Tackling Staff-Patient communication to improve compassionate care – Part two 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 this blog post, Robyn Cooper and Dr Susanne Käsbauer discuss why patients consider it necessary that hospital staff demonstrate their professional competence and an understanding of the patients’ conditions, and some suggestions on how to go about making evidence-based improvements.
Staff demonstrating their professional competence and understanding of patients’ conditions.
As part of our recent NIHR funded project, we asked patients what was most important to them in terms of compassionate care. Patients told us repeatedly that it is important for them to feel safe and secure when in hospital. It soon became clear that patients consider security to be much more than just the building and site security.
Patients shared that all hospital staff can help them “feel safe and in the right place” when those with the right skills and experiences are caring for them. The knowledge that staff have all the necessary skills and fully understand the patient’s condition can prevent worries, stress and feelings of discomfort for patients.
While patients know that all staff have similar training and maintain their professional validations or certifications, they can detect subtle differences in the knowledge or experiences of staff.
“Some staff don’t seem to be as experienced as others and seem to not show as much care and compassion.”
Some patients also felt that there was a lack of staff understanding with regards to specific conditions.
“One nurse did not know what coeliac meant.”
“Staff did not really understand mental health. [I was] made to feel uncomfortable.”
It is important for staff to show patients their knowledge and professional competence, as it helps patients to feel comfortable about their care, and may aid in reducing any patient anxieties.
“Very quick and knowledgeable staff made me feel at ease”
In conclusion, patients felt it vital that staff understand them and demonstrate knowledge of their conditions. By doing this, patients are helped to feel safe and secure. This understanding can prevent patients feeling uncomfortable, or being placed in a situation that could be detrimental to their care. The following patient’s carer described a fall that could have been prevented if the staff member had fully understood the extent of the patient’s limited mobility.
“Staff kept asking the patient to lift her legs herself but the patient couldn’t. Patient was taken to the toilet by a nurse and fell, and was in tears. Was offered no help to get up”.
Volunteer on behalf of a carer
Our recent project acquired nearly four thousand survey responses from A&E visitors and inpatients on wards providing care primarily to the elderly, 89 percent of respondents stated that staff always appear confident and able to perform their tasks when caring for the patient. The resulting 11 percent of respondents indicated that staff either did not appear confident and able or only appeared this way to some extent.
Based on the results to this survey question and additional free-text comments provided in response to the same survey, six hospitals across England have already taken action to improve the way they demonstrate and communicate their competence or understanding of the patients’ conditions. The following improvements were made by consultants and nurses with the goal of making patients feel “safe and in the right place” during their time in hospital.
- Asking patients questions when interacting with them, as a form of active listening and to keep them engaged;
- Demonstrating understanding using body language and repeating their questions back to patients along with the answer;
- Giving information around diagnosis to patients and family members or carers in writing. This was considered especially important for older patients who may forget that they have received the information;
- Admitting when the answer to a patients’ question is unknown at the time;
- Demonstrating experience in the field by conveying that patient feedback is taken on board and acted on.
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.