Supplements

Communication

Copyright © 2006 Society of Hospital Medicine

Communication refers the transfer of information between individuals, groups, or organizations. Hospitalists communicate in multiple modalities with patients, families, other health care providers and administrators. Patient‐centered care requires that physicians and members of multidisciplinary teams effectively inform, educate, reassure, and empower patients and families to participate in the creation of a care plan. Effective communication is central to the role of the hospitalist to promote efficient, safe, and high quality care and to reduce discontinuity of care. Hospitalists can lead initiatives to improve communication amongst team members, patients, families, primary care physicians and receiving physicians within the hospital and at extended care facilities beginning with admission and through all care transitions.

KNOWLEDGE

Hospitalists should be able to:

  • Describe key elements in a message.

  • Describe various modalities used to communicate, including advantages and disadvantages of each.

  • Describe techniques of providing and eliciting feedback, and differentiate formative and summative feedback.

  • Define the role of effective communication in risk management.

SKILLS

Hospitalists should be able to:

  • Explain issues of pathophysiology, treatment options, and prognosis using language understandable to patients, family members, and other care providers.

  • Listen without interruption to the questions and concerns of patients, family members and other care providers, and promptly address any issues.

  • Identify potentially problematic family and team dynamics and explore their effects on the patient.

  • Identify a family spokesperson.

  • Facilitate family meetings when necessary, collaborating with nurses and other team members to identify goals for the meeting, summarize conclusions reached, and utilize support staff as needed.

  • Effectively utilize a translator when communicating with patients and families speaking a different language.

ATTITUDES

Hospitalists should be able to:

  • Appreciate the positive impact that subtle changes in body language, such as sitting and appropriate touching, have on patient and family perceptions of an interaction.

  • Demonstrate empathy for patient and family concerns.

  • Recognize the importance of allowing patients and families to have questions answered in a straightforward and timely manner.

  • Demonstrate cultural sensitivity in all interactions with patients and families.

  • Appreciate the importance of active listening.

  • Counsel patients and families objectively when considering various treatment options.

  • Acknowledge and remain comfortable with uncertainty in issues of prognosis.

  • Provide a quiet and comfortable setting for family meetings.

  • Discuss the patient's illness realistically without negating hope.

  • Ensure that input from surrogate decision makers accurately reflects the patient's interests, with a minimum of personal bias.

  • Communicate with nursing staff and consultants on a regular basis to convey critical information.

  • Remain available to the patient and family for follow‐up questions through all care transitions.

  • Lead, coordinate or participate in hospital initiatives to assure adequate translator services and cross cultural sensitivities.

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