The Lack of Communication in Healthcare Settings - Literature review Example

Topic: The lack of communication in healthcare settings and the importance of communication in order to improve quality of care. Introduction The provision of quality health care services is one of the primary goals for all healthcare facilitilities or institutions. According to Hughes (2008), quality healthcare is the extent to which health services provided to patients enhance the attainment of the desired health outcomes and are consistent to current professional standards and knowledge. Due to the critical nature of the health care profession, quality improvement has become an integral preoccupation in services healthcare facilities. The reason why most health care facilities emphasise on quality improvement is so as to ensure patient and staff safety, to promote positive health outcomes amongst patients and effective implementation of health care policy (Beilenhoff & Neumann, 2008). Evidently, health care settings are complex in nature due to variables such as the changing mix of patients, limited resources, inefficient processes, health insurance complexities and different education and experiences of health care professions. As a result, most health care facilities function at lower levels particularly when it comes to delivering safe, efficient, patient-centered, equitable and timely healthcare services (Hughes 2008). Many scholars have over the years conducted studies in an attempt to decipher the measures or approaches that can be used to improve quality healthcare or enhance quality assurance. A considerable number of studies have linked communication to improved quality of health care services (ACSQHC 2008; Arora et al 2009; McMurray et al, 2011; Street et al 2009; WHO, 2008). For instance, McMurray et al (2011) established that clinical communication plays a very essential role when it comes to promoting patient safety. Similarly, Street et al (2009) found that effective communication within the health care settings leads to improved health outcomes amongst patient. Therefore, communication plays an integral role in the realisation of quality health care services. This paper depicts communication processes and systems incorporated in the delivery of healthcare services and how they help to improve the quality of health care services provided by different health facilities and institutions. It will particularly focus on reviewing scholarly literatures in a bid to demonstrate the use of process and outcome data in the delivery of safe, quality nursing care in health institutions. Use of process and outcome data in promoting quality health care services Over time, quality improvement has become a driving force in most healthcare facilities and institution. Generally, quality improvement is an integral aspect of providing quality health care services at all levels in healthcare systems. In essence, the provision of quality health care services has become the core business in medical or clinical practice. Nevertheless, unless quality is measured, it is would be difficult to know what needs to be improved and whether any progress has been made in improving the process of service delivery. Most healthcare facilities have complex adaptive systems thus making changes in order to enhance the quality of healthcare can be difficult. Effecting quality improvement fundamentally demands that health professions should have in-depth knowledge about what is happening in service delivery, the factors that affect delivery of services and how they can influence these factors in order to realise service quality. In a complex system such as a health care facility, it can be detrimental to rely on assumptions, emotions or isolated occurrences when making decisions. Solid evidence is needed in order to support decisions (VQC, 2008). Therefore, quality improvement heavily relies on measurement since it provides process and outcome data that provide healthcare professional evidence based information about what needs to be improved and what can be done to facilitate improvements in health care services. According to WHO (2012), process data refers to records or information obtained through measurements of the workings of health care systems. In most cases process data encompass the components of systems which are linked to negative outcomes. This type of data provides information to health care professions about how well the healthcare systems or service is working. For instance, process data can incorporate information about delays in drug administration, the frequency in which swab counts are carried out or challenges associated with limited capacity or bed space in the wards or ICU (WHO , 2012). On the other hand, outcome data refers to records or information obtained through outcome measurements. It incorporates aspects such as the frequency of adverse events, unexpected death cases, medical errors or accidents and information about service encounters or satisfaction. Outcome data are commonly collected through auditing of medical records, interviews and survey that seeks to establish the perspective of staff, patients and their families regarding issues relating to service quality (WHO, 2012). A wide range of scholarly literatures provide compelling evidence demonstrating how process and outcome data can be used in the provision of safe and quality health care service. For instance, Ellenbecker et al. (2008) observes that it is important for healthcare professionals to be vigilant in order to avoid medical errors. Therefore, accurate documentation and review of data relating to aspects such as a patient’s symptoms, medication or diet regime is crucial in facilitating the provision of quality healthcare. Ellenbecker et al. further observe that regular reviews of data relating to medication and collaboration with healthcare professionals like pharmacists can help to avert events linked to poor medication management. Technology offers a wide range of option to improve communication with patients, monitor their medication regime and educate them on how to effectively take their medication (Ellenbecker et al. 2008). A study conducted by Beilenhoff & Neumann (2008) provides vivid examples of how process and outcome data can be used to facilitate safety and the provision of quality health care services. In their study, Beilenhoff & Neumann focus on quality assurance in endoscopy nursing. Firstly, they observe that endoscopy staffs are responsible for individualised and comprehensive documentation of process and outcome data. In relation to process data, Beilenhoff & Neumann (2008)illustrate identity documentation is crucial. Prior to undertaking any procedure health professional should review or document the identity of the patient so as to ensure that the right patient undergoes the right procedure. This process not only promotes patient safety but it also ensures the delivery of appropriate service. Beilenhoff & Neumann (2008) asserts that systematic identity check and review of process data can avert or minimise the number of wrongly treated patients. Beilenhoff & Neumann (2008) further depict that outcome data comprising of patient’s information regarding concurrent conditions, infection, allergies previous surgery and special can enable health professionals to assess risk factors. Nurses are responsible for assessing a patient’s health condition and risk factors so that they can identify suitable pre or post procedure care. Furthermore, the identification of patient’s risks factors enables health professionals to take necessary measures in order to ensure patient’s safety (Dumonceau et al, 2010; Riphaus et al, 2008). In addition, process data helps health professions to determine whether after treatment or surgical procedure patients have met the discharge criteria prior to their discharge. Process data touching on procedure activities or nutritional regime can help staff to determine the measures to take in case of adverse complications occur. Lastly, Beilenhoff & Neumann (2008) observe that the regular collection of outcome data on patient satisfaction can help health professionals to evaluate the levels of service quality and areas that require improvements (Faigel &Cotton, 2009). Conversely, a study conducted by Philips & Clark (2010), sought to establish whether outcome data on the prevalence of ulcers can provide meaningful insights that would lead to improvements in service quality. Phillip & Clark established that the process of collecting, evaluating and reporting ulcer outcome data has mainly focused on the scale of negative outcomes such as cause of wound, severity, size and location. This data has failed to measure other critical metrics like adherence to preventative care protocols. Consequently, assessment of pressure ulcer has significantly remained detached from patient safety and quality improvement processes. This has in turn had very little impact on the improvement of overall health outcomes. Philips & Clark (2010) recommend that in order for outcome data on the prevalence of ulcers to facilitate patient safety and quality improvement processes, outcome measures should be modified mathematically so as to incorporate population differences between health care facilities. This will enable health professional to carry out accurate trend analysis , make reliable comparisons and identify hot spots for condition. Furthermore, they recommend that the assessment process should be refocused so that it reflects the quality of preventative measures employed (Philips & Clark, 2010). McMurray et al (2011) examined the perspectives of patients regarding bedside handover. This study illuminated the importance of outcome data in the realisation of smooth bedside handovers. McMurray et al observe that understanding of patients’ needs and preferences provides a foundation for health professionals to carryout bedside handovers that reflect their needs, values and perspectives thus encouraging their involvement in decision making. Process and outcome data enable health professionals to understand patients’ health condition, experiences, needs and vulnerabilities. As a result, they are able to provide patient-centered care thus realising smooth bedside handovers (Wiggins, 2008; Yee et al, 2009). According to Levinson et al (2010), patient centered care is one of the key elements of high quality health care. Basically patient centered care entails taking into account and addressing the needs, wants and preferences of patients in order for them to make personal choices about their care that is convenient to their condition and circumstances. Communication skills play a crucial role in the implementation of patient centered care. There is a substantial amount of evidence in literature that suggest that patient-oriented communication significantly influences patient satisfaction and adherence of the patient to the recommended treatment (Epstein et al. 2010; Haidet et al, 2009; Rosenthal, 2008). Patient-oriented communication also positively impacts on the overall health outcomes of patients. Breakdown in communication has been commonly associated with patient dissatisfaction, malpractice and medical errors. Through patient oriented communication, health care professionals are able to understand the individual needs, values, perspectives of patients, this in turn enables them to identify ways that they can meet their patients’ needs effectively. However, in order for health care professionals to effectively practice patient oriented communication, they require sound communication skills that will enable them to create a rapport with patients, appropriately question and assess patients’ needs, concerns and preferences, listen to them attentively and provide guidance (Levinson et al, 2010). Street et al (2009) notes that, patients are more likely to realise better health outcomes when health professionals attending to make decisions about the health that are; consistent with the values of the patient, based on clinical evidence and mutually agreed upon. In most cases, medical decisions are made through information exchange and consultation. Information exchange may involve communication between the health profession and the patient. In this case, the patient may share with the health profession his or her beliefs, values, preferences and expectations. On the other hand, the health profession may communicate clinical perspective pertaining to the patient’s condition. Subsequently, they may consult or deliberate with each other in order to find a common ground about the form of treatment that the patient can undergo in order to improve their health outcomes. Process and outcome data often incorporate information exchange between a health profession and a patients. Thus these data can be used to determine suitable approach of service delivery (Street et al, 2009). Conclusion This paper has examined the use of process and outcome data in the delivery of safe, quality nursing care in health institutions. Based on a critical review of various scholarly literature the findings of this essay show that quality improvement has become a driving force in most healthcare facilities and institution. However, unless quality is measured, it is would be difficult to know what needs to be improved and whether any progress has been made in improving the process of service delivery. Process and outcome data are based on measurements of the workings of health care systems. Process data focuses on health care and operation process whereas outcome data focus on the effects of occurrences within the health care settings. Literatures reviewed in this paper have provided compelling evidence demonstrating how process and outcome data can be used in the provision of safe and quality health care service. Generally, process and outcome data helps health professions to understand the needs of patients, identify patient’s risks factors and make suitable decisions regarding patient’s treatment. References Arora, V., Manjarrez, E., Dressler, D., Basaviah, P., Hatasyamani, L.,& Kripalani, S. (2009). ‘Hospitalist handoffs: A systematic review and task force recommendations’. Journal of Hospital Medicine, 4(7), 433-440. Australian Commission on Safety and Quality in Health Care. (ACSQHC)(2008). Nine priority programs. Retrieved on August 17 2011 Beilenhoff, U. & Neumann, C.S. (2008). ‘Quality assuarance in endoscopy nursing’. Best Practice and Research Clinical Gastroenterology 25, 371-385. Dumonceau, J. M. Riphaus, A. Aparicio J. R, et al. (2010). ‘Guideline: non-anesthesiologist administration or propofol for GI endoscopy’. Endoscopy 42:960–74 Ellenbecker,C.H. Samia, L. Cushman, M.J & Alster, K. (2008). Patient safety and quality in home health care. In R. G. Hughes. Patient safety and quality: An evidence-based handbook for nurses. Rockville, MD: Agency for Healthcare Research and Quality. Epstein, R.M. Fiscella, K. Lesser, C.S & Stange, K.C. (2010) . ‘Why the nation needs a policy push on patient-centered health care’. Health Affairs 29(8), 1489-1495. Faigel, D.O, Cotton, P.B. (2009). ‘The London OMED position statement for credentialing and quality assurance in digestive endos-copy’. Endoscopy 41, 1069–74 Haidet, P. Fecile M.L. West H.F. & Teal C.R.(2009). ‘Reconsidering the team concept: educational implications for patient-centered cancer care patient’. Patient education and Counselling 77(3), 450-455. Hughes R. (2008).’Tools and strategies for quality improvement and patient safety’. In Hughes RG, ed. Patient Safety and Quality: An Evidence-Based Handbook for Nurses. Rockville, MD: Agency for Healthcare Research and Quality. Levinson, W. Lesser, C.S. & Epstein, R.M. (2010). ‘Developing physician communication skills for patient-centered care.’ Health Affairs 29(7), 1310-1318. McMurray, A. Chaboyer, W. Wallis, M. Johnson, J. & Gehrke, T. (2011). ‘Patients’ perspectives of bedside nursing handover’. Collegian 18, 19-26. Philips, L. & Clark, M. (2010). ‘Can meaningful quality benchmarks be derived from pressure ulcer prevalence data?’ Journal of Tissue Viability 19, 28-32. Riphaus, A. Wehrmann T. & Weber B, et al. (2008). ‘S3 Guideline: sedation for gastrointestinal endoscopy’. Endoscopy 41, 787–815. Rosenthal T.C (2008). ‘The medical home; growing evidence to support a new approach to primary care’. Journal of the American Board of Medicine 21(5), 427-440. Street, R.L. Makoul, G. Arora, N.K & Epstein R.M. (2009). ‘How does communication heal? Pathways linking clinician-patient communication to health outcomes’. Patient Education and Counselling 74, 295-301. Victorian Quality Council (VQC) (2008). A guide to using data for health care quality improvement. Retrieved on August 17 2011 World Health Organization (WHO) (2008).’Communication during patient handovers’. Patient Safety Solutions, 1(3). Retrieved on August 17 2011 World Health Organization (WHO) (2012). Quality Improvement Methods. Retrieved on August 17 2011 Wiggins, M. (2008). ‘The partnership care delivery model: An examination of the core concept and the need for a new model of care’. Journal of Nursing Management,16, 629—638 Yee, K. C., Wong, M. C., & Turner, P. (2009). ‘Hand me an isobar’’:A pilot study of an evidence-based approach to improving shift-to-shift clinical handover. Medical Journal of Australia,190(11), 121-124 Read More