In healthcare, it can generally be agreed that one of the central pillars of the delivery of high-quality patient care is communication. It can also be readily agreed that communication is a central pillar of both inter- and intra-team cohesion and relationships.
If this is truly the case, then why does communication break down so often and what can we do about improving it in the interest of staff satisfaction and retention, as well as the satisfaction of patients and their loved ones?
The idea of universally clear, compassionate, and coherent communication is truly crucial to the very heart of our healthcare system, and woe to any healthcare facility, provider, executive, manager, or clinician who sees this as simply a “soft” skill that does not apply to them.
Clarity and Compassion
Whether it’s the case of a nurse giving report to another nurse, the surgeon giving orders for post-op care, or a medical social worker sitting with a patient and their family as they receive unwelcome news, how concepts are conveyed could not be more important and deserving of our attention.
Clarity is needed in every aspect of healthcare-related communication. Unclear orders from a physician hold great potential for being dangerous and possibly deadly. The hand-off from the surgical service to the urology service must be seamless, and the patient’s chart and accompanying verbal instructions need to be one-hundred percent unambiguous.
In team meetings involving any combination of employees, clarity is essential. If a manager focuses on what employees do wrong and never offers praise, staff can feel unappreciated and blamed.
While the manager may say, “I simply had to convey what was going wrong in order to fix a problem,” she’s missing the point that employees can more readily receive feedback when they also understand what they’ve done right. And if said manager wants to achieve clarity of purpose (e.g., improved patient care) then she should learn that there are plenty of things that warrant praise even when something else is amiss.
Bad news broken to a patient without compassion is harsh, cold, and perceived poorly by the patient and their family. During an annual employee review, a supervisor can reach a nurse whose challenges at home are negatively impacting his performance by expressing compassion for his struggles. Even a small expression of compassion can disarm an individual who fears the worst.
The Power of Coherence
Coherence refers to the characteristics of logic and consistency. Returning to the aforementioned manager meeting with their team, a coherent narrative is always easier to follow and accept as opposed to a narrative rife with inconsistencies.
For example, let’s say bullying behavior on the part of a particular nurse has been reported by members of a nursing team to their supervisor. Even though this supervisor has always been an outward proponent of staff camaraderie, her reply to the staff that this nurse is “too valuable to be fired” and that they just have to “accept the way she is” could certainly be received as a wholly incoherent message. The nurses might think to themselves, “If she can just continue to get away with this awful behavior that undermines team cohesion and patient care without consequences, will we then also tolerate similar behavior from anyone else? Are we that unsafe and unsupported on this unit?”
You see, without coherence, mistrust can be sown where we certainly want and need as much trust as we can muster. After all, compassionate, clear communication is a true hallmark of a positive workplace culture.
Creating Compassion, Clarity, and Coherence
There are innumerable avenues towards creating compassion, clarity, and coherence in healthcare-related communication. Such skills can be learned and developed by both individuals and groups, and institutions keen on creating forward-thinking workplace cultures and patient care should have improved communication in their sights. Strategies for doing so may include:
- Medical improv, an increasingly popular form of communication training in both the clinical space and academia
- Trainings, workshops, and seminars on emotional, relational, and behavioral intelligence
- Consultants with expertise in the art of workplace communication
- Advanced communication training for managers and executives
- Improving on the significant lack of appreciable communication training in nursing, medical, and other healthcare-related educational institutions
- Fostering inter- and intra-team communication in a variety of settings
- Looking beyond the financial bottom line
- Focusing equally on patient and staff satisfaction
Many healthcare workers would not be mistaken if they felt their employers seem to care about one thing: the financial bottom line. This sad truth is not applicable to every employer, yet a vast number of those employed in the industry would be hard-pressed to find shining examples of how those they work for model the type of behavior and communication in which these workers feel they can thrive.
Courage is Called For
The promotion of clear, coherent, compassionate communication should not be rocket science, yet it takes a courageous leader to make this triad of values central to the raison d’etre of any institution.
Cynics who see such strategies as “soft” or ineffectual should spend time in teams where such styles of communication are rare, and in other locations where these values are held dear. The contrast in employee and patient satisfaction, clinical outcomes, and workplace culture would likely be stark, and such cynicism should in such cases give way to evangelism for the power of communication born of clarity, cohesion, and compassion.
If we are to improve healthcare here in the United States, there is no silver bullet, yet the underpinnings of success and greatly improved outcomes and employee retention must be at least partially rooted in conscious communication; if not, large-scale improvement may be something we all continue to grasp for yet never satisfactorily achieve.
