Healthcare Interpersonal Communication - Research Paper Example

? EFFECTIVE INTERPERSONAL COMMUNICATION BETWEEN THE PATIENTS AND THE HEALTHCARE PROVIDERS Effective Interpersonal Communication Communication, especially in the interpersonal level, is known to satisfy different human needs, which involve the physical, identity, social and practical realms, among others (Adler and Proctor, 2011, Chapter 1, pp. 5-8). As Adler and Proctor pointed out (2011, Chapter 1, pp. 5-8), human beings communicate to satisfy the needs itemized by Maslow (Engwall, 2011, p. 7) in his famous hierarchy: physiological, safety, love and belongingness, esteem and self-actualization. Communication is important in practically all human endeavors, especially in the provision of healthcare. The Mental and Physical Health Platform noted that “better communication and cooperation between medical disciplines, careers, families and service users, must be prioritized to ensure a 360° approach to mental and physical health” (Bowis et al., n.d., p. 1). All those involved in healthcare- health professionals, patients and family members should be able to communicate well as part of good practices in improved recognition, monitoring, diagnosis and management of health problems. Likewise, the Mental and Physical Health Platform recognized that implementation of “measures for improved health literacy, access to better health promoting services, information and advice on lifestyle changes and other factors “ is pat of empowering the “service users together with their families and careers”. Definitely, effective communication is vital in this empowerment. Ensuring effective communication is a great task which should be pursued by the healthcare providers. There are communication problems which have to be identified, and properly solved to guarantee the desired results in healthcare provision and management: health, survival and quality of life. “The relationship between patient-clinician communication and outcomes of care is, from a conceptual standpoint, one of the least developed areas of communication research” (Pathways from Communication to Health Outcomes: Mediators and Moderators, n.d., p. 56). Applications of interventions and other solutions to communication problems are vital to healthcare provision and management. Identification of barriers and other interpersonal communication problems and their possible solutions, between and among healthcare professionals and patients will improve delivery of healthcare services. There are three types of Interpersonal communication (IPC), namely, caring/socio-emotional communication, diagnostic communication/problem solving and counseling According to De Negri et al. (1995, p. 15), effective IPC is the one resulting in the following outcomes: 1. The patient discloses enough information about the illness to lead to an accurate diagnosis. 2. The provider, in consultation with the client, selects a medically appropriate treatment acceptable to the client. 3. The client understands his or her condition and the prescribed treatment regimen. 4. The provider and the client establish a positive rapport. 5. The client and the provider are both committed to fulfilling their responsibilities during treatment and follow-up care. Nevertheless, the aforementioned outcomes cannot be perceived as the guiding line within the context of effective communication. These steps generally include encouraging a two-way dialogue, establishing a partnership between patient and provider, creating an atmosphere of caring, bridging any social gaps between provider and client, accounting for social influences, effectively using verbal and non-verbal communication, and allowing patients ample time to tell their story (De Negri et al., 1995, p. 15). COMMUNICATION BETWEEN HEALTHCARE PROFESSIONALS “Poor communication has been shown to lead to disruptions in continuity of care, delayed diagnoses and duplication of or unnecessary interventions” (Astrom et al., 2007, p. 279). In the study of Astrom et al. (2007, pp. 279-285), it was shown that communication between individuals in a healthcare setting, specifically in the London Teaching Hospital, has varying degrees of problem. This specific study aimed to identify the key problems in communication between specific individuals which are crucial to patient-clinician welfare: doctors, nurses, pharmacists and physiotherapists. It was observed that these problems can be summarized into two cultural-related key problems. The first problem is to highlight individual issues. Whether one is a doctor, a nurse, a pharmacist, or any kind of health worker, when one communicates with another person, there would always be some kind of issues. These issues may be related to one's professional work, personal life, or these issues may not be even related at all. Still, issues can cause a lot of problems with regards to communicating, especially those in the field of health and medicine. Whether it is one or many, issues prevent or disable effective communication. The second main problem is communicating in a timely manner. One of the proposed solutions for this is to actually have a joint note/record where health workers, from whatever stature or position, could easily see the status of the patient. In short, what they really need is a central point of communicating the specific their needs to each individual within their circle of communication. Although this is currently happening, these health workers would still have to share their knowledge to each other so that the specific ideas that are in the notes can be fully understood. In summary, the study by Astrom et al. (2007, pp.279-285) identified the communication problems as follows: incomplete documentation, difficult contacting other healthcare providers, lack of formal methods or places to provide information or ways to follow up on the actions taken. It was concluded that communication would be easier in the long term if there were joint communication notes. The study also highlighted the differences among the professions; hence there is a need to account for such professional and behavioral differences in the implementation of future developments in communication. Astrom et al. (2007, p. 285) appropriately emphasized the timely and effective way of providing and transferring the information “in a secondary setting and the needs to develop a culture where healthcare providers can highlight individual issues for resolutions.” LINGUISTIC COMPETENCE AND HEALTHCARE QUALITY Brach et al. (2005, p. 424) noted that the quality of communication between healthcare providers and patients can have a major impact on health outcomes. Proficiency in the language used, can interfere with effective communication. It has been shown that language barriers have negative impacts on access, patient satisfaction and sometimes cost. Those with difficulty in communicating with healthcare providers are less likely to seek medical attention, and when they do, they usually receive less medical services due to several reasons. Some of these reasons include the following: a) poor quality care in emergency departments; b) inadequate communication of diagnosis, treatment and prescribed medication; and c) medical errors. Language barriers can also create additional costs, which are called “language barriers premium or LEP (Hampers and McNulty, as cited by Brach et al., 2005, p. 425). Patients with LEP undergo more diagnostic tests, “presumably because of physicians' attempts to compensate for communication difficulties, and they are more likely to be admitted to the hospital from the emergency departments.” Other costs include the loss of business from the group with language difficulty, from private purchasers of health coverage, and from public purchasers who require strict linguistic competence (Brach and Fraser 2002 as cited by Brach et al., 2005, p.425). Strategies that may work to address the language barriers may include the following: a) use of bi-lingual healthcare providers; b) use of interpreters; and c) developing language assistance programs. Language assistance programs, in turn, require the following: a) collecting data on members' languages; b) recruiting and identifying bilingual staff and physicians; c) organizing and financing interpreter services; and d) educating members and physicians about interpreter services (Brach and Fraser 2002 as cited by Brach et al., 2005, p. 425). Brach et al. identified six priority activities that health plans can initiate to improve linguistic competence: a) develop a language assistance plan; b) collect and use language data; c) don't rely exclusively on physicians who have historically served LEP patients; d) educate physicians and hold them accountable; e) recognize language assistance as an integral part of quality; and f) negotiate with purchasers (Brach and Fraser 2002 as cited by Brach et al., 2005, p. 425). Public and private purchasers have a major impact on the availability of language assistance because they control the “business case”. They can do several things to make the plans and providers shoulder the cost of language assistance by a) making them pay for interpreter services; b) making expectations explicit; and c) requiring plans and providers to report on language assistance (Brach and Fraser 2002 as cited by Brach et al., 2005, p.425). On the other hand, policy makers can: a) encourage and support health plan collection of language data; and b) develop national measures and standards (Brach and Fraser 2002 as cited by Brach et al., 2005, p. 425). Researchers, in partnership with healthcare providers, can work on answering some questions on the following: types of interventions that can be most effective and cost-effective as well; methods to implement such interventions in various settings; impact of cultural and linguistic competence on healthcare delivery and health outcomes, and other unanswered questions related to language competence and healthcare. Conclusion Problems encountered in interpersonal communication between and among healthcare professionals and patients together with their family and careers may be solved by providing health plans which include language assistance program, timely sharing of complete documentation and properly addressing differences, including behavioral differences among healthcare providers. Other stakeholders, who can have positive impact on solving problems and setting interventions, when necessary, are the public and private purchasers, health plan providers, together with the researchers who can work to address some unanswered questions on the link between interpersonal communication and healthcare provision and management. References Adler, R.B., & Proctor II, R.F. (2011). Looking out, Looking in. 13th ed. Wadsworth Publishing. Astrom, K.A., Duggan, C., & Bates, I. (2007). Developing a way to improve communication between healthcare professionals in secondary care. Pharmacy Education, 7(3), 279– 285. Bowis, J., et al. Mental and physical health: A call to action. Retrieved from http://ec.europa.eu/health/mental_health/eu_compass/policy_recommendations_declarat ions/mh_charter_action_en.pdf Brach, C., Fraser, I. and Paez, K. (2005). Crossing the language chasm. Retrieved from http://www.vdh.virginia.gov/ohpp/clasact/documents/clasact/language/crossing_language_chasm.pdf De Negri, B., Brown, L. D., Hernandez, O., Rosenbaum, J. and Roter, D. (1995). Improving interpersonal communication between health care providers and clients. Retrieved from http://pdf.usaid.gov/pdf_docs/PNACE294.pdf Engwall, D. (2011). Abraham Maslow presentation. Retrieved from www.psychology.ccsu.edu/engwall/Maslow.ppt Pathways from Communication to Health Outcomes: Mediators and Moderators. Retrieved from http://outcomes.cancer.gov/areas/pcc/communication/pccm_ch3.pdf Read More