What is communication?
Communication is “the imparting or exchanging of information by speaking, writing, or using some other medium.”
You may already have read our recent blogs that looked at words the harm and words that heal and how words can be nociceptive. Today we are considering how you communicate and the purpose of communication in your clinic.
Within your clinic there are many ways you communicate to your patients – both verbal and non-verbal:
The practice environment
Your reception staff
Website and literature
Your persona/body language
Patient interaction – speech, touch
What are the aims of communication in your clinic?
Ultimately patients have come to your clinic to find out 4 things (as summarised by Louis Gifford)
- What’s wrong with me?
- How long is it going to take to get better?
- Is there anything I can do to help myself?
- Is there anything you can do to help me?
You should be fulfilling these aims in your communication with patients. Consider how clearly you communicate each aspect with your patients. You could ask your patients to repeat back to you what they have understood at the end of a session in order to assess how well you have communicated with them.
Other elements that are important in communication are listed below. These may be communicated verbally or by other means. It is important that you are fulfilling each of these as a good foundation for clinical communication and avoiding misunderstandings:
- Understand who you are and what you do
- Expectations of treatment
- Understanding of the patient’s condition – patients want to know they have been heard and understood
- Shared decision making and consent to treatment
- Education regarding their condition
- Health promotion, health enabling
What are the signs of communication success?
Patients understand and are empowered to self-manage their condition
Patients know that together you have chosen an appropriate treatment plan
Patients know and understand their treatment plan and expectations
Patients know that you would have referred them elsewhere if you couldn’t help
Patients are informed about treatment and consenting to proceeding
Patients are ‘raving fans’ of your practice
Patient Expectations – met and unmet
The OPeN report gave a detailed insight into expectations of osteopathic treatment:
This list provides a helpful resource to assess your practice. You could either use it as a reflective exercise to identify areas for improvement in your practice or you could use the list as the basis for a patient feedback survey.
|support in making informed choice about treatment/management
help understand their problem, manage it and prevent further problems
|specialist knowledge of their problem and the treatment options open to them
maintain clear professional-patient boundaries
wide knowledge of treatment options and routes of referral
appropriate and patient-centred attitudes of staff
flexible appointment times, value for money
staff enabling rapport to be built
healing therapeutic environment engendering hope, peace, calm and relaxation
|consultation includes time for manual treatment
demonstrate specialist manual and information-giving skills
treatment would impact on symptoms
on-going care if required
patient involvement in decision-making and self-management
|importance of being believed that symptoms were real
develop trusting relationship with their osteopath
respect for confidentiality, safety and efficacy
sense of longer-term connection with their osteopath
Amongst the osteopaths and patients in the survey the following well-met and unmet expectations were identified. Consider this list in relation to your own practice – these could form the basis for identifying areas for improvement and development in your practice. Maybe you could use them as the basis of a discussion with colleagues for CPD.
Open discussion, explanation of cause of their problem and clear osteopathic diagnosis
Specialist knowledge, professional, hygienic environment, evidence of qualifications
Flexible, pleasant environment, good value for money
Case-history taking, diagnosis, information and explanation, duration of session, monitoring reactions to treatment
Empathetic therapeutic relationships, respected, listened to and believed, continuity of care and sympathetic caring manner
Advice on how to prevent the problem recurring
How and when they communicate with wider network of health professionals in their area
Make it more explicit to patients that they conduct effective triage process at first appointment with onward referral if required
Provision of pre-treatment information, telephone advice, disabled access, information about the practice complaints procedures
Home exercises – not given regularly
Information about risks and side effects
Reassurance of confidentiality
Mixed – Patients expect treatment of one patient at a time. This can be unmet when practitioners operate several patient rooms in parallel or answer the telephone during a treatment session
Another potential CPD exercise could be to ask a colleague or someone else to look at your website and practice literature to see how well you are communicating your message and whether you are passing on enough information in an understandable manner.
Hopefully this has challenged you to consider communication in your practice and potentially helped you to identify areas where you may be able to make improvements. In this series of blogs we will publish a list opportunities for CPD on Communication.
Leach, J; Cross, V; Fawkes, C; Mandy, A; Hankins, M; Fiske, A; Bottomley, L and Moore, A (2011) The OPEn project investigating patient’s expectations of osteopathic care – SUMMARY REPORT