Good communication skills are essential to patient safety, wellbeing and the overall efficiency of busy healthcare organisations. At Cambridge Boxhill Language Assessment this is something we’re very interested in as we jointly own the Occupational English Test (OET), a widely used international English language test for healthcare professionals. Earlier this year we commissioned a piece of research that looked into the challenges of communicating clearly to patients, with the leading healthcare accreditation body Joint Commission International (JCI).So what challenges did the white paper highlight?
The paper highlights the serious problems that can result from poor quality communication, not just linguistic. For example a typical patient sees many different healthcare professionals during their treatment, and in multiple settings, each presenting a different set of communication challenges. If professional communication skills vary in quality, then a patient’s understanding of their health status may lack context, completeness and accuracy – often causing confusion and potential harm. In the US, for example, communication failures in hospitals and medical practices were responsible (at least in part) for 30 per cent of all malpractice claims, resulting in 1,744 deaths and $1.7 billion in malpractice costs over five years according to the Risk Management Foundation of the Harvard Medical Institutions.
Patients and their families expect to receive the information they need to understand care goals and make informed decisions, but the quality of this information can be compromised by poor communication between staff at handover points, as patients move through a healthcare system, and when they are discharged. Communication can be further impaired if a patient’s English or literacy skills are poor, or if they have limited ‘health literacy’ which affects their understanding of key instructions or explanations. Other challenges include cultural barriers, sensitivities to certain words, concepts or metaphors, and age-appropriate communication. Verbal miscommunication can also be an issue, with different accents, dialects or pronunciations all potentially adding confusion, especially when certain drug names or numbers can sound very similar.
But evidence-based practice focused on improving communication outcomes does exist. For example standardized methods, forms and tools can greatly improve consistency in handovers, for example, and when discharging patients, and staff should also be trained to accommodate different literacy, cultural or age-related needs. The verbal communication of medical orders or test results should also be limited to emergency situations, for example, or sterile procedures, and only when the prescriber is present and the patient’s chart available. Strategies should also be in place to help build the empathetic, relationship-building skills required to gain a true understanding of the patient’s perspective.
We found the findings really interesting as it’s an area that is constantly under the spotlight. The OET test takes these challenges into account and uses test material which reflects real healthcare scenarios, and generates results which help governments and regulators select staff with the language skills required for patient safety and quality care.
‘Communicating Clearly and Effectively to Patients: How to Overcome Common Communication Challenges in Healthcare’ was published in 2018; the white paper can be downloaded from: https://www.occupationalenglishtest.org/healthcare-communication-whitepaper/