Martina Beranek, Consultant
Successful communication is the basis of good cooperation. In hospitals, too, it helps to strengthen the team spirit and prevent idle time at work. However, where the atmosphere and work efficiency suffer from communication problems, this can lead to a loss of motivation, tensions and even errors in treatment. In extreme cases, poor communication damages the hospital's reputation.
The scientific literature now shows quite well that inadequate communication in hospitals can result in time-consuming and cost-intensive legal proceedings. For example, patients in the USA often justify their lawsuits against medical staff by claiming that the treating specialist did not listen to them well and showed them too little respect [1]. Moreover, after critical incidents, patients often take legal action against the healthcare provider not because of the actual event, but because of inadequate communication [2].
Better communication - fewer legal cases
In Switzerland, too, communication between healthcare professionals and patients is a recurring sore point. Daniel Tapernoux, executive board member and consulting physician at the Swiss SPO Foundation, commented in a 2019 interview with Schweizer Familie magazine that about one in two telephone contacts with the foundation involved a communication problem between doctor and patient [3]. The SPO's 2018 annual report also states that, according to the Foundation's preliminary medical investigations, "in about two-thirds of all inquiries, there was a fateful course or communication problems [4]."
That there is another way and that successful communication has a positive effect on the number and type of legal cases is shown by a somewhat older, but no less impressive example from the USA. In 2002, the University of Michigan in the city of Ann Arbor stipulated that physicians simply acknowledge and apologize for their mistakes. This policy, which was introduced at the time, led to a reduction in the time taken to deal with complaints from an average of 1,000 days to 300 days. The cost of legal support was also reduced by two-thirds. Lawsuits and complaints decreased overall [5].
Respect, precision and clarity
However, successful communication in the medical environment is not only aimed at reducing the number of legal cases and thus lowering effort and costs. Rather, it is an important factor for the motivation and work efficiency of the team and for patient compliance and therapeutic success.
Members of a team who respect each other and see working together as mutually enriching are more likely to develop a strong sense of cohesion. This is because those who see themselves as important members of a group, can contribute to the achievement of collective goals, and enjoy the respect of colleagues tend to be more motivated. And a team that is bound together by such values is better able to pool its strengths and achieve more in extraordinary situations.
Of course, an appreciative approach alone is not enough to ensure successful communication. Whether communication is successful also depends to a large extent on the precision and clarity of the statements. Precise and clear statements help to prevent information gaps and misunderstandings in the team and to reduce frustrating repetitions of discussions. Precise and clear communication thus has a direct influence on work efficiency and motivation in the team.
Respect, precision and clarity naturally also play an important role in communication with patients. After all, those who feel taken seriously and valued by the treating professionals and who understand the explanations about their illness and therapy are more likely to be motivated to implement the therapeutic measures actively and correctly. Precise, comprehensible, respectful and appreciative communication therefore also makes a significant contribution to compliance and subsequently to (cost-)efficient treatment.
Knowledge and appreciation
If successful communication is so simple in theory, why do conversations between medical professionals and laypersons often end unsatisfactorily? Why do patients complain about consultations or preoperative explanatory talks?
Among other things, the literature cites the divergent expertise of the interlocutors, which manifests itself in an asymmetry of knowledge, as the cause. Such an asymmetry can be found in any kind of conversation. However, it is particularly common in doctor-patient contact, as many laypersons do not sufficiently understand even simple medical contexts.
A representative study commissioned by the Swiss Federal Office of Public Health in 2015, for example, determined the actual state of health literacy among the Swiss population: The results showed that many Swiss people have difficulty finding, understanding or even applying health information [6]. It is true that the Internet nowadays offers an increasing wealth of information, so that patients can inform themselves better and better. However, the difficulty lies in assessing the correctness and classification of the information found.
But it is not only an asymmetry of knowledge that can trigger an unsatisfactory conversation. According to a reader survey conducted by DIE ZEIT DOCTOR magazine in 2017, unsuccessful communication between laypersons and medical professionals often has to do with the culture of the conversation or with the expectations placed on the course of the conversation. The ZEIT survey focused on the doctor-patient conversation and, in particular, on the question of what patients would like to see from the healthcare professional. The editors received hundreds of suggestions, almost all of which went in the same direction: "Doctors should listen more, take their time, be more attentive, explain better and take patients more seriously [7]." The large number of readers' letters prompted DIE ZEIT to devote a separate cover story to the doctor-patient conversation.
More than a linguistic expression
We can all communicate. Somehow. But reality shows that our counterparts do not always get what we actually mean. The examples given in this article show that successful communication involves much more than just conveying information. Only when we are prepared to reflect on our personal communication behavior and, if necessary, to adapt it to the circumstances and abilities of the person we are talking to, when we recognize respect and appreciation as an important basis for gaining access to our counterpart, and when we learn to prevent information gaps and misunderstandings by using precise and clear language, only then will we know the ingredients of successful communication.
Would you like to learn more about what you as a hospital professional can do to improve communication within the team and with your patients? I look forward to hearing from you at +41 61 264 88 03, martina.beranek@int-ext.com.
This contributes to successful communication
Respectful interaction is an important prerequisite for a successful conversation. This is all the more true when interlocutors disagree or there is a great asymmetry of knowledge between them.
A good atmosphere in the team is the basis of successful cooperation. Analyze the conversation culture in the team. Look for common reasons for mood killers, misunderstandings and inefficiencies with your colleagues and determine solutions together.
Sporadically practice communicating precisely and clearly even under great time pressure.
Consider what background knowledge you can expect from your counterpart and adapt to this health competence in terms of content and language. If in doubt, ask what your counterpart has understood.
Attend customized communication trainings together with your team.
Sources
Swiss Academy of Medical Sciences (SAMS). Communication in everyday medical practice. A guide for practice. 2019.
Foundation for Patient Safety, Basel/Zurich. When something goes wrong. Communicating and acting after an incident. A Harvard Hospitals consensus document. 2006.
Annette Wirthlin. No sting for Dr. Rüpel. In: Swiss Family. 39/2019. p. 52 - 55.
SPO Patient Protection. Annual report 2018. 2019.
Patient Safety Foundation, Basel/Zurich. When things go wrong. Communicating and acting after an incident. A Harvard Hospitals consensus document. 2006.
gfs.bern.ag. Population survey "Health literacy survey 2015". Final report. Study commissioned by the Federal Office of Public Health, Health Strategies. May 2016.
Claudia Wüstenhagen. The power of words. In: DIE ZEIT. DOCTOR. Everything that helps health. No. 4, November 2017. p. 3.