1.03 What needs to be communicated and why?
One way to start trying to answer this question is to look at the aspects of communication which patients say they want to be improved. A Review of the NHS Hospitals Complaints System: Putting Patients Back in the Picture, is a report from October 2013 by Rt. Hon. Ann Clwyd MP and Professor Tricia Hart. They stated the top five reasons for complaints in NHS hospitals to be as follows:
Key reasons for hospital complaints
Lack of information
Compassion
Patients said they felt uninformed about their care and treatment. Patients said they had not been treated with the compassion they deserve.
Dignity and care Patients said they felt neglected and not listened to.
Staff attitudes
Resources
Patients said they felt no one was in charge on the ward and the staff were too busy to care for them. Patients said that there was a lack of basic supplies like extra blankets and pillows.
Whether you work in a hospital environment or not, these points give us the clearest clues regarding what a good doctor needs to communicate to their patient. This includes the effective transfer of information. The patient is a human being with thoughts, feelings and emotions who may be curious / frightened / frustrated. Doctors, nurses and the wider team must be seen to be both caring about the outcome and to be taking proper responsibility. There are numerous elements which contribute toward this.
In his book, The New Consultation – Developing Doctor-Patient Communication( 2008), David Pendleton describes and explains an overwhelming amount of research that associates great communication with improved patient outcomes – from history taking through to ongoing management of health.
He describes how the cycle of care works best for the patient and encourages health improvement if there is an effective consultation. Studies by Kaplan et al( 1989) and Stewart( 1995) have shown how the quality of history taken and management communication directly impact upon health outcomes including pain control, physiological measures, symptom resolution, function and emotional health.
It is clear to Pendleton that everyone can improve their consultation skills. He believes( perhaps somewhat optimistically) that nearly all doctors have a range of sophisticated communication skills, though these are sometimes not used in the consultation.
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