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Communication

Copyright © 2010 Society of Hospital Medicine

Introduction

Communication is defined as any process in which a message containing information is transferred, especially from one person to another, via any of a number of media. Communication may be delivered verbally or non‐verbally, directly, (as in face‐to‐face conversation or with the observation of a gesture) or remotely, spanning space and time (as in writing, reading, making or playing back a recording, or using a computer). Pediatric hospitalists must be effective communicators in many venues such as when rendering direct patient care, performing hospital committee work, or educating trainees. However, the most important of these is the verbal communication that occurs at the bedside with patients, family/caregiver, and healthcare team. Successful patient care is elusive or wanting without proper communication.

Knowledge

Pediatric hospitalists should be able to:

  • Compare and contrast the importance of listening and speaking for effective communication.

  • Define the components of effective expressive and receptive (listening) communication, such as introduction of team members, avoiding medical jargon, tone, word choice, allowing time for patients and the family/caregiver to speak, and body language.

  • List examples of common non‐listening behaviors such as allowing distractions, asking unrelated questions, jumping to conclusions, interrupting the speaker, and failing to notice the speaker's non‐verbal language.

  • Cite methods that can be used when faced with difficult behaviors during communication, such as asking for a behavior change and paraphrasing to diffuse emotion.

  • Describe patients in a cultural and spiritual context.

  • Explain how vulnerabilities, life situation, limitation in activities of daily living, education, language and other factors should each be addressed when communicating with patients and the family/caregiver.

  • Identify personal values, biases, skills, and relationships that may influence communication.

  • Discuss the significance of including the family/caregiver and others who are most important to patients in patient care discussions.

  • Explain why effective communication is central to patient care handoffs and list examples of best methods for communication both within hospitalist groups and with other healthcare providers.

  • Articulate how to give bad news by expressing empathy, giving patients and the family/caregiver time to ask questions, maintaining calm, and choosing a quiet, private location for the discussion.

  • Cite important features of effective written communication.

  • Compare and contrast specific examples of effective and ineffective written communication, including timing of entries, legibility, disagreements on patient care decisions, documentation of changes in clinical status and others.

Skills

Pediatric hospitalists should be able to:

  • Demonstrate command of a comprehensive array of expressive and receptive communication skills.

  • Coordinate discussions with all caregivers to ensure a single clear message is given to patients and the family/caregiver.

  • Actively participate in conflict resolution.

  • Summarize the entire process and sequence of care for patients and the family/caregiver in understandable terms following the principles of family centered care.

  • Maintain concise, complete written records that meet expectations of external reviewing agencies and malpractice carriers.

  • Develop and implement a plan for daily communication that is family centered.

Attitudes

Pediatric hospitalists should be able to:

  • Respect the skills and contributions of all involved in the care of patients.

  • Exemplify professionalism in all communications.

  • Seek opportunities to enhance communication skills.

Systems Organization and Improvement

In order to improve efficiency and quality within their organizations, pediatric hospitalists should:

  • Collaborate with hospital administrators to improve medical record documentation systems by technical means.

  • Assist in the development of and/or participate in hospital and system‐wide educational programs on communication skills.

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