chapter 16: healthcare communication Flashcards
What is communication?
the exchange of information
- clearly and accurate
the sending and receiving of information between 2 or more individuals
what is communication used in in healthcare
assessment
diagnosis
treatment
documentation
What are two imperative skills in health care
precision and confidentiality
What are breakdowns in communication
incomplete patient histories
test inaccuracies
billing miscalculation
treatment oversight
What 3 things can result from communication failure
prescription error
misdiagnosis
death
What is the communication process described as
the foundation of society
the primary aspect of patient-provider relationship
Describe communication relative to humans
humans are social beings whose needs are met with association of other humans
What are the 3 elements of the communication process
4th optional
sender - person who transmits message message - the information the sender conveys receiver - the person who gets the message feedback - evaluation by receiver and sender to verify that the message was sent
Describe the communication process (with the elements)
sender/source of message begins communication process. The message is sent and the receiver interprets it. This process goes back and forth.
If you require clarification as a receiver, you sent a message to the sender (this is feedback)
What is the channel of communication
medium by which message is sen
- most communication is speaking
- speaking, sight, and touch
What are the three modes of communication
- verbal communication
- nonverbal communication
- written communication
What does a sender’s words (no matter the mode of communication) depend on
4
socioeconomic background
culture
age
education
What is verbal communication
spoken words used to exchange information
- deliberate form as you CHOOSE what you want to say
- most common form
What are four good verbal communication guidelines
- use polite tone to put others at ease
- use proper English (do not be uneducated and unprofessional)
- Speak respectfully (do not talk down)
- Avoid using overly technical vocabulary- all patients are not familiar with medical terms
What are the 5 factors of successful verbal communication
language manner and tone competence verbal encouragement humor
How should language be used for verbal communication
- language determines first impression
- speak clearly and concisely
- use terms patient understands
- avoid med. terminology
- reword message if it does not make sense
How does manner and tone contribute to verbal communication
volume and tone conveys emotions
- calm or agitate patient with the tone of your voice
How can you be competent in healthcare communication
- be knowledgeable honest and dependable
- give patient up-to-date information
- be confidence and certain when conveying information
Why is verbal encouragement important
helps patient feel like they are PARTNERS in health care communication
- provider should be receptive
- persuade patient to share all concerns
How can you implement humor in verbal communication?
- mild and respectful humor to minimize the status difference
- make sure comments are sensitive and respectful
What is a non-language sound
a form of communication that transmits messages unintentionally
- includes sighs, sobs, laughs, grunts
spoken words and meanings differ
What are assertive behaivors
hallmark of professional relationships
- different from aggressive behavior
What is the key to assertiveness
open honest and direct communication with “I feel” or “I think”
What are the four components of assertive responses
having empathy
describe feelings or situation
clarifying one’s expectations
anticipating consequences
What are characteristics of assertive demeanor
confident and open body posture
make eye contact
use clear conscious I statements
be honest
What are the 5 characteristics of an assertive work attitude
- capacity to work with or without supervision
- the ability to remain calm under pressure
- willingness to ask for help when necessary
- the ability to give and accept compliments
- honesty in admitting mistakes and taking personal responsibility for them
What is active listening
ensures that messages are correctly received and interpreted
- gain valuable information in return
How can you ensure you understand what someone is saying
use your brain and ears
- give full attention to person speaking
- do not interrupt
- pay attention to body language and nonverbal cues
What is nonverbal communication or body language
relays a message without speaking or writing a single word
- not consciously controlled
- tells more about what you are feeling than spoken words
What percent of true emotions are conveyed through body language
60-90%
What are 4 types of nonverbal communication
kinesics
proxemics
touch
eye contact
What is the meaning behind
- leaning back in chair
- yawning
- looking at a clock
- shifting or shuffling feet
boredom
fatigue
disinterest
impatience
What is the meaning behind
- smiling
- nodding agreement
- keeping eye contact
- leaning forward
interest
enthusiasm
agreement
humor
What is the meaning behind
- avoiding eye contact
- frowning
- scratching head
- pursing lips
confusion disagreement suppressing thoughts or feelings anger suspicion
What does maintaining eye contact with someone speaking show
that you are interested in other people and what they are saying
- that they’re message is important
What does good eye contact when you are speaking show
adds truth to your message
makes you seem comfortable
What is kinesics
body movement including
- facial expressions
- gestures (shrugging)
- eye movement
- touch
What do portrayed moods and emotions add to the message
emphasize or contradict what is being said
reveal inner true feelings that may be concealed in the conversation
What is proxemics
personal space
- an invisible bubble that surrounds you
What does your proximity to someone show
your relationship with that person
When is personal space largest
when talking to a stranger
- most people are 4-7 feet away from each other when talking to a stranger
When is personal space smallest
when you know the person you are talking to closely
Describe personal space and gender
personal space is larger between two men than between two women
How does personal space depend on culture
Europeans are comfortable with personal space that is HALF that of Americans
Describe personal space and healthcare
- approach patient in professional manner and explain clearly what you intend to do
- respect the patients personal space
Name some ways touch is experienced
handshakes
pats
kisses
Describe positive and negative touch
positive feelings arise from natural touch
negative feelings arise from manipulative or insincere touch
What should you do when touching a pateint
watch for nonverbal cues
determine how patient feels about being touched
What are 2 guidelines in effectively transmitting and receiving nonverbal communication
- maintain proper personal space, position, and posture
- look patient in face and be at eye level
- be aware of cultural diff.
- sit if patient is sitting
- use proper gestures
- use touch if situation is appropriate - Observe the patient’s facial expressions and posture.
- ask questions to clarify mixed message between nonverbal and verbal cues
- tell supervisor concerns if clarification is not made
What is written communication
to communicate with clearly and accurately written work
What are seven written communications that healthcare professionals use
meeting agendas letters messages patient charts consultation reports patient instructions laboratory reports
Describe how the written communication should be? (mistake wise)
concise proper grammar spelled correctly planned beforehand organized logically
What are three ways of organizing information
chronological organization
problem-oriented organization
comparison organization
What is chronological organization
- items are presented in sequence of earliest date to the most recent date
- e.g. history and background
What is problem-oriented organization
problem is identified and explained
instructions are given to solve problem
e.g. condition, causes, and treatment
what is comparison organization
when two or more pieces of information are compared
pros and cons
What is less formal communication
interoffice communication such as memos and meetings
- still require same preparation, composition, and editing
How can you use the internet for written communication
computer software programs have templates and spell check
Why does medical writing have to be accurate and with clarity?
placed in permanent medical record mistakes could result in - injury - death - lawsuits - professional harm
What are four things to pay attention to in medical writing?
spelling
capitalization
abbreviations and symbols
numbers
Describe spelling in medical writing
- proofread written ommunication
- do not solely rely on spell check
Describe capitalization in medical writing
- pay attention to how words and abbreviations are capitalized
- verify information with seniors
Describe abbreviations and symbols in medical writing
using abbreviations and symbols SAVE time
- if typing, SPELL OUT words
- use the medical abbreviations used in the office
Describe numbers in medicine
1-10 is spelled out
- units of measurement are written as numbers (5 mg)
- numbers referred to an obstetrical patients condition are NOT spelled out
What are the three common types of communication
verbal
nonverbal
written
What is one of the most challenging aspects of working in health care
communicating ACCURATELY and EFFECTIVELY with patients
What (3) things should you keep in mind when conducting an interview
- listen actively
- ask appropriate questions
- record information accurately
Describe an interview
Start with professionalism and concern for patient privacy. Introduce yourself
Know what questions you will ask and the order of the questions.
Record patient answers (paper or electronically)
Do not answer phone calls or distractions
Let the patient know what will happen next
What are the six interviewing techniques
- reflecting
- paraphrasing
- clarification
- open-ended questioning
- summarizing
- silences
What is reflecting
To use open-ended statements to repeat back what you hard from the patient.
Do not finish your sentence.
“You were saying when your back hurts you….” patient finishes
encourages patient to make further comments and ensure that subject is understood b healthcare provider
do not overuse it as patients do not want t constantly repeat their words
what is paraphrasing
to use your own words and phrases to repeat what you heard.
verifies that you have understood what the patient said
patients can clarify their thoughts and statements
begins with “you’re saying that” or “it sounds as if” followed by the rephrased content
what is clarification
if you are confused about information form patient, ask patient to give example of the situation
e.g. describe the dizzy spells you have been having
provides insight into how patient perceives the situation
what is open-ended questioning
best way to obtain information
ask questions that require patients to formulate answer with details
use words like what when and how
avoid “Why” as it sounds judgmental or accusing
avoid questions with one word answers (most of the time)
What is summarizing
review information you have obtained and give patient chance to clarify statements or correct misinformation
helps organize complex information in sequential order
what is silences
periods of silence allowing patients to formulate thoughts, reconstruct events, evaluate feelings, assess what has been said
- can be beneficial or uncomfortable
What topics are covered in new patient histories
Medical History - hospitalizations and dates - surgeries and dates - chronic problems Female Patients - pregnancies and complications - miscarriages, stillbirth, abortion Family History - age and health of parents - age and health of siblings - genetic problems Body System review - general questions about all body systems Social History - alcohol, tobacco, drug use - hobbies - education and employment Medications - any prescription medicines - any over the counter medicines - any vitamins and herbal supplements
What 5 things should you do when interviewing an established patient
- review patients chart for health problem information
- make a list of questions to ask patient to update health information (including medical problems and changes in health)
- confirm that patient is still on med/ treatment in chart
- ask about allergies
- record patient information
What is patient education? What are the three key concepts
more than just telling a patient which medications to take or suggesting lifestyle behaviors
- help patient accept illness
- involve patient in knowledge-gaining process
- provide positive reinforcement
What three skills are important in patient education
- active listening
- interviewing skills
- new discoveries and trends in medicine
What are the five steps of the patient education proces
assess
- collect info about patients healthcare needs
plan
- establish goals and objectives
implement
-begin training process
evaluate
-determine how well patient is adapting and applying new information to daily life i
document
- all conversations, events, and results should be recorded
Describe additional information regarding patient interviews
sit in quiet room with sufficient time
allow time for follow up questions
provide information clearly and consicesly and sequential manner
keep informational handouts and brochures
give written and verbal instructions
What does accurate documentation entail
assessment of patients needs and conditions
- important as patients receive care from multiple HC providers
What allows for consistent care and patient safety
patient information needs to be recorded completely and precisely
- no room for misinterpretation
- make sure this information is left in secure locations
- any action concerning patient (even phone call) should be documentation
What is the main reason of patient confusal?
provider uses complex medical terms
How can distractions lead to medical misunderstandings?
both parties are less likely to ensure that their message was adequately conveyed
How does environmental noise cause distractions
healthcare facilities are full of sounds that may disturb patients
- speak with patients in quiet and private areas
Describe language barriers in communication
- interpreter may be necessary
- patients 18+ need written permission allowing family member to accept medical history
- family members are prohibited by HIPPA form participating in provider patient conv.
How should healthcare providers help hearing impaired patients
touch patient to gain attention
talk directly in front of patient so they can read your lips
use short sentences and picture boards
How can you help people with brain injuries as a healthcare provider
- they have difficulty with normal thought processes
- they need an appointed power of attorney to speak on their behalf
Why should you not be defensive with a patient
you do not know what issues are making them angry or upset
it is best to be upfront about the cost, payment options, etc..
How should you deal with patients experiencing grief
allow them to talk about their feelings
allow them to discuss their fear of dying and concern for surviving loved ones
why is telephone communication harder than face-to-face communication
- need to project a caring and professional attitude while talking on the telephone
What 4 guidelines should you follow when talking on the phone
- answer promptly and quickly
- identify yourself and your office to the caller (let them know they have reached he correct number)
- speak politely even if call interrupted work
- do not answer the phone and immediately put caller on hold
