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Communication and Feedback in health care

Communication

Effective communication between health care providers and patients is an important element for improving patient satisfaction, treatment compliance, and health outcomes. Patients who understand the nature of their illness and its treatment and believe the provider is concerned about their well-being show greater satisfaction with the care received and are more likely to comply with treatment regimens. Several studies conducted in developed countries show strong positive health outcomes and improved quality of care associated with effective communication. Provider-patient communication has been linked to patient satisfaction, recall of information, compliance with therapeutic regimens and appointment keeping.

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Communication is a process by which people share ideas, experience, knowledge and feelings through transmission of messages both verbal and non-verbal.

Communication can also be defined as the transfer of information from one person to another for the purpose of sharing the idea or information (via speech, writing or physical signs/gestures).

Components of communication

  1. A sender creates a message for the receiver
  2. The sender uses a channel to relay the message
  3. The receiver and the sender use feedback to clarify and ensure the message is understood.

The SENDER or source is the one who initiates the communication. (The SENDER can be the Health Care Provider (HCP) when talking to the client. The SENDER can also be the client talking to the HCP). The sender should be interested in the subject, familiar with receiver and receiver’s needs and interests. The sender conveys the message at the knowledge level of the receiver and chooses an appropriate communication channel to transmit the message.

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The MESSAGE should be clear, concise, accurate, relevant to the needs of the receiver, timely, meaningful and appropriate to the situation.

The CHANNEL or MEDIUM is the format in which the message is transmitted. The channel should be appropriate, accessible and affordable. Examples of common channels are speaking, writing, body language, sign language, telephone, pictures, symbols, diagrams, drumming, dancing, visual images and hand signals.

The RECEIVER is the person receiving the message and translating it into meaning. He/she has to be interested in the message, aware and willing to accept the message. He/she understands the value and applicability of the message and is able to give feedback once he/she receives the message.

The FEEDBACK is an essential part of communication; the receiver has to respond to show that he/she understood the message or not. Also, the sender has to find out whether he/she has been understood by the receiver. Feedback can be verbal, non-verbal response, immediate or delayed.

Effective communication means that the correct message goes from the sender to the receiver successfully. It requires the ability of both the sender and the receiver to:

  • Listen
  • Pay attention
  • Perceive what the other is trying to communicate
  • Respond verbally or non-verbally i.e. provide feedback.

Differences in how messages are perceived can lead to confusion.

Importance of communication

Communication helps to develop a good working relationship between the patient and the provider

  • Patient better understand recommendations from health care providers
  • Patient feel respected and understood
  • Patients feel motivated to adhere to care plan

Therefore, it is important to use good communication to:

  • Share knowledge and experiences
  • Build relationships
  • Motivate
  • Inform and teach
  • Persuade and inspire
  • Entertain
  • Give or receive directions and feedback.

Feedback

Feedback is information given in response to a product, service or a person’s performance of a task or service.

Feedback is essential throughout the service delivery process; many health service providers find it difficult to acquire the skill of giving or receiving performance enhancing feedback which is very useful. Health service providers usually need practice to become more confident with essential skill. If they are unable to effectively give or receive constructive feedback, not much will be accomplished to improve the quality of services.

Feedback is an important component of communication in health care settings as it opens channels for clients to express their opinions on the services provided and can help to identify service quality gaps and possible solutions for improvement.

Giving and receiving feedback helps to foster good communication, performance improvement and client satisfaction.

After obtaining suggestions for improvement, ensure feedback is released by either:

  • Implementing suggested changes or
  • Informing clients what actions will be taken

Basic guidelines for giving effective feedback

  • Ask permission first
  • Don’t be judgmental or use labels
  • Don’t exaggerate or generalized. Be specific
  • Make positive suggestions for improvement
  • Use the first person: “I think,” “I saw,” “I noticed.”
  • State facts, not opinions or interpretations
  • Describe what you observed and be specific
  • Address what a person did, not your interpretation of his or her motivation or reason for it
  • When making suggestions for improvement, use statements like, “you may want to consider…”, “another option could be to…”
  • Take responsibility for your own feedback. Speak for yourself, not for others.

Feedback can be provided

  • During a patient encounter
  • Immediately after a patient encounter
  • During a  review meeting at the end of the day

The closer the feedback is to the event, the more likely it will be remembered.

Example of descriptive, specific feedback

“When you gave the injection of local anesthetic, you did not tell the client what to expect. I saw her wince and thought she was tense, making it difficult for you to gain her cooperation later in the procedure.”

Example of judgmental, non-specific feedback

“You always seem to be in such a hurry that you completely ignore the client’s needs.”

Gaining client feedback

Feedback is information given in response to a product, service or person’s performance of a task or delivery of a service. Client feedback can be obtained through one or combination of the following channels:

  • Use of questionnaires asking opinions about the service provided
  • Carrying out interviews for selected clients for example exit interviews
  • Carrying out focus group discussion with select group of clients
  • Holding regular meetings with clients/community to discuss on their opinions about service delivery
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