Communicating Effectively With Patients to Improve Quality ...

Communicating Effectively With Patients to Improve Quality and Safety

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Contents

Introduction .................................................................................. 1 Objectives ..................................................................................... 1 The Impact of Communication Failures .......................................... 2 Committing to Quality Service and Patient Satisfaction .................. 2 Making a Positive Impression ........................................................ 4

During Patient Triage................................................................................... 4 During Patient Encounters ........................................................................... 4

Remember Common Courtesies......................................................................... 5 Maintain Awareness of Nonverbal Communication ............................................... 6 Create an Open Dialogue and Listen.................................................................. 7 Ensure Comprehension .................................................................................... 7 Keep Conversations Professional and Appropriate ............................................... 9 Establish an Atmosphere of Cultural and Gender Sensitivity ................................10

Engaging Patients With Satisfaction Surveys ............................... 10 Developing Policies and Standards for Telephone and Electronic Communication............................................................................ 11

Telephone Communication ......................................................................... 11 Establishing Phone Communication Protocols.....................................................11 Giving and Receiving Information.....................................................................12 Using an Answering Service.............................................................................12 Documenting Telephone Communication ...........................................................12 Monitoring Trends ..........................................................................................13

Electronic Communication.......................................................................... 13 Defining Acceptable Uses for Electronic Communication......................................14 Determining Appropriate Users ........................................................................14

Establishing Timeframes for Electronic Inquiry Response ....................................14 Developing Standard Disclaimers for Electronic Communication ...........................15 Specifying Privacy and Security Features and Limitations of Electronic Communication ..............................................................................................15 Establishing Documentation Guidelines for Electronic Communication...................15

Managing Patient Complaints ...................................................... 15 Disclosing an Unanticipated Outcome .......................................... 17 Conclusion................................................................................... 18 Resources.................................................................................... 18 Endnotes ..................................................................................... 19 Appendix A. Sample Patient Satisfaction Surveys for Healthcare Practices ..................................................................................... 21

Guideline: Communicating Effectively With Patients to Improve Quality and Safety

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Introduction

Effectively communicating healthcare information is one of the most important aspects of the provider?patient relationship. When communication lapses occur in healthcare, they can be detrimental in various ways. Patients who do not understand healthcare information and instructions might not adhere to their treatment plans or might have unrealistic expectations about the outcomes of care. As a result, healthcare providers may struggle to engage patients in their care and build meaningful patient relationships, which could potentially increase liability exposure.

Healthcare providers and staff need to be cognizant of both how and what they communicate to ensure that patients thoroughly comprehend their diagnoses, treatment plans, care instructions, and other pertinent information.

Implementing proactive strategies to provide high-quality service, deliver patient-centered care, make a positive impression, measure and improve patient satisfaction, and efficiently manage patient complaints can help clinicians and staff build strong partnerships with patients. These strategies also may reduce the likelihood of miscommunication and preventable adverse events.

Objectives

The objectives of this guideline are to:

? Review the impact of communication failures ? Discuss key elements of a service-oriented culture and how to promote effective

communication ? Discuss methods of making a positive impression during patient encounters ? Describe actions that demonstrate a commitment to patient satisfaction ? Discuss strategies for developing electronic and telephone communication policies ? Outline effective strategies for managing patient complaints ? Provide information related to communicating an unanticipated outcome

Guideline: Communicating Effectively With Patients to Improve Quality and Safety

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The Impact of Communication Failures

Research indicates that ineffective communication among healthcare professionals is one of

the leading causes of medical errors and patient harm.1 In 2018, CRICO Strategies released a

report that presented the results from an analysis of almost 124,000 medical professional liability cases filed between 2007 and 2016. CRICO's data showed that communication issues, which were found in

Ineffective communication among healthcare professionals is one of the leading causes of medical errors and patient harm."

all care settings, were one of the top

contributing factors in malpractice cases. Communication failures (between patients/families

and healthcare providers as well as among healthcare providers) occurred at these rates in

these settings:

? Thirty-one percent of ambulatory care cases (examples included inadequate consent, poor communication about medication risks, unprofessional communication, and unclear responsibility)

? Thirty-one percent of inpatient care cases (examples included lapses in reading the health record, failure in reaching a consensus, deficient discharge/follow-up instructions, and inadequate notification of adverse events)

? Thirty-two percent in emergency department care cases (examples included communication issues related to hierarchy, language barriers, and inadequate followup instructions).2

These data speak to the significance of communication's impact in healthcare and the need for healthcare providers and staff to include communication as part of quality improvement and patient safety initiatives.

Committing to Quality Service and Patient Satisfaction

Creating and maintaining a service-oriented culture, which focuses on providing exemplary customer service and quality patient care, is an important strategy for reducing the risk of communication failures that could potentially lead to patient complaints, errors, and even

Guideline: Communicating Effectively With Patients to Improve Quality and Safety

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liability exposure. Good customer service is the foundation for patient satisfaction and the basis for engaging patients in the shared responsibility of their healthcare. Promoting a service mindset requires:

? Leadership involvement to convey the message that the healthcare practice is committed to service excellence

? A mission statement that reflects the importance of quality care and patient satisfaction

? Policies that outline expected behaviors and mechanisms to achieve the mission (e.g., use of patient satisfaction surveys and techniques for handling complaints)

? Involvement of all staff members in setting priorities and working toward improving the practice's level of service

? A retaliation-free environment in which staff members can speak up and hold each other accountable to the practice's mission and goals

? Measurement of patient engagement indicators in a formal quality improvement process, and sharing of results with the practice's providers and staff on a regular basis

? Recognition of staff for outstanding customer service

Actions that demonstrate a commitment to patient satisfaction include:

? Treating all patients in a courteous manner at all times without exception (e.g., in-person, over the phone, and via electronic communication)

? Offering timely access to appointments and provider advice, as needed ? Providing adequate time during each patient encounter for the patient to explain

his/her reason for visiting without feeling rushed ? Monitoring patient wait times, frequently updating patients regarding delays, and

providing the option to reschedule when a delay is longer than 30 minutes ? Respecting patients' modesty, dignity, cultural preferences, and confidentiality

Guideline: Communicating Effectively With Patients to Improve Quality and Safety

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? Continuously soliciting feedback on patient satisfaction, and conducting formal patient satisfaction surveys

? Addressing patient complaints promptly on a case-by-case basis

? Analyzing trends in patient complaints and applying corrective actions to improve service

Making a Positive Impression

During Patient Triage Patients' initial interactions with healthcare practices often occur when they schedule appointments. Scheduling that is responsive to patients' needs and takes into account their specific circumstances can help establish a positive impression of the practice.

In healthcare practices, scheduling should adhere to standard written procedures that use the following criteria (modified as necessary):

? Emergency care: life-threatening conditions that require immediate referral to an emergency department

? Urgent care: conditions that require attention the same day

? Routine care: nonurgent conditions that require a timely appointment in the near future

? Preventive care: physical examinations and similar services that require a visit within a reasonable period of time

During Patient Encounters Several patient-centered techniques can enhance communication with patients and convey a positive impression during patient encounters. The term "patient-centered" refers to healthcare approaches that are responsive to patient needs, perspectives, and values.3 According to the Picker Institute, eight dimensions of patient-centered care include:

1. Respect for the patient's values, preferences, and expressed needs 2. Information and education

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