Good communication is at the root of humanity in healthcare: James Munro; CEO Patient Opinion, on learning from patient stories
James Munro, Chief Executive of Patient Opinion, the UK’s independent and most influential platform for health and social care experience discussion, offers his perspective on how to learn from these stories and improve care quality.
As a medical student, I was taught that good communication with patients and their families was a vital part of healthcare. I didn’t really know why. It seemed to be mainly to do with getting patients to “comply” with treatment.
However, after a decade of working daily with patient stories through the independent feedback website Patient Opinion, I’ve learned from patients and carers themselves why clear, honest and timely communication is so important and what happens when it is absent.
Put simply, good communication is at the root of humanity in healthcare. It enables not just the transfer of information (my naïve understanding as a medical student), but the building of trust, the creation of meaning and the possibility of a respectful, compassionate relationship.
On Patient Opinion we hear thousands of stories about good communication and they have in common just a few simple elements: time, empathy and most importantly listening.
For example, one service user who previously had problems with a service wrote:
“What made the appointment a success in my view was that Dr Williamson actually listened to me and gave me the chance to fully explain my issues… I actually felt my opinion was being valued and taken seriously and that I was seen as a person, not a problem.” (https://www.patientopinion.org.uk/opinions/229431)
Good communication is a prerequisite for trust, as this patient about to undergo a procedure for kidney cancer made clear:
“My first meeting with Dr Wah filled me with complete confidence. She explained the procedure, the hopeful outcome and completely reassured me.” (https://www.patientopinion.org.uk/opinions/225096)
When communication is poor or absent, trust very quickly falls away. A patient concerned about possible cancer wrote:
“Communication is appalling within this department. I received conflicting information and nothing as yet has been put in writing. I don’t have faith in the hospital as we are passed from one department to another trying to get result information.” (https://www.patientopinion.org.uk/opinions/219309)
Similarly, when staff fail to introduce themselves to patients – surely the most basic of communication skills – the result is a feeling that care is dehumanised, or even dangerous:
“Some trained nurses came to my room and administered IV antibiotics, IV fluids without any introduction… This made me feel very unsafe, frightened and uncomfortable.” (https://www.patientopinion.org.uk/opinions/227140)
About three-quarters of stories on Patient Opinion receive a response from healthcare staff. This provides a further opportunity to observe communication in action and learn from those who do it so well. The core of good communication remains the same whether online or face to face: listen first, empathise, be respectful.
Responding to a long story of care, raising a number of concerns, an ambulance service manager wrote:
“You apologise for the length of your story but I found reading about your experience intriguing and extremely insightful. Your story highlights so many areas for us to learn from.” (https://www.patientopinion.org.uk/opinions/223840#224697)
And a member of CCG staff, replying to a service user giving feedback about the mental health crisis service, wrote:
“Some of the concerns you have raised sound really bad and so I’d like to check that you are ok and see if we can give you any other support you might need.” (https://www.patientopinion.org.uk/opinions/182221#202971)
These kind of open, welcoming and positive responses are the sorts of things you might say to a friend you cared about – and a world away from the standardised “your feedback is important to us. Please contact PALS”. Communicating like this takes courage: the courage to look inside yourself and ask the simple question: “If this were me, what would I need to hear?”
It’s easy to think good communication and honest, empathic relationships are an optional extra in healthcare: nice to have but not as important as the complex, sophisticated, scientific interventions we now have available – the “things that work”. But increasingly, I am convinced it is actually the human relationships of healthcare which are at the heart of creating hope and the possibility of healing. Simple human communication has always been, and still is, the bedrock on which effective, compassionate care is built.
To share your own or read more compelling patient stories visit the Patient Opinion website