Communication Skills in Healthcare: Challenges and Best Practices

This report, focusing on communication skills in healthcare practice, highlights the crucial role of effective communication in patient care and satisfaction. It explores the challenges healthcare professionals face, such as communication barriers leading to reduced patient satisfaction and adverse health outcomes, while also emphasizing the importance of building positive relationships between healthcare providers and patients. The report discusses the impact of poor communication, including increased costs and decreased adherence to treatment plans. It also provides a reflection on a personal interaction with a patient, demonstrating the importance of open communication, empathy, and patient-centered care. The report concludes by emphasizing the need for continuous improvement in communication skills to enhance the patient experience and promote better health outcomes. The report also references various studies and reports to support its findings and recommendations.

COMMUNICATION SKILLS IN PRACTICE
BY
ADEBUKOLA OMOBOLANLE ALLAIN

INTRODUCTION
Communication is the act of conveying meanings from one entity or group to another
through the use of mutually understood signs, symbols, and semiotic rules. (Harper
2013). Communication in a healthcare setting is one of the most important tools we
have for providing great patient care and improving patient satisfaction. However, lines
of communication can frequently be crossed and lead to lower patient satisfaction
scores, illnesses or worse. According to information shared in a recent article from
Becker's Hospital Review: "...more than a quarter of hospital readmissions could be
avoided with better communication among healthcare teams and between providers
and patients." Every patient who comes to a hospital has a team of people involved in
providing care throughout their healing process: from doctors and nurses to
housekeeping and culinary teams, and even their family and loved ones. With so many
parties involved, it's understandable that missteps in communication could occur. At
HHS, we take communication and patient care seriously and train our team members to
break down these communication barriers to provide excellent patient care.
Strong and effective communication is important in the healthcare sector. A doctor,
nurse or clinician may excel at their work, but if the communication is not clear and
effective, it is of no use. Building positive relationships between healthcare
representatives and patients is extremely important to the success of the organization.
Effective communication can enhance the patient experience, reduce complaints, and
Increase nurses’ self-confidence, professional standing, career prospects and job
satisfaction and reduce stress. Jones (2010) suggests that patients are less likely to
remember technological interventions than the communication and human interaction
from health professionals and judge the quality of their care by these markers. They
have more confidence in health professionals who communicate effectively, which in
turn makes it more likely that treatment regimens are followed or advice taken.
COMMUNICATION CHALLENGES & QUALITY OF CARE
Communication challenges are associated with under-use of primary and preventive
services, limited comprehension of medical information, lack of adherence to medical
advice, and less cost-effective use of medical services, including a greater need for
tests and longer medical visits (Weiss et al. 2006). In Canada, the discussion
concerning access to health services in a person’s first language, particularly where that

language is an Official Language of the state, tends to be framed as a “rights” issue.
However, while there are rights aspects to the discussion, from a health care
perspective the fundamental issue is patient safety and risk: there are inherent risks
associated with the failure to address language barriers encountered during the
provision of health care services. Internationally, there is a growing body of literature
documenting the impact of communication challenges on access, use and quality of
medical services. The effects of communication challenges on health care delivery have
been considered in other countries. According to the Institute of Medicine of the
National Academies (U.S.), communication challenges contribute to reduced quality,
adverse health outcomes, and health disparities. Furthermore, there is evidence that
communication challenges may result in increased use of expensive diagnostic tests,
increased use of emergency services and decreased use of primary care services, and
poor or no patient follow-up when such follow-up is indicated (Greising, 2006).
COMMUNICATION SKILL IN HEALTH CARE PRACTICE
Communication skills are a vital part of the clinical practice. They help you to exchange
information with your patients, improving the patient experience as well as their levels of
satisfaction with you and with the service they receive. Communication between health
care providers and patients affects patient outcomes. Safe practice depends on
effective communication. The Quality and Safety Education for Nurses (QSEN) links
communication knowledge, attitudes and skills to improved patient outcomes and
quality of care.( Cronenwett et. at. 2007). Communication skills enable effective
interactions between nurses and patients, and nurses and other healthcare workers.
(Sully et. al. 2005). Improving communication among health care providers has been
identified as part of the 2015 National Safety Goals.
IMPACT OF COMMUNICATION IN PATIENT
It is estimated t hat the cost of poor communication to the NHS is over £1bn per year,
and can lead to poor adherence to medication regimens, repeat visits to clinics,
disputes and ultimately litigation (McDonald, 2016). The 1993 Audit Commission report
on communication within the NHS is as good a place to start as any, not least because
it reflects some of the themes which brought the question to the fore.(Audit commission,
1995). The report is notable for three reasons. First, there is a strong sense that this is

new ground, not fully understood or researched. Second, there is recognition that there
are deep-seated organisational and cultural factors causing deficiencies in
communication and these will be difficult and expensive to fix. Instead, it opted for an
assault on low-hanging fruit. Third, the report conceives of communication in
transactional terms. It concerns itself with the delivery of information to patients, with the
quantity of information and with complaint mechanisms.
There is a wealth of research data that supports the benefits of effective communication
and health outcomes for patients and healthcare teams. The connection that a patient
feels with his or her clinician can ultimately improve their health mediated through
participation in their care, adherence to treatment, and patient self-management. (Duffy.
et. al. 2004).
Another study found that less than half of hospitalized patients could identify their
diagnoses or the names of their medication(s) at discharge, an indication of ineffective
communication with their physicians. (Makaryus et. al. 2005)
The Institute of Medicine (IOM) Report on Health Professions and Training, has
identified that doctors and other health professionals lack adequate training in providing
high quality healthcare to patients. The IOM called upon educators and licensing
organizations to strengthen health professional training requirements in the delivery of
patient-centered care.( Institute of Medicine 2003). The patient-centered care model,
( Stewart 1995) underscores the essential features of healthcare communication which
relies heavily on core communication skills, such as open-ended inquiry, reflective
listening and empathy, as a way to respond to the unique needs, values and preference
of individual patients. ( Stewart et. at. 2000)
REFLECTION OF COMMUNICATION WITH PATIENT ISSUE
This reflection examine the interaction between myself and the mother of a child who
has recently been diagnosed with diabetes mellitus (Mrs. Dickson). I was very
conscious of the mother’s initial reticence in her opening exchanges with me. She
initially sat in a “closed” position and largely avoided eye contact. As the conversation
unfolded she clearly became more relaxed and trusting. She adopted a more “open”
and relaxed posture and startled to express herself with appropriate hand gestures.
(Hulsman et al. 1999) I particularly recall the jabbing gestures she made to emphasize a
point relating to giving injections. I have to observe that the environment that was used

for the interview was very contrived and I believe that this may have had an influence on
both myself and the client. I think that, in a real situation I would be able to allow the
conversation to be far more fluid and relaxed.
During the interview I purposely made a point of asking open questions to try to draw
out the client’s response
Mrs. Dickson was clearly at ease after a while and even when closed questions were
asked she would answer them Yes or No and then go onto both expand what had been
said and volunteer other information.
I had varying degrees of success in eliciting the information that I was after. Trying to
establish whether it would be difficult to get the patient to comply with his diet I touched
on the subject of diets and Mrs. Dickson clearly has a major psychological difficulty in
coming to terms with her own diet. I allowed her to express her views about her obesity
before trying to bring the conversation back on track. After Mrs. Dickson’s outburst
about her “serious morbid obesity” I made three attempts to both empathize and
sympathize with her feelings in order to gain her trust by asking supportive and non-
contentious questions before returning to the point relating to injections with the
question
Phrasing the question in this way appears to show considerable empathy for Mrs.
Dickson’s situation and allows her then to offer her opinion. (Richards 1999)
There were several instances where I needed to summarise what was said in order to
be sure that I had understood the thrust of Mrs. Dickson’s comments
On reflection I believe that I made a reasonable attempt in the circumstances to get as
much information from Mrs. Dickson as I could. By the end of the interview Mrs. Dickson
was getting tired and losing concentration so I believe that it was correct to terminate
the interview at this time. (Wilkinson et al. 1999)

CONCLUSION
Information and communication technology offer powerful means for restructuring many
health service processes, and there currently are an increasing array of communication
channels, media, and devices from which communication services can be constructed.
By spending a little time reflecting on how you communicate, and working at improving
any weak areas, you can reap the many personal rewards of being an effective
communicator – including a better patient experience for those in your care.

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