Communicating with patients and colleagues

Effective clinical communication is two-way (or multi-way if between teams), structured and continuous communication that results in timely, accurate and appropriate transfer of information. It is tailored, open, honest and respectful, and there is the opportunity for clarification and feedback.

Key messages

  • Communication is integral to all aspects of patient care
  • Communication is a core clinical skill that can be developed and improved with practice, experience, continuous learning, mentorship and support
  • Effective communication has a significant positive influence on patient experience and satisfaction
  • Poor communication contributes to teamwork failures, errors, misdiagnosis and inappropriate treatment
  • It is important to tailor your communication and consider the health literacy needs of patients, families and carers. This includes providing an opportunity to clarify the information received and to check understanding
  • Communicating with kindness and empathy improves interactions with patients and their families, and your colleagues.

What is effective clinical communication?

Clinical communication is the exchange of information about a person’s care that occurs between treating clinicians, members of a multidisciplinary team*, and between clinicians and patients, families and carers.

The process of communication is the way in which information is exchanged. It involves several components – the sender (the person who is communicating the information); the receiver (the person receiving the information); the message (the information that is communicated); and the channel of communication. The way information is delivered, including structure and non-verbal communication (body language, eye-contact and tone) are also important considerations.

Various channels of communication include verbal (face to face, over the phone, via video calls e.g. FaceTime, Skype), written (emails, letters, faxes) and electronic means. Communication processes can occur at the same time, such as verbal communication between two clinicians, or at different times, such as written communication where a clinician documents a patient’s goals, assessments and care plan in the healthcare record, which is later read by another clinician.

*A multidisciplinary team is a team that includes two or more clinicians from multiple disciplines, who work together to deliver comprehensive care. The team may operate under one organisational umbrella or may be from several organisations brought together as a unique team. Multidisciplinary care includes interdisciplinary care.

Why is it important?

Communication failures, lack of teamwork and inadequate documentation in healthcare are known to result in errors, misdiagnosis, inappropriate treatment and poor care outcomes. Evidence shows that:

  • Communication problems are a major contributing factor of hospital sentinel events
  • Communication failures one of the most commonly cited underlying causes of complaints about the healthcare system.
  • Poor medication management and communication can significantly increase the risk of adverse drug events
  • Poor communication and transfer of information at discharge can result in an increasing number of readmissions, with lack of effective of communication between health professionals cited as the primary factor that affects post-discharge care transitions
  • Poor transfer of information and/or delayed or late referrals can affect quality of care and timeliness of treatment.

Communication skills

Key considerations

Given the complexity of care delivery, the purpose of communication will vary depending on the setting or context of care. To communicate safely there needs to be flexibility and consideration of what is required locally. To determine this it may be helpful to breakdown the communication process into the following key considerations:

Element Reflective questions

WHY

are you communicating?

  • What is the purpose?
  • Is it to inform, gather information, discuss, check understanding, seek advice, raise concerns or follow-up?

WHO

do you need to communicate with?

  • Is there are specified person/or people that you need to communicate with?
  • Who else is part of the care team? Consider multidisciplinary team members and the patient, family or carer.
  • Is there one person responsible for the patient’s overall care?
  • How do you know who you need to communicate with?

WHEN

do you need to communicate?

  • Does your organisation specify when you need to communicate with other members of the clinical team? (e.g. transitions of care and high risk situations).
  • Do you know when you need to communicate a concern or worry?
  • What are the high-risk situations for communication in your organisation?

WHAT

information are you communicating?

  • What is the minimum information content that you need to communicate?
  • Do you have all the relevant information?
  • Do you need to check other sources, such as information from the patient themselves, family members or carer?
  • Are there any special considerations or risks that you need to consider for your specific patient?
  • Does the patient and their family understand their diagnosis and management? Are they up to date on their progress?

Information should be tailored to the purpose and the person that you are communicating to and about.

HOW

are you communicating?

  • What is the agreed method for communication? I.e. face-to-face, via the telephone, email, or a number of different methods?
  • What is the agreed structure to facilitate communication?
  • What communication skills do you need to exercise?
  • What are the processes, strategies or tools available to support your communication?
  • How is the person you are communicating with receiving / responding to the information?
  • Are you communicating in a way that easily understood and meets the communication needs of the person you a communicating with (another clinician or patient)?

WHERE

are you communicating?

  • Do you need to consider privacy and confidentiality issues?
  • Does your environment support effective communication? E.g. can everyone hear? Are there lots of interruptions?

Special considerations for patients at higher-risk of harm

The health workforce needs to be aware that some patient groups can have multifaceted communication issues. This could be related to complexity of information that can be gleaned from the patient or to be given to the patient, or complications with language and comprehension, or both. These patients groups may include: 

  • Aboriginal and Torres Strait Islander people
  • Older people
  • Disability
  • Homelessness
  • Cultural and Linguistically Diverse 
  • Mental Health
  • Undergoing surgery
  • Paediatric 
  • Palliative Care 
  • Admitted to intensive care
  • Multiple co-morbidities.