The majority of medical errors occur due to communication issues. On the bright side, since communication can be learned and exercised, this means that medical errors can be reduced and patient satisfaction can be improved through training and practicing good communication.
Read on to learn some easily-employed, core communication practices that greatly enhance patient satisfaction.
No matter how simple and clear your explanations and instructions, there's a good chance that nothing you say will get through to the patient if you’re perceived as uncaring.
A common complaint of patients is that they don’t feel heard by their healthcare provider. Especially during upsetting adverse events, many patients will only remember the emotional impact of a conversation - such as whether they like the doctor or feel respected by healthcare staff.
Patients who don't feel heard may feel their diagnosis is inaccurate or that the prescription is irrelevant or impractical, and are less likely to comply with the prescribed course of treatment.
On the other hand, sometimes empathy is a cure in itself. Often, patients will feel better after little more than being listened to.
By learning some best practices in empathetic communication, you can help patients feel heard, understood, and respected. Try the following to better empathize with patients:
- Ask questions to elicit the patient’s experience and understanding of their situation.
- Just listen at first. People often need to express themselves and feel heard before they’re ready for solutions.
- Acknowledge and reiterate the patient’s understanding in your own words to ensure you understand, and to assure the patient, as well.
- Get the patient’s feedback on whether you’re understanding correctly.
- Ask the patient what they think they need.
- Address the problem the patient perceives, not just the problem as you see it.
Create a Feedback Loop
When conversing with patients, it's easy to take a smile and a nod to mean they understand. To avoid disappointing treatment results later on, establish a feedback loop to assess patient understanding.
Not only does a feedback loop help you know where the gaps in comprehension lay, it can even help patients process conversations and increase comprehension.
Here are three ways to create a positive feedback loop:
Ask open-ended questions. By directing the patient to express themselves with more than a yes or a no, you're able to assess the extent of their understanding of the conversation.
Use the teach back method. After giving an explanation or instructions, ask the patient to teach you back what you just told them.
Use the Ask Me 3™ method. Created by the National Patient Safety Foundation, this method encourages patients to ask their health care providers three questions: 1. What is my main problem? 2. What do I need to do? 3. Why is it important for me to do this?
Avoid Bias and Assumptions
Biases and assumptions can be communication-killers; by their nature, they blind us to possibilities and avenues of conversation.
Whether it’s a cultural bias or an assumption about patient preferences, these presuppositions often determine what doesn’t get discussed. Patients and healthcare providers may fail to ask vital questions or to detect and address unspoken issues. Patients are less likely to feel heard when biases and assumptions are at play.
One study even shows that a doctor’s unspoken beliefs and biases can affect the effectiveness of treatments!(1)
The only ways to prevent biases and assumptions are to uncover them and explore new perspectives. Here are a few ways to go about that:
- Always assume you’re making assumptions. Create the habit of asking the patient lots of questions to make sure you haven’t jumped to conclusions about them.
- Get the patient’s perspective and collaborate with them. Imposing your diagnosis and prescription upon them without working with their beliefs and concerns is more likely to lead to misunderstanding or non-compliance.
- Educate yourself and be curious. Learning more about patients and their beliefs, cultures, alternative medical systems, and more can help you relate better to patients.
- Get expert help. When the situation is too far outside your scope of expertise or understanding, don’t hesitate to employ an expert - such as an interpreter to help navigate cultural beliefs and linguistic differences.
Follow Up With Patients
Patient satisfaction increases significantly with duration of visits (in terms of interaction with healthcare providers, not long waits in waiting rooms!) and follow up. This leads to increased compliance, which results in even greater satisfaction - establishing a virtuous cycle.
During follow up, the effectiveness of previous communication can be assessed, misunderstandings corrected, and the course of treatment adjusted. Patients can take the opportunity to air grievances and suggest improvements. This empowers them to be agents in their own care, makes them feel like part of their own healthcare team, and provides valuable feedback to healthcare providers.
Follow up can take many forms, including scheduling follow-up visits, written or telephone surveys, sending relevant information or post-care instructions, or just calling to ask how the patient is doing.
Changing individual communication habits may be difficult or insufficient without improving the communication practices of your entire organization. Here are some ways you can systematically ensure better communication for your patients:
- Training: healthcare providers need constant training to expand and maintain their communication skills.
- Meetings: hold team meetings regularly to ensure opportunities to assess communication bottlenecks, discuss patient survey feedback, examine strengths and weaknesses, and exchange information and ideas for improvement.
- Screening: devise methods of pre-screening patients for communication barriers, cultural biases, linguistic challenges, treatment preferences, and more to prepare doctors to offer the best care. Proper screening and intake can ensure proper measures, such as bringing in an interpreter for a non-English-speaking patient, are triggered.
- Protocols: systematizing the process of greetings and discharge, the taking of patient histories, assessing patient comprehension, collaborating with the patient on treatment, and other aspects of care can help everyone follow best communication practices effortlessly.
- Follow up: schedule a series of procedures to follow up with each patient in the weeks after their visit.
- Checklists: leave nothing to chance. Make sure that no communication gets overlooked and that the proper protocols are followed in every situation by having someone sign off on every step. If you’ve read The Checklist Manifesto by Atul Gawande, you know that checklists save lives in the medical field when it comes to surgeries - now it’s time to extend this to the systematization of communication in healthcare.
- Metrics: know how effective your communication practices are. Keeping track of progress in cold, hard numbers can help you see clearly where improvements can be made.
- Streamline and automate with technology: once you’ve designed your system, take advantage of technology to make it easier to communicate with patients. This can include digitizing healthcare records, online appointment scheduling and intake, automated email or telephone surveys, teleconference interpreting, and more.
Most of these principles and techniques are easy enough to adopt, but can take some practice to master. Scheduling lots of training is well worth the time, considering communication - not lack of medical expertise - is the main factor in both medical errors on one extreme, and superior client satisfaction on the other.
Looking for more information on how communication, specifically with Limited-English Proficient patients affects health outcomes? Download our white paper on this topic by clicking the button below.
- Gracely, R. H. (1979). “Physicians expectations for pain relief.” Society for Neuroscience Abstracts 5: 609; also in Levine, J., N. Gordon, and H. Fields (1978). “The mechanism of placebo analgesia.” The Lancet 312(8091): 654–657.