Communication in Healthcare is not just about niceties! By Dr. Indu Arneja

Friends,

Patient Communication

According to a report by Joint Commission International (JCI) (2013), communication failure is the lead cause of medical errors.  The Report reveals that 70-80% of errors in patient care are the result of communication failure.  It is because all interactions in patient care are based on communication.  It could be with the patient, their family members or with other healthcare professionals.  Communication has become a cornerstone of quality healthcare and patient satisfaction.  Still communication is not considered an essential skill in patient care.  

The biggest hurdle in accepting communication skills as an integral part and parcel of patient management is the thought process that considers communication as just simple niceties and basic courtesies in handling patients.  There is no doubt that we need to be courteous and well behaved with the patient and their family but that is not the end of it.  Communication in healthcare is a lot more than that.  Communication in healthcare is not just about niceties, it is about the serious communication that happens between the healthcare professionals and the patients, where the patient has a set of information about his health and disease that needs to be collected in a systematic manner and a set of information that the healthcare professionals including doctors, nurses and other caretakers that they need to share with the patient in a manner that the patient understands it and is able to apply it to recover from the illness and regain health.  

Patient care is teamwork.  

Sharing the Treatment Plan

A lot of information about the patient’s medical condition is shared amongst the team members managing the patient.  The team includes consultants, residents, nurses, technicians and other paramedics.  This exchange of information is also a part of the clinical communication.  A major chunk of the errors in patient care are the result of communication failure amongst the healthcare professionals.  Careful, accurate, systematic, and timely exchange of information is the basis of quality healthcare.  So, in nutshell, clinical communication is an exchange of health related information either with the patients and their family or with the fellow healthcare professionals and is not just about niceties.

Communication with a patient is not the regular communication between two healthy individuals.  This is the communication between a trained and qualified healthcare professional and a person (patient), who is not feeling well, who is in need of help, and who is seeking your attention, care and advice.  In such a situation, communication can not be a simple exchange of conversation.  It has to be a mindful effort from the healthcare professional to proactively connect with the patient, understand his/her health needs and meet them in the best possible manner.

There are a lot of communication opportunities with the patients and their families like collecting patient history, informing and explaining about the diagnosis, discussing about the options available to treat an illness and the pros and cons of each treatment modalities.  Each of this communication requires understanding of quick ways of building rapport, getting all important health related information in the shortest span of available time, winning patients’ trust to reach a mutually acceptable treatment plan and answering patient’s queries in a manner to create patient satisfaction.  There is a huge knowledge differential between the treating doctor and the patient.  The treating doctor is expected to acknowledge this gap and make sure to design the communication in a manner that is understandable to the patient.  This requires the knowledge and understanding of principles of communication and effective tools to communication.  Clinical communication is learning and practicing all about it.

Patients may have unrealistic expectations from the treating doctor or the treatment modality.  It is helpful to be aware of these expectations and how to help them accept realistic expectations.  All this needs understanding of the fact, how the human mind does not accept anything less than the best and how to fine tune it to match with the reality.  This is the negotiation and persuasion aspect of communication and is required in everyday handling of patients.

At multiple times the communication with the patient is very sensitive in nature and requires real experience in terms of handling challenging situations like asking personal sensitive information, taking sexual history, communicating with suicidal patients, communicating with rape and abuse victims, informing about treatment failure or medical error, handling aggressive patient, or breaking bad news like serious diagnosis, or announcing death.  Managing these communications require training and experience and these are part and parcel of healthcare communication.  Understanding, learning, practicing and demonstrating these skills need training.

In an average stay of 3 to 4 days, a patient’s information exchanges 50 to 60 hands.  A lot of errors in patient care are the result of internal communication failure.  When two or multiple healthcare professionals with different educational, professional, and experience backgrounds work together, there is a risk of miscommunication or missed communication.  Unless you have standardized ways of communicating to bring uniformity and minimize the impact of individual difference in communicating, lapses are bound to happen.  Most of these lapses in the care of patients, leading to fatal consequences are the result of communication failure amongst the healthcare professionals.  Clinical communication is all about learning and practicing communication protocols to prevent these errors, and ensure continuity of care, patients’ safety and quality health outcomes.

Communication needs of patients have changed drastically over the last couple of decades.   Today, they wish to know their disease and actively participate in choosing treatment options considering their suitability as well.  They don’t want to be a mute spectator of their treatment planning and management.   It is time that we respect patients’ autonomy and give it due importance without compromising the clinical goals.  Involving the patient in decision making, answering their queries, addressing their concerns and acknowledging their experiences is the basis of modern medicine practices.  Now the patient is an important team member in healthcare delivery.  Engaging them in planning and management of their health condition is a definite way to create patient satisfaction and would also enhance professional satisfaction of the care providers.  After all, the purpose of all our actions is creating happiness and satisfaction.

Considering these facts in the background, it is time we realize the importance of clinical communication in providing quality healthcare including continuity of care, patient safety and patient satisfaction and take these skills seriously!

Dr. Indu Arneja is Founder Director of Indian Institute of Healthcare Communication, A pioneer in the field of Healthcare Communication in India
She has conducted around 1500 Clinical Communication programs for doctors, nurses and other healthcare professionals in more than 100 hospitals and medical colleges across the country.

She is an external assessor for NQAS, Ministry of Health and Family Welfare and NABH (IRCA), QCI, India.  Is a core group member of Advisory Board on Health and Mental Health for Nation Human Rights Commission.

She is also a visiting faculty to some of the very prestigious organization like IIM Ahmedabad, Delhi Judicial Academy, Maulana Azad Medical College, Delhi University, IGNOU and PHFI.  She has over 30 years of experience in the field of health and training.

She is a regular invitee at National and International Conferences.  Recently, she was invited to attend Annual Summit on "Patient Experience and Empathy" by Cleveland Clinic, Ohio, USA, 2019.  She has been awarded scholarship to attend a prestigious communication course ‘ENRICH’ organized by Academy of Healthcare Communication at Pittsburgh, USA in 2019.

She regularly conducts webinars for national and international audiences. She has conducted multiple webinars for Anschutz Medical Campus, Colorado, US.  She has a YouTube channel in her name Dr. Indu Arneja and has an on-going series under the titles - "Heart to Heart talk with Dr. Indu Arneja" and "Master Stroke with Dr. Indu Arneja".

arnejaindu@gmail.com
www.iihcglobal.com

#hospital #hospitals #treatment #medicine #patient #communication #effective #right #patientsrights #doctors #relatives #family #accreditation #technology nabh #jci #technology #patientcommunication  #patientengagement #medicalpractitioners #nursing #nursingcare

 

 

Wait Your Turn - Stay Positive by Annonymous

​It is a mistake to think time is going. Time is not going. Time is here until the world ​​ends. It is you that is going. You don’t waste time. Time is infinite. You waste yourself. You are finite. It is you that grows old and dies. Time doesn’t. So make better use of yourself before you expire. And one of the worst things to do with time is comparing yourself to others. 

A cow eats grass and gets fat but if a dog eats grass, it will die. Never compare yourself with others. Run your race. What works for one person may be that which will kill you. Focus on the gifts and talents God gave you and don’t be envious of the blessings He gave others_ .

Noah's Ark - Illustration by Chris Neville

Both Lion and Shark are professional hunters, BUT:

A Lion cannot hunt in the Ocean and a Shark cannot hunt in the jungle

That a Lion cannot hunt in the ocean doesn't make him useless and that a Shark cannot hunt in the jungle doesn't also make him useless both have their own territory where they can do well

If a rose smells better than tomatoes, It doesn't mean the rose can make a better stew. Don't try to compare yourself to others.  You also have your own strength, look for it and build on it.  All animals that exist, were in Noah's ark. A snail is one of those animals. If God could wait long enough for snails to enter Noah's ark; His door of grace won't close till you reach your expected position in life. Never look down on yourself, keep looking up.  Remember that Broken crayons still color.

Keep on pushing, you never can tell how close you are to your goal...!

Author: Anonymous

Sufian Ahmed's Success in Indian Civil Services Examination by Dr. M. Wasim Ghori

Sufian Ahmed's Success in Indian Civil Services Examination by Dr. M. Wasim Ghori

Sufian Ahmed

The Covid-19 pandemic delayed the results of the coveted Indian Civil Services Exam 2019 conducted by the Union Public Service Commission (UPSC). Nonetheless, it has thrown up several stories of grit, motivation and inspiration with candidates from diverse backgrounds making it to India's elite administrative service. 

One such candidate is Sufiyan Ahmed whose success has been hailed as an inspiring story for youngsters in Nimbahera, Chittorgarh District, Rajasthan. He is an architecture graduate from Aligarh Muslim University with a Master’s degree from IIT Kanpur and hails from a well-educated family with two elder academically bright sisters and an equally brilliant elder brother too.  Father Imtiyaz Ahmed - a Retired School Principal of repute and Mother Shama Nasreen - a Retired School Teacher have always supported and encouraged him to do better in life.  Elder brother, Bilal Arshad, a QA/QC Pharmaceutical professional himself backed Sufiyan too all along his journey.

From zero knowledge and background in Civil Services to All India Rank 303, it has been one hell of a roller coaster ride for Sufiyan Ahmed.  Grandson of an Imam, it was at Aligarh that he first learnt that there was a career in Civil Services. “I used to participate in group discussions revolving between Power and Money and which of the two has the greatest impact on the communities.  Thus, I began nursing my dream of joining Civil Services,” said Sufiyan on phone from his hometown.  He joined Zakat Foundation of India-funded coaching and later the Residential Coaching Academy (RCA) at Jamia Millia Islamia and cracked the Civil Services Exam in third attempt.

 

Sufian Ahmed with his family

He first sat for the Civil Services Exams in 2017 and cleared both Prelims and Mains but couldn’t make it to the final list.  Surprisingly, he didn’t qualify even the prelims in 2018 and felt dejected. “I was devastated after two successive failures, but I analysed my mistakes and told myself that I can bounce back. Sometimes it doesn’t happen alone. You need someone to chip in with you in tougher times and for this no better than my uncle (mother’s brother) Dr. Wasim Ghori, a UK Alumni and Consultant Diabetologist in Mumbai who motivated me to attempt again,” said Sufiyan.

“Since Sufiyan was frustrated at the failure in second attempt in 2018, I invited him over to Punjab Bhavan, New Delhi with the sole purpose to re-instil self-belief and confidence so that he could start his exam preparations with a fresh perspective and a positive frame of mind.  Furthermore, I took him to an iftar invitation at the Parliament House Annexe so that he could meet and interact with Bureaucrats, Consul Generals and Ambassadors from different countries. The intention was to silently remind him of his vision for which he had opted for Civil Services in the first place,” recalled Dr. Ghori whose father Abdul Salim Ghori (Sufiyan’s grandfather) had a great influence in charting out the family’s course. 

“The biggest contribution of my Uncle (Dr. Ghori) in my life is that he motivated me to aim high in life.  For him being satisfied with small things when bigger things can be achieved is an injustice to one’s own talents and gifts,” said Sufiyan. “I am sure Sufiyan will attempt again and improve his rank next year.  He is a role model and the Roger Barrister of his hometown, Nimbahera.  He will certainly motivate and inspire many more students to take India's prestigious civil services examination in the years to come.” said Dr. Ghori.

Sufiyan also reflected that being a full-time resident at the RCA for two years has helped him meet students from diverse backgrounds and interacting with them has shaped his personality.  “I come from a small town in Rajasthan’s Chittorgarh district and understand the problems rural India face. But living with students from Manipur, Kerala and Kashmir, I understood the diversity of the problems and challenges the country faces and how issues are unique to a region,” he said.

Sufiyan added that the RCA is different from other coaching centres as it has an entrance examination and only those who are serious about the examination are admitted here.  “At a private coaching institute, anybody who can pay the fee is in your class and not everybody has the required dedication. I graduated from IIT – Kanpur after studying design and was the only person from my class that did not sit for placements and gave up on a job. This is how serious I was about serving the nation,” said Sufiyan.

On exam preparations, Sufiyan says, “The number of hours you have to study per day depends on the goal of your studies. If you decide a time of ten days to complete a book, then you will have to study daily according to it. I cannot study ten or twelve hours continuously. So, I had a schedule of five-five or six-six hours for myself”.

Speaking about his achievements, Sufiyan said “when the chips are down, talk to someone who will lend their ears to you. Keep your ego out and discuss with peers and seniors. Share knowledge and be inquisitive to gain knowledge and the more you do, the more it comes back to you. Surround yourself with people who are optimistic and are ready to have a healthy discussion with you”.

Sufian Ahmed - Third from left with Dr. Wasim Ghori, his Uncle on his left side

 

Sufiyan adds that the entire town and family are ecstatic with these developments and understandably so. His father Imtiyaz Ahmed says “I want my son to work with utmost honesty and integrity in whichever services he opts for”. The same sentiments were echoed by mother Shama Nasreen who is delighted at the success of her younger son and understandably so. 

Grand-father Abdul Salim Ghori had encouraging words to add too “Sufiyan has become a source of inspiration to many youngsters; I am sure that he will discharge his duties towards Nation-building with utmost dedication, commitment and sincerity and serve the under-privileged sections of our great country India to the best of his abilities”.

Grand-mother Zainab Ghori – an accomplished Mumbai-based Retired School Administrator extended her blessings to grandson Sufiyan as he looks forward to serving the nation in the coming years. She has urged students to have faith in hard work and to put consistent efforts for achieving their goals.

I give Sufiyan my blessings and wish to see him as a top ranking bureaucrat in the Government of India and a career full of success and achievements and that he may some day bring Glory to India and make us all proud.

Contributed by Dr. Wasim Ghori

 

Dr. M. Wasim Ghori, Medical Director & Consultant Diabetologist, Heart & Diabetes Clinics, Mumbai discusses the need to follow certain protocols that can help overcome the COVID-19 pandemic and not to stigmatise an individual, locality or a community.