© Springer-Verlag Berlin Heidelberg 2015
Diana Slade, Marie Manidis, Jeannette McGregor, Hermine Scheeres, Eloise Chandler, Jane Stein-Parbury, Roger Dunston, Maria Herke and Christian M.I.M. MatthiessenCommunicating in Hospital Emergency Departments10.1007/978-3-662-46021-4_77. Action Strategies for Implementing Change
Diana Slade1 , Marie Manidis1 , Jeannette McGregor1 , Hermine Scheeres1 , Eloise Chandler1 , Jane Stein-Parbury1 , Roger Dunston1 , Maria Herke2 and Christian M.I.M. Matthiessen3
(1)
University of Technology, Sydney, New South Wales, Australia
(2)
Macquarie University, Sydney, New South Wales, Australia
(3)
Hong Kong Polytechnic University, Hong Kong, Hong Kong SAR
7.1 Introduction
7.2.2 Provide Explicit Explanations to Patients About Processes and Procedures in the Emergency Department
7.3 Conclusion
7.1 Introduction
In this book, we have described how organisational and clinician practices and roles in emergency departments manifest in particular communication patterns and interactive styles between clinicians and patients. The central figure throughout the book is the patient, and the central question we have asked is: How does communication in emergency departments affect both the quality and safety of the patient experience?
But we have also focused on the clinicians. We have described the intense pressure they work under—a result of insufficient funding to emergency departments, rising patient loads, bed block, patients presenting with multiple morbidities, and increasing linguistic and cultural diversity . In such high-stress contexts, inadequate communication has been shown to be a major source of unsafe situations.
Our onsite recordings demonstrated vulnerable points in clinician–patient interactions, which we have called ‘potential risk points’ (PRP) . We have argued that these have the potential to jeopardise patient safety. If communication is effective, it can also be the best way of controlling potential risks.
As we have shown, communication, whether spoken, gestured, written, or electronic, underpins what is done in the emergency department. From handovers to taking blood, giving medication, talking to patients, listening to colleagues, reading computer screens, or doing resuscitations, clinicians are constantly speaking, listening, reading, and writing. The ways in which the communicative, social, and clinical practices work together in the complex context of the emergency department define the overall quality of the experience for patients and the ultimate work satisfaction of clinicians.
We have found that both the quality of patient care and the patient’s experience of that care are negatively affected by two interlinking factors:
Contextual complexity: The complex, discontinuous, and fragmented nature of emergency department consultations can result in loss of knowledge transfer, inadequate and confusing explanations, and insensitivity to the patient.
Foregrounding of the medical over the personal: The failure of clinicians to build rapport and create relationships with patients can inhibit a patient’s understanding of a diagnosis and compliance with the treatment.
In this chapter, we present seven action strategies to improve communication in emergency departments. Some of these are organisational; some of these are suggesting complementary evidence-based communication research, vital as a basis for implementing systemic recommendations and change.
7.2 Action Strategies
7.2.1 Achieve a Balance Between Medical and Interpersonal Communication
Our research shows that two broad areas of communication affect the quality of the patient journey through the emergency department: (1) how medical knowledge is communicated and (2) how clinician–patient relationships are established and built. We argue that to deliver care effectively, clinicians must communicate care effectively. To do this, clinicians must build rapport with the patient. We therefore propose that strategies and skills both in communicating medical knowledge and in building interpersonal relationships be a required component in the training and assessment of emergency department clinicians. We summarised and exemplified these communication skills in tables 5.1 and 6.1 and discussed each strategy in detail in Chaps. 5 and 6.
Related posts:
Effective Clinician–Patient Communication: Strategies for Communicating Medical Knowledge
Effective Clinician–Patient Communication: Strategies for Bridging the Interpersonal Gap
Communication Risk in Clinician–Patient Consultations
The Patient’s Journey in the Emergency Department from Triage to Disposition
The Context of Communication in Emergency Departments
The Role of Communication in Safe and Effective Health Care
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