they could not understand anything about the treatment plans that were taken for them. All these resulted in suffering of the patients with longer stays at the hospital, readmission of the hospitals even after discharge, lack of idea about how to modify their lifestyles and many others. All such affected the reputation of the hospital that increased the risk of potential loss of consumer base and hence lack of profits. Identification of the stakeholder: From the ineffective communication scenarios that take place between the patient and providers and among the providers, the patients are the main stakeholders who remain exposed to higher levels of risks. The patients are the only stakeholders who have to face severe consequences due to infective communication with the professionals as well as that among the professionals (Blais, 2015). Providers who do not know about the proper ways of communicating with the patients or are unaware of the importance of effective therapeutic communication can affect the patients in different ways. They may take inadequate informed consent that might harm the dignity and autonomy of the patient. This might make them feel depressed as they feel
2 ISSUE IN HEALTHCARE that their self-esteem is hurt. They feel that providers do not respect and therefore they fail to comply with the interventions set by the professionals. Ineffective therapeutic communication takes place, as the professionals cannot ensure empathy and compassion in their interactive sessions.Suchunsympatheticresponseduringtimesofpatients’complaints,queriesand concerns affect their morale and they feel uncared and unloved. These have negative impacts on the health outcomes (Koukouta 7 Papathinasiou, 2014). Moreover, improper communication between the professionals makes the patients suffer due to medication error, missing of important facts during delegation, longer waiting times of patients and many others. All these result in poor quality care of patients that affect the patients emotionally, mentally and physically. As the patients face all these issues only, therefore they are the most important stakeholder identified. Root cause of the problem: After taking extensive research to find out the main root cause of the problem, it was seen that two important reasons contributed to ineffective communication in the healthcare centres. The first identified issue is the lack of proper knowledge among the nurses who are working on the floor. They believe that only having clinical expertise is enough to bring out the best treatment plan for caring of the patients. Recent day researchers are of the opinion that effective communication is an important attribute that has the capacity to develop therapeutic relationship between service users and service providers (O’Hagan et al., 2014). Patients tend to develop trust and bond with nurses with effective communication skills and these have positive outcomes on health of patients. Therefore, this knowledge was lacking in the professionals that resulted them to fail miserably to communicate with the patients effectively. The second root cause was the power struggle among the junior and senior nurses. They suffered from complexes and therefore they did not communicate with each other sufficiently. Therefore, junior nurses could not get
3 ISSUE IN HEALTHCARE guidance from senior nurses when they required help or when they felt confused about medication or treatment procedures (Jensen et al., 2015). On the other hand, senior nurses did not communicate with junior nurses and therefore suffered from huge work burden that took away their energy to communicate freely with patients. Hence, all these were found to be the root cause of ineffective communication. Planned improvement: From the above discussion, it became extremely important for the healthcare authorities or the nursing managers to take active initiatives to solve the issues and develop a proper organisational culture. Plan:Initiatives should be taken for arranging training sessions for both the junior nurses and senior nurses where trained professionals would describe the skillsthey need to posses, importance of developing the skills in clinical settings, and disadvantage of conflicts among professionals. In order to develop relationships among nurses, constructive feedback sessions were arranged everyday for one hour where nurses needed to interact with each other and provideconstructivefeedback(Pound&Jensen,2018).Theseensuredmaintenanceof transparency and overcoming of complexes. Do: the healthcare authorities need to be approached so that they can understand the benefits of the planned programs. They would provide financial help that would in turn allow allocation of trained professionals who would be guiding the nurses. The nurse leaders would be approached. They would be requested to hold the feedback sessions of junior and senior nurses. They should be also requested to provide ideas and uptake activities that would ensure better communication and relationship development among the professionals (Chan & Psy, 2016).
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4 ISSUE IN HEALTHCARE Study: the reports can be provided by the trainers which can then be used in order to analyse whether the nursing professionals are developing communication skills or not. Besides, reports that would be prepared by the trainers, the nursing leaders would also develop reports about how the professionals are faring in the meetings and how eel they are moving towards the success of the goals and objectives set (Chu et al., 2018). Act methodology: as the initiatives that are planned can be implemented successfully and can help in development of communication among the nurses and also among the patients, they can be implemented in the clinical setting. The training sessions would be conducted twice a week for two hours after shift. The feedback sessions would be conducted everyday for one hour. Evaluate the effectiveness of your actions/improvement initiative: Questionnaires would be developed for the patients about the effective communication that they are having with the professionals. More the positive results of the questionnaires and lesser the number of complaints in the complaints departments, it can be well understood that the initiativesarehelpingtomeetthegoals.Anotherquestionnairewouldbedevelopedto understand the feelings of nurses and to find out power struggles still exists or not. The evaluation committee would be also observing the feedback session to develop cues and ideas about the success of the feedback sessions (Doherty et al., 2016). All these would help to make sure that the planned initiatives are aligning with the objectives or require further modifications for getting successful results.
5 ISSUE IN HEALTHCARE References: Blais, K. (2015).Professional nursing practice: Concepts and perspectives. Pearson. Chan,J.C.Y.,&Sy,P.Y.(2016).Therelationshipsamongpersonality,intercultural communication,andculturalself-efficacyinnursingstudents.JournalofNursing Research,24(4), 286-290. Chu, C. H., Sorin-Peters, R., Sidani, S., De La Huerta, B., & McGilton, K. S. (2018). An InterprofessionalCommunicationTrainingProgramtoImproveNurses’Abilityto CommunicateWithStrokePatientsWithCommunicationDisorders.Rehabilitation Nursing Journal. Doherty, C., Landry, H., Pate, B., & Reid, H. (2016). Impact of Communication Competency Training on Nursing Students’ Self-advocacy Skills.Nurse educator,41(5), 252-255. Jensen, L. R., Løvholt, A. P., Sørensen, I. R., Blüdnikow, A. M., Iversen, H. K., Hougaard, A., ... &Forchhammer,H.B.(2015).Implementationofsupportedconversationfor communicationbetweennursingstaffandin-hospitalpatientswith aphasia.Aphasiology,29(1), 57-80. Kourkouta, L., & Papathanasiou, I. V. (2014). Communication in nursing practice.Materia socio-medica,26(1), 65. O'hagan, S., Manias, E., Elder, C., Pill, J., Woodward‐Kron, R., McNamara, T., ... & McColl, G. (2014). What counts as effective communication in nursing? Evidence from nurse educators' and clinicians' feedback on nurse interactions with simulated patients.Journal of advanced nursing,70(6), 1344-1355.
6 ISSUE IN HEALTHCARE Pound, C., & Jensen, L. R. (2018). Humanising communication between nursing staff and patientswithaphasia:Potentialcontributionsofthehumanisationvalues framework.Aphasiology.