Communication; It doesn’t have to be so clinical
The healthcare treatment of individuals must be tailored, while keeping within your board's codes and guidelines and meeting general requirements. As a medical defence insurer, MIPS is sometimes notified of the breakdown in communication between colleague
Key messages
- The fundamentals of communication can be easily developed with practice and learning
- Poor communication is one the most commonly cited cause of complaints in healthcare that can severely impact the quality of care and timeliness of treatment.
Medical and Dental Boards Codes of Conduct
Communicating with patients
- Listen to patients
- Encourage patients to speak up about their condition and how it is managed
- Inform patients of all aspects of clinical care
- Discuss available healthcare options
- Check for patient’s understanding of information given
- Inform patients of the risks associated with all clinical procedures
- Keep patients informed of their clinical progress
- Be mindful of and cater (whenever practical) to cultural, language and/or specific communication needs, including the use of qualified translators
- Share information effectively with other members of the treating team.
The ‘RACGP Standards and RACS Set of Competencies – Communication’ also provide useful recommendations:
- Establish rapport, trust and ethical therapeutic relationships
- Adopt a patient-centric approach and consider your patient’s values, needs and preferences.
- Respect patient confidentiality, privacy, autonomy and diversity
- Convey relevant health information to patients, families and colleagues in a simple yet accurate manner to foster discussion about procedures, potentialities, risks associated and to encourage informed decision making
- Develop a common understanding (with patients, families, colleagues) on issues, problems and therapeutic plans
Communicating with colleagues
- Show respect for other healthcare professionals – communicate clearly, promptly and respectfully
- Acknowledge the contribution of all healthcare professionals involved in the care of a patient
- Behave professionally and courteously to all colleagues and practitioners.
Main risks
- Having claims, complaints and investigations being made against you
- Misdiagnosing a patient or delayed treatment with the potential of causing harm
Research shows that ineffective communication in healthcare settings can serve as a precedent factor leading to a claim as well as a precipitating factor causing a claim directly (Studdert et al., 2000; Krause et al., 2001). Improving your communicating skills, obtaining written consent, maintaining boundaries, and safe prescribing are useful ways to mitigate these risks.
- Never criticise a colleague or staff in front of a patient.
- Be courteous, appreciative and professional to all staff
- Seek regular feedback and lead by setting examples
Useful tips - COVID-19
Consider how any restrictions on your normal practice such as wearing PPE or maintaining a distance may impact on the level of communication. Reassurance, agreement and understanding is critical.
Telehealth
- In-person consultations may still be required. Assess individual patients based on their specific clinical needs. Is telehealth the appropriate mode of communication? Video conferencing is preferred to telephone
- Your patient may need educating about telehealth to ensure an appropriate level of communication. Explain the limitations, you may need to calm and reassure anxious patients. Follow-up and continuity of care needs to be communicated clearly
- Be mindful of elderly patients who may be at higher risk of miscommunication issues. Ensure your treatment plan is agreed and understood
- Always follow AHPRA, Colleges and MBS requirements for telehealth.
When in doubt
References
Krause, H. R., Bremerich, A., & Rustemeyer, J. (2001). Reasons for patients' discontent and litigation. Journal of Cranio-Maxillofacial Surgery, 29(3), 181-183.
Studdert, D. M., Thomas, E. J., Burstin, H. R., Zbar, B. I., Orav, E. J., & Brennan, T. A. (2000). Negligent care and malpractice claiming behavior in Utah and Colorado. Medical care, 250-260.