“Bedside manner” is more than a cliché. The way healthcare professionals, non-clinical staff and even family caregivers interact with adults has practical benefits, too.
According to the National Institute on Aging, patient-centric communication and interaction can:
• Help limit medical errors
• Strengthen the patient-provider relationship
• Support better patient outcomes
Here are some tips for healthcare professionals and patients’ family members to help you work more effectively with people at every stage of care.
At Intake & During the Appointment or Admission
The healthcare journey begins as soon as patients come through the door and continues throughout the visit or admission.
Professional caregivers and staff – from receptionists and billing reps to techs and case managers – must create an affinity with patients and caregivers. “By establishing the right rapport, we allow ourselves to be part of that patient's care team,” explains Amir Barzin, director of the University of North Carolina Family Medicine Center in Chapel Hill, NC. “We gain their trust to allow us into their lives.”
To build rapport, try one or more of these techniques:
1. Use preferred forms of address. We’ve all had that awkward experience when someone speaks to us too familiarly or formally. It throws off the whole interaction. Introduce yourself to patients and family member in attendance, and confirm how they wish to be addressed. Note this on the chart and in the patient record so the rest of the team knows, too. And avoid using casual terms of address like “Love” or “Dear” with people you don’t know well because it can be taken as condescending or insulting.
2. Make genuine inquiries. Taking a legitimate interest in others is an easy way to make a connection. Ask open-ended questions that get people talking.
3. Keep information flowing. Uncertainty is stressful. Explain what will happen during the visit or admission, and whom the patient will see. If delays are possible, let the patient and family member know. Transparency helps people feel more trusting and less anxious.
4. Accommodate special needs. Sometimes sensory impairments make it hard to communicate. “Both hearing loss and cognitive issues are common, and their outward appearances can be similar,” acknowledges retired ER physician Ben Hippen of Decorah, IA. “When in doubt, speak up. It’s better that they ask you to speak more softly than that they don’t hear or understand what you’re saying.” For patients with auditory problems, it’s also helpful to look directly at them and consider moving to a quieter location. When patients have trouble reading forms and directions, offer to print them out in a larger font, assist with the completion or provide more light.
For professionals and family caregivers, it’s crucial to listen to patients and give them their due time.
Yet staff and care team members may hurry through the visit because they feel pressured to move on to other patients who are waiting. “It’s part of our job to listen, explain medical conditions, answer questions, and make sure the patient understands,” Barzin says. “If we don’t listen, we may not pick up on other important details of the person’s care.” This can lead to medical errors and poor care.
Similarly, family caregivers sometimes rush patients – perhaps because they have to get back to work or have other conflicts to address. They may also talk over their loved ones because they want to provide their own helpful insights to the care team. Waiting for your family member to finish or making arrangements to speak with healthcare providers before or after the appointment ensures everyone’s thoughts, concerns and observations are heard, and that parents feel respected.
Before sending patients home, carefully review conclusions, instructions and recommendations.
“Discharge instructions are made to relay the clinical care in any setting to the patient,” Barzin explains. “This has to be done in a manner that the patient can understand.”
Deeper understanding of this information makes better health outcomes more likely.
Clinical staff, case managers and social workers should go over instructions with patients and caregivers, using these patient-centered communication strategies to ensure understanding:
• Use plain language. We use jargon with other professionals for accuracy and concision, but it’s not appropriate when talking to people outside the healthcare profession.
• Write down instructions and recommendations. Patients and caregivers may nod when you’re talking to them and say they have no questions, only to get home and realize they don’t remember or understand what you said. Providing written instructions – again, in plain language – gives them a valuable reference.
Family and professional caregivers should take careful notes and not just rely on printouts the care team may provide. If something isn’t clear, definitely ask for clarification immediately. And find out whom to contact if you encounter questions or problems after you leave the office.
At Home & In Recovery
It’s just as important to focus on good interactions at home. Recovery can be challenging and confusing, so it’s important for professional and family caregivers to act accordingly.
“Without compassion and patience, there is no care,” Barzin states. “Healthcare is more than just a diagnosis – it’s a complex approach to the wellbeing of a human being. As in any situation, this has good times and difficult times. During those difficult moments, it’s important to remember to treat others as we would want to be treated.”
As professional or family caregivers, we can demonstrate compassion and patience when we:
1. Listen without interrupting. Even small interruptions chip away at our sense of trust and feeling of being understood and respected. Hold comments until the patient is finished. Make eye contact and acknowledge that you’re following along with nods and short statements, like “yes” or “I see”.
2. Respond to emotions. We all want to feel understood and cared about, and when we do we’re happier and more confident. Producing those feelings reduces conflicts and increases emotional wellbeing. Find openings to say affirming things like, “I bet that’s hard” or “I’m sorry you’re frustrated. Let’s work together on accomplishing this.”
Delivering Patient-Centric Interactions
Showing compassion and adapting our interactions in these ways builds stronger relationships, establishes faith and trust, empowers more effective caregiving, and yields better health and overall wellbeing.
“As our population continues to age, we have to adjust the way we approach medicine and think of the care of the elderly and how they might have different needs,” Barzin concludes. “This allows us to provide patients with not only the most appropriate care, but the best care possible.”