Tackling Staff-Patient communication to improve compassionate care – Part three 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 part three of a blog series, Robyn Cooper and Dr Susanne Käsbauer discuss the importance of listening to patients and offer some suggestions on how trusts can help their patients feel listened to.
Staff listening to what patients are saying.
When thinking about communication, listening often isn’t the first thing which comes to mind. Yet, listening is an essential aspect of good communication.
Take a few seconds and reflect on your experiences.
Are you able to spend as long as you would like talking to patients? Do you have time to truly understand what matters to them? Do you always ask patients if they have any questions or concerns, and answer them to your best abilities? Do you do simple things, like smile, use eye-contact, and ask if they’d prefer to be addressed by either Mr/Mrs or just their first name?
Findings from our 10 month data collection period at six sites demonstrates that overall the majority of patients did feel listened to, which is great to see, but there were still many patients who didn’t always have such positive experience.
The following graphs show the extent to which patients felt listened to during their recent hospital visits.
Listening to patients goes a long way to making them feel like a person. Without this, they can feel insignificant and undervalued. It is also important to bear in mind that they are the experts of their own body, and can give healthcare practitioners information about how they are feeling and previous health problems. So by paying attention to what patients are saying and understanding why they are saying it, can go a long way to ensuring that patients feel heard and valued.
“[When] helping me settle before the night, two girls asked me how I broke my hip. I said I did not break my hip. Again, they asked me how I broke my hip and again, I said I did not break my hip, it was an arthritic hip. Within my hearing, one said to the other “she should not be here”. This set me back a little.”
“Some staff [are] not careful when handling me when previously being advised that my right arm is painful.”
During our research, trusts developed action plans to help improve communication. One trust introduced “my life” cards, which let staff know important information about the patients. This would give the patient a chance to tell staff what is important to them, what they like and what they don’t like. Staff on the wards found that it was useful to offer patients the opportunity to complete the cards. For those that didn’t fill a card in, staff would have a conversation with the patient instead, and make notes on the card on their behalf. The aim of these cards are to help make patients feel valued and treated like a person, not just another medical case.
Throughout the data collection phase, trusts also encouraged doctors to engage in active listening when talking to patients, to involve the patients in their care, and treat them as experts on their own bodies.
“The Drs have been really good with treating me as an expert patient due to my complex health needs and have consulted me in regards to my treatment and what I would like to do. Sometimes I have trouble communicating this to the nurses who sometimes don’t understand the urgency of my need for medication or review from a Dr.”
“I am uncertain that the registrar took notice of my experience from six previous shoulder dislocations when he used Propofol anaesthetic. I explained my shoulder needed full muscle relaxant to relocate the joint as the two previous occasions did not work without it. Once of which, I explained was here at [trust], by a junior doctor who would not listen to my protests when she insisted using Entonox. Damage was caused and a second attempt had to be made.”
Volunteers can also play an important listening role. In our research, we used volunteers to deliver a tablet based survey to A&E and elderly care patients. We found that the presence of volunteers on wards provided patients with an opportunity to speak to someone. Volunteers who participated in the research reported that on occasion they could spend up to an hour with some patients. Patients enjoyed the chance to share stories and life experiences, regardless of their relevance to the survey questions.
By giving patients the chance to speak to volunteers about their healthcare experiences, it can provide a secondary source of feedback, where frontline staff can address some patient concerns immediately.
While we know that frontline staff often do not have the time to sit and talk to patients, maybe there is credence to the thought of being creative in volunteer recruitment and the tasks they are assigned, so they can spend time with patients? Instead of recruiting from the general public, why not target Health and Social Care students at your local colleges? It would give them great opportunity to get some patient contact if they want to have a career in healthcare. Why not involve your trusts governors or ward administrators to spend a few minutes with patients?
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.