During their stay in hospital, people often require care from many clinicians; they may move wards and their care plans may change. This can cause stress, particularly in older patients. We can use communication to reassure patients, alleviate their fears and develop a partnership to reach the best possible outcomes.
We can think of communication as a ‘procedure’1 that we use to encourage patients to participate in their care. We know from the feedback received by hospitals, that communication and the quality of our interactions are very important to our patients. Older people remember how we made them feel during their hospital stay and not necessarily what we did. We also know that failures of communication and teamwork can play a role in avoidable adverse events in hospitals.
Elements of communication
Communication is more than information exchange, it includes the subtle ways we interact and how we use and respond to verbal and non-verbal cues1,2. Often, communication is about being curious, observing your patient and, most importantly, listening and responding to their concerns.
Communication is the interplay of many elements including:
- language and speech
- eye contact
- body language, gestures and postures
- facial expressions
- active listening
- distance from the person
- voice quality, rate, pitch, volume
- communication tools and frameworks
- written aids
- communication aids (for example, interpreters, hearing aids, glasses)
- identifiers such as red trays, the cognitive identifier, falls risk signs to indicate a prevention plan is in place to staff and patients
- health system design
- health system roles, hierarchies and teamwork.
Effective use of these elements encourages older people and their families and carers to participate in their care.
1. The Ossie Guide to Clinical Handover Improvement, 2010. ACSQHC: Sydney.
2. Keller, A.C, Bergman, M.M., Heinzmann, C., Todorov, A. Weber, H., Heberer, M. The Relationship between Hospital Patients Ratings of Quality of Care and Communication. International Journal for Quality in Health Care, 2014. 26: pp. 26-33