Tackling Staff-Patient communication to improve compassionate care – Part one of a four part blog series
Communication has been consistently highlighted as a target area for improvements within healthcare, and with so many resource limits, sustained change has not always been possible. In a four part blog series, Robyn Cooper and Dr Susanne Käsbauer will be discussing areas of communication highlighted as important by patients, why they need to be improved, and some suggestions on how to go about making improvements.
Over the course of the next few months, we will be covering the following topics:
- Staff demonstrating knowledge about conditions and treatments
- Staff listening to what patients have to say
- Giving patients clear and concise information that they can understand.
Compassionate care centers largely on patient experiences of communication. Recent literature such as Jeffrey (2016) suggests communication is key to conveying empathy to the patient, which in turn, can help clinicians gain insight into the patients concerns and feelings. Studies have also shown that a healthcare professional’s ability to listen, explain, and build a connection with a patient can affect patient outcomes and experiences of care. The Royal College of Nursing highlights that communication can help patients feel less anxious about their health, feel more in control of their health, and helps them to feel valued as a person.
Good communication is also central to the Picker principles of patient centred care.
Based on recommendations found in the Francis Inquiry (2013), Picker and the University of Oxford collaborated on a 30 month long project, examining near real-time patient reported experiences of compassionate care at six NHS trusts in England. A survey was specifically designed for this research, and filled in by patients who were treated in A&E departments, and wards which primarily served the elderly. A free toolkit containing the survey and other learning is readily available to trusts wishing to use near-real time to improve compassionate care within their trust.
Overall, 3928 responses were collected during a ten month data collection period. Action planning workshops were held four months after data collection began, where members of the research team guided staff in identifying and prioritising areas for improvement. Staff also developed actions that could be implemented right away to improve patient experiences.
Communication is at the heart of all human interaction, and as we know, can present in many forms. So it stands to reason that communication can have a large impact on how patients experience their care. It is also often brought up in patient feedback as something that needs to be improved, so it is of no surprise that all trusts prioritised communication as their focus for improvements during action planning workshops.
Action points derived from the six case study sites focussed on improving communication of staff with patients, communication among staff, and patient understanding of their condition, treatment and what happens next. Nurses, doctors and HCAs were included in the planned improvements. Throughout the series we will discuss examples of actions implemented by trusts to help improve communication.
According to the case study sites, these small changes had a positive effect on patients’ experiences of compassionate care. The figure below reflects the change in the survey’s overall summary score (calculated as the mean of the ward-level means), over the 10 month data collection period.
Ongoing collections of the patient experience data revealed a small but statistically significant improvement to the patients’ experiences of compassionate care.
Long term, it is hoped that insights from this study can support NHS trusts to facilitate improvements to patient experience and address deficiencies in compassionate care, such as those highlighted in the Francis Inquiry (2013).
“This has given us a marvellous opportunity to understand what we do well, work on what we struggle with, and strive towards excellence in care and compassion.”
- ED Matron Geoffrey Walker, Poole Hospital NHS Foundation Trust
The financial pressures facing the NHS means that any approach to improving compassionate care needs to be practical and cost-effective. And that’s the challenge: ensuring quality isn’t compromised on limited resources.
Stay tuned for part 2 of the series, which focuses on the importance of why patients feel it vital that staff understand them and demonstrate knowledge of their condition(s).
This project was funded by the National Institute for Health Research Health Services and Delivery Research Programme (project number 13/07/39). The views and opinions therein are those of the authors and do not necessarily reflect those of the HS&DR Programme, NIHR, NHS or the Department of Health. This article presents independent research funded by the National Institute for Health Research (NIHR). The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR or the Department of Health.