We spoke with two people actively involved as patient advocates locally and nationally at medical organizations. The following are their views on how effective communication between patients and providers can ease anxiety, prevent errors, and improve outcomes.
Carole Hemmelgarn, a member of the board of directors for the Collaborative for Accountability and Improvement, draws on her background in health care to help bridge communication divides between patients and providers.
WHY IS COMMUNICATION A TOP BARRIER BETWEEN PATIENTS AND PROVIDERS?
When my daughter was treated for leukemia in 2007, I realized how confusing the medical world could be—even for someone like me with a background in health care. For most patients, “health-care speak,” using acronyms and big words, is completely foreign, and patients aren’t sure how they can change the dialogue.
WHEN ADVOCATING FOR A CHILD, WHY IS PATIENT-PROVIDER DIALOGUE PARTICULARLY IMPORTANT?
Parents know their children better than anyone else does. When parents sense that something is not right, it’s essential that a provider stop and listen. Parents can remember the “CUS” patient-safety keywords: “I am concerned,” “I am uncomfortable,” and “this is a safety issue.” Providers are trained to listen when patients speak up in this way; using the right language helps trigger an appropriate response.
HOW CAN HEALTH-CARE ORGANIZATIONS IMPROVE COMMUNITY AROUND PATIENT SAFETY?
It’s vital to encourage bidirectional communication between patients and providers. Patients need to feel comfortable asking questions, and providers need to understand the generational and cultural barriers to effective communication. For example, in Latino culture, the term “diabetes” might not mean much, but “high blood sugar” does. Some patients might not feel comfortable requesting to see a different provider, or they may believe that offending their nurse or doctor could result in receiving lower-quality care. There’s a lot of fear out there. Providers need to understand that their responses to patient questions very much impact how the relationship proceeds.
Steve Lovell is a patient advocate who serves on the Seattle Cancer Care Alliance’s Patient, Quality, and Service and Falls Prevention Committees, and the Patient and Family Advisory Committee.
HOW CAN ORGANIZATIONS PROACTIVELY APPROACH PATIENT COMMUNICATION?
Lack of information fuels anxiety in patients. I saw this firsthand during my own treatment for myelodysplastic syndrome in 2010. When patients are sent for various scans and tests without understanding why, they can become unnecessarily anxious, which has a ripple effect that can impact their treatment. Making sure that patients and their family members have the information they need in terms they can understand can help prevent anxiety and miscommunication. Patients want and need to know what they can expect in terms of their health-care experience.
WHAT SHOULD PHYSICIANS REMEMBER WHEN COMMUNICATING WITH A PATIENT’S FAMILY OR CARETAKERS?
Patient-centered care centers around a patient, but also includes family and other advocates. Self-advocacy is important, but sometimes patients are too tired and drained to research all their options or stay on top of the information that’s coming their way. Often patients have others helping them, and it’s important for providers and patients alike to remember that they’re part of a care team.
HAS PATIENT-PROVIDER COMMUNICATION IMPROVED IN RECENT YEARS?
Absolutely. I’ve seen the needle move in a positive way, so to speak. Today more hospitals and clinics offer patient navigation services, and organizations and insurance companies are working together on patient navigation. The Washington Patient Safety Council, Seattle Cancer Care Alliance and other groups are working to educate patients and providers about how better communication can prevent errors and improve outcomes, and helping all parties involved learn how to maintain open lines of communication.