EFFECTIVE COMMUNICATION AT THE HOSPITAL

By Umi Kulsum

FK UB MMRS 2021

Communication errors are a major contributing factor in hospital sentinel events. At

transitions of care, there is an increased risk of communication errors occurring. This can lead
to poor health outcomes, distress, or inappropriate patient care. Effective patient-clinician
communication is a core clinical skill. The ability of health workers to communicate information
openly, honestly about patients' conditions, and to be able to listen to the patient, requires good
communication skills. Ineffective communication is reported as a significant contributing factor
in medical errors and inadvertent patient harm. In addition to causing physical and emotional
harm to patients and their families, adverse events are also financially costly. Today, healthcare
is more complex and diverse, and improving communication among healthcare professionals is
likely to support the safe delivery of patient care. Communication is essential to help patients
understand their health situations, problems, and treatment plans. Good communication skills
not only improve patient safety standards but also build good relationships with patients.

In healthcare, effective communication involves arriving at a shared understanding of a

situation and in some instances a shared course of action. This requires a wide range of generic
communication skills, from negotiation and listening, to goal setting and assertiveness, and
being able to apply these generic skills in a variety of contexts and situations. The Joint
Commission reported that poor communication is a contributing factor in more than 60% of all
hospital adverse events they reviewed. Communication errors among health care providers are
complicated by a hierarchical reporting structure, gender, education, cultural background,
stress, fatigue, ethnic differences, and social structure. It is reported that differences in
communication styles between nurses and physicians are one of the contributing factors to
communication errors (Dingley, 2019). Effective communication also requires individuals and
teams have access to adequate and timely information necessary to perform their role
effectively and appropriately. The use of technical terms and jargon, acronyms and
abbreviations and, diagrams to communicate can influence how well information is shared and
therefore the effectiveness of communication. As in business, adhering to the five standards of
effective communication in healthcare is likely to facilitate improvements in the exchange of
information between healthcare professionals, and information should be complete, clear,
accurate, concise, concrete. Poor communication is found in many different healthcare settings
and is especially prominent in patient hand-offs and settings where fast and effective
management is indispensable.

Implementation of SBAR (Situation, Background, Assessment, and Recommendation), a

structured communication tool improves the clarity and content of interprofessional
communication. And is used for practice and organizing upcoming communications about actual
patient situations. SBAR was developed to increase handover quality and is widely assumed to
increase patient safety. Sharing patient-specific health care information during handoff requires
situational awareness, which is an understanding of a patient's current condition and clinical
trajectory. Loss of situational awareness could lead to adverse events and hence compromise
and patient care. SBAR helps health care providers who have different ways of communicating
to equalize perceptions about the patient's condition. This aims to prevent miscommunication
that could impact subsequent patient care and will affect patient safety standards.
Communication problems are multidimensional, being influenced by technology, personnel,
process, information design, and biology itself. Despite huge investments in technology to
record, store, disseminate, and access information, studies still find communication in health
care continues to be problematic (O’daniel, 2008). Health care providers need to be cognizant
of the challenges facing handoffs, including physical setting, social setting, language barriers,
and communication barriers. Some of the most commonly reported environmental obstacles to
effective communication are distractions, insufficient time, and interruptions.

SBAR improves patient safety and the quality of health service. When the quality of
health services increases, patient satisfaction will also increase. The importance of patient
satisfaction in healthcare cannot be overstated. When patients have a high level of satisfaction
with the care they receive from a healthcare provider, patient outcomes are likely to be better.
Patients are also more likely to remain with the same healthcare provider. If a patient has a bad
experience, he/she could change providers and share the bad experience on social media, the
internet, or word of mouth. That could easily make it harder for healthcare providers to attract
patients. The Joint Commission reports that investing to improve communication within the
healthcare setting can lead to improved safety, improved quality of care and patient outcomes,
decreased length of patient stay, improved patient and family satisfaction.
 Ineffective communication can lead to improper diagnosis and delayed or improper
medical treatment. If the healthcare professionals have good communication skills, it will help
respectful and build relationships with patient, their relations, and colleagues. Ineffective
communication has repercussions for organizations, like poor customer experience, low
productivity, and an undesirable bottom line. In the healthcare world, bad communication has
more severe consequences medical errors, malpractice suits, disengaged medical providers,
and, in the worst-case scenarios, fatalities. Many factors affect effective communication which
consists of individual abilities and characteristics, team behaviors and systemic factors, and the
lack of organizational support of culture safety. Actions and strategies that may help improve
patient-clinician communication are provided for three key transition points when the first time
engage with a patient. To ensure to have all the relevant information that needs to help inform
clinical assessment, and that care decisions about care are appropriate and reflect the patient's
needs and preferences. Second when transferring care to another provider. To ensure that any
information transferred is up to date, accurate and, reflects the patient's needs and preferences.
when discharging the patient. To ensure that the patient, and their family and carer, manage
any next steps they need to take. It is recognized that these transitions do not occur in isolation
of one another and that some strategies and actions will be relevant at all transition points
(Skarbaeline, 2019). Coordination and communication between health care providers, the
patients, their family and carer, and other healthcare providers across all these points are
essential to ensuring safe, continuous care.

Patient safety is the priority in inpatient care, and communication errors are the most
common cause of adverse events during patient care. Health care providers make every effort
to avoid communication errors during patient handoff. SBAR communication tool is a structured
communication tool that has shown a reduction in adverse events in a hospital setting. Various
medical associations and leading health care organizations have been endorsing SBAR
communication tools for handoff among health care providers. This communication tool creates
a shared mental model around the patient's condition and has been used for the transfer of
patient care in various clinical settings. Effective communication will enable the collaborating
caregiver professionals to be able to detect health problems early, improve diagnosis accuracy,
prevent medical crises and, avoid long-stay care. In addition, it can also increase the patient's
knowledge of their health problems, as well as increase patient compliance with the therapeutic
process and disease prevention. Effective communication between nursing professions will
greatly assist the role of integration and coordinating care for patients. In the end, this will
increase patient satisfaction, prevent patient safety, improve service image.

Reference :

Dingley, Catherine. (2019). Improving Patient Safety Through Provider Communication Strategy
Enhancements. Denver Health Medical Center,7,1-18.

Skarbaliene, Aleitha. (2019). Effective Communication in the Healthcare Settings: "Are The
Graduates Ready For It ?". DOI, 24,137-147.

O'Daniel, Michelle. (2008). Patient Safety And Quality: An Evidence-Based Handbook for
Nurses. NCBI,33.