Chapter 12: Communication
Katie Baker
Whether communicating with other providers, your supervisors or staff, or patients and their families, professional communication is important for a number of reasons. Providing clear communication helps patients in your care receive the best treatment outcomes for their health concerns. Communication can refer to written messages (emails, letters, text messages, presentation slides), verbal messages (phone calls, video conferences), or in-person communication, such as meetings, presentations, and patient visits.
Clarity is important for the recipients to be able to understand and perform the requested action as well as understanding the information that you are trying to convey. Timely communication is important as well. Ensuring that patients receive timely communication about their care and that providers receiving your referrals are able to follow up in a timely manner and ensure that patient outcomes are the best possible.
Concise communication means that you do not include unneeded information in your message. As someone who is presenting information in a large meeting, you want to be sure that your content is presented in a concise but memorable way. You would not include slides that do not relate to your content.
The presentation of your message is an opportunity for your patients and colleagues to develop respect for your professionalism through your communication skills. Using the proper tone, and appropriate spelling, grammar and punctuation will ensure that your recipients will view you professionally.
Selecting the proper recipient is also an important component of communication. You will need to know who to communicate with on a care team about a patient’s condition in order to provide helpful information for their care to those who can use it to help. In another example, your organization might have a particular chain of command for communication that tells you who to contact for specific concerns (manager first, department director second, then Human Resources) and it is expected that you will follow it.
Communication May Depend on Audience
As a healthcare professional, you will work daily with people in different positions relative to your job. You may communicate with supervisors and other superiors in your organization. You may have the task of training new employees, which will require a strong set of communication and listening skills. You will communicate with providers to whom you are referring patients. You will communicate with patients and their families directly.
While it is common to use a casual tone when speaking to coworkers, it is important that communicating with employees be done in a professional and compassionate way. Workplace communication norms may vary between colleagues and between employees at different levels and it is important to understand the norms for the workplace in which you work. Many people have a more casual and friendly relationship with their supervisors than used to occur in the workplace and this can be a challenge when there are generational differences within a staff. It is always best to err on the side of being more formal and following the lead of a supervisor in communication. Some providers may prefer to be referred to by their title at all times, for example “Dr. Baker”, or only in certain instances: “You can call me Katie, but please refer to me as Dr. Baker in front of the patients”.
therapeutic communications with patients should always be professional and compassionate, clear and concise. Communications with patients should always be done in a way that leaves a record. For example, any emails or letters that go out to patients will have a copy maintained by the provider’s organization and any verbal or phone conversations should be logged into the patient chart in the appropriate area. When healthcare providers communicate with patients, putting the communication into the patient chart helps to address any miscommunications or misinterpretations by the recipients.
It is not appropriate to text patients unless you are using a HIPAA-compliant texting service for patient reminders and notifications. Test results and diagnosis should never be sent via text message. Patients should be reminded that text messaging is not an option for contacting their provider about concerns. Aside from scheduled telehealth visits, diagnosis and treatment should not be performed via text or email, due to the confidential nature of the communication. Further, encryption must be in place to prevent accidental violation of HIPAA due to theft or loss of the communicating device, such as a laptop or cell phone.
Introduction to Written Communication
Communication can be divided into seven components, outlined below. For each component, we will define and give examples of how it is important in your professional written communication.
Context
Context is the surrounding environment or meaning behind something. Context in communication might refer to the purpose for your phone call or email and the situation or relationship between you and the recipient of your message. Context can also refer to cultural or organizational norms of communication and will set the tone for the communication. The context of a letter, for example, would be your relationship to the person to whom you are writing and the tone could vary from formal to casual, depending on the recipient and the message.
Sender
You, as the sender, will be responsible for transmitting your ideas, whether written, verbal, or in person. You will choose the tone of the message and its content. Your status within an organization and your relationship to the recipient will affect your communication. As a sender, you will have a different relationship with your employer, your trainees and your patients and your tone will reflect that.
Ideas
The content of the communication will also have an effect on the way in which it is communicated. The central idea of the message must be clearly communicated, with details providing support and a conclusion that reiterates the main idea. In a presentation, the slides that you use should be ordered in a way that makes it clear what the main idea is and where the details fit in. Having a colleague review your presentation slides can be helpful in discovering areas of confusion before your presentation.
Encoding
Encoding refers to the way in which the message’s ideas are conveyed. We can utilize text, punctuation marks, images, and even audio or video clips in presentations to share our information. While the use of punctuation and grammar can be a powerful indicator of emotion (such as multiple exclamation points when you are excited about something or stretching the word by repeating the last letter), appropriate professional communication limits the use of punctuation at the end of sentences to a single punctuation mark. It is typical for professional communications to utilize periods or question marks at the end of sentences and to refrain from using exclamation points. It should also be noted that emoticons/emojis and text speak abbreviations are not recommended in professional communication of any kind.
Medium
The medium is the method of communication. This can be a call, an email, a text or even verbal communication. The choice of your communication medium reflects the formality or importance of the message as well as the relationship between the sender and receiver. For example, it might be appropriate for you to send a quick text to the workplace cell phone of an x-ray technician to let them know you are sending a patient their way but it would not be appropriate to text your CEO or text a patient telling them they have a terminal diagnosis.
Receiver/Decoder
The receiver or decoder is the recipient of the message. In the professional realm, this could be a colleague, superior, subordinate or patient. In all communications, the sender and the receiver both come to the message with their own moods, opinions and interpretations, which can occasionally lead to miscommunications. It is important that your written communications are clear to minimize these and to ensure that your receivers do not misinterpret your message. If this does happen, it is always best to follow up with a phone call or in-person discussion as written communication does not always convey tone.
Feedback
Feedback refers to the response from the recipient. It is always important to provide a response when you receive a professional communication directly (this is not always the case for organization-wide or department-wide communications, such as announcements, unless requested). Feedback is important because it helps to clarify any misunderstandings. For example, if you send a referral for an MRI of the right knee and the response is that the patient has been contacted about an MRI of their left knee, you will know that you need to correct that before the imaging appointment occurs.
Communication between the provider and patient that seeks to establish and build trust and sense of safety.
Oral communication through spoken words and sounds that convey meaning.