Healthcare Communication Methods

### Technical Channels for Communication

• Technical channels for communication have limitations such as more noise and interference
• Technical interference makes messages harder to interpret as there is less feedback or feedback can be delayed.
• This places greater demands on the communication skills of the HCP and requires a higher level of expertise.
• Technical channels are sometimes helpful in removing barriers, such as language or hearing difficulties, using software to help with language barriers.

Online GP or Pharmacy Services

• Online GP or pharmacy services are becoming more common.

Remote Consultations

• Remote consultations, such as over the phone or video link, were used more during the pandemic
• In some cases, remote consultations are useful for straightforward situations such as repeat prescriptions.
• Face-to-face consultations are often more beneficial.

Face-to-Face Communication

• There is immediate feedback and it is a dynamic process.
• Information is transferred through verbal and non-verbal channels.
• There can be both deliberate and accidental communication.
• It is irreversible and inescapable.
• It is complicated and what counts is not what you said but what they understood.

Barriers to Communication

• Barriers to communication can be placed into four main categories.

Congruence

• Congruence occurs when verbal and non-verbal communication match, reinforcing each other.
• Non-verbal communication can be as powerful as spoken words.

Body Language

• Body language is the same in all people regardless of culture or ethnicity, with some universal facial expressions
• Body language can also vary based on culture or ethnicity.

Verbal Communication

• The way you speak and the words you use in a particular situation are known as your register.
• Formal and casual are two common registers.

The Calgary-Cambridge Model

• The first 90 seconds of a consultation are crucial for establishing rapport.
• First impressions matter, including how the practitioner dresses.
• Introduce yourself and clarify your role.
• Apologize if running late or the patient has had to wait.
• Show respect and interest.
• Consider the environment's privacy, professionalism, and if it meets patient needs.
• Be aware of potential barriers to communication.
• Use good eye contact, politeness, and allow the patient to speak without interruption.

### Probing Questions

• Examples include "What, exactly, triggers the pain?" and "Tell me more about..."
• Process questions, such as "How does that work in practice?", can help to gain detail.
• A non-verbal probe, like raising eyebrows and tilting the head, can show interest and ask for detail without words.

### Closed Questions

• Closed questions can be used to maintain control of a conversation and refocus the consultation.

Narrative

• Encourage the patient to tell their story in their own words.
• Establish timescales and the sequence of events.

Time to Respond

• Give patients enough time to answer, as they may need thinking time.

Questions to Avoid

• Leading questions: Push the patient towards a specific answer.
• Double questions: Two questions in one, making it hard to get answers to both parts.
• Compound questions: Multiple parts, causing confusion for the patient.
• Options: Limits the patients' answers to the given options, even if none are entirely accurate.

First Problemitis

• Avoid assuming that the first problem identified is the only one.
• Patients may not disclose all their problems at once.

Medicines Reconciliation

• Identify the patient's current medications accurately.
• Compare the list with the current list in use and recognize any discrepancies.
• Document any changes and create a complete list of medications.
• Perform this at all transfers of care (e.g., from primary to secondary care).
• Record medication information: Name, strength, form, dosage, frequency, route of administration, and duration (if known).
• Also document any non-prescription items such as herbal medicines, vitamins, over-the-counter medicines, nutritional supplements, and recreational drugs.