Communication with Patients, Families, and Coworkers

1. 4 Communication with Patients, Families, and Coworkers

2. Learning Outcomes 4.1 Identify elements of the communication circle. 4.2 Understand and define the developmental stages of the life cycle. 4.3 Give examples of positive and negative communication.

3. Learning Outcomes (cont.) 4.4 List ways to improve listening and interpersonal skills. 4.5 Explain the difference between assertiveness and aggressiveness. 4.6 Give examples of effective communication strategies with patients in special circumstances.

4. Learning Outcomes(cont.) 4.7 Discuss ways to establish positive communication with coworkers and management. 4.8 Describe how the office policy and procedures manual is used as a communication tool in the medical office.

5. Learning Outcomes(cont.) 4.9 Describe community resources and how they enhance the services provided by your office. 4.10 Explain how stress relates to communication and identify strategies to reduce stress.

6. Introduction • Medical assistants must • Recognize human behaviors • Communicate effectively, with professionalism and diplomacy • Recognize obstacles that affect therapeutic communication

7. Communicating with Patients and Families • You are the key communicator between the physician and patient • Your interaction sets the tone for the office visit • Developing strong communication skills is just as important as mastering administrative and clinical skills Communication will influence how comfortable the patient feels in your practice.

8. Patients are #1! Communicating with Patients and Families(cont.) • Customer service • Most important part of communication • Two points fundamental to customer service • The patient comes first • Patient needs are satisfied

9. Communicating with Patients and Families(cont.) • Examples of customer service • Telephone techniques • Writing or responding to telephone messages • Explaining procedures to patients • Assisting with billing issues • Creating a warm and reassuring environment

10. Apply Your Knowledge What are the two key parts of customer service? ANSWER: The two fundamental parts of customer service are that the patient comes first and you must satisfy patient needs. Good!

11. The Communication Circle • The communication circle involves an exchange of messages through verbal and nonverbal means.

12. Communication Process • Patients often believe that health care has become impersonal due to • Technological advances • Managed care organizations • Maintain a patient-centered approach

13. What are the three elements of the communication circle? Apply Your Knowledge ANSWER: The three elements of the communication circle are the message, source, and receiver. RIGHT!

14. Understanding growth and development enhances communication skills Physical development Psychological and emotional growth Guidelines for communication based on developmental stage Infant Toddler Preschooler School age Adolescence Young, middle, old adult Human Behavior: Stages of the Life Cycle

15. Maslow’s Hierarchy of Human Needs Self-Actualization Esteem Needs Love/Belonging Needs Safety Needs Physiological Needs Deficiency (Basic) Needs

16. Apply Your Knowledge You can communicate with all people in the same way. Is this statement true or false, and why? ANSWER: The statement is false. Not all people are at the same place on Maslow’s hierarchy of human needs. To communicate effectively with a person, you need to understand what he or she is deficient in. For example, you would use different communication styles when talking to a homeless person who may have psychological and safety needs than when talking to an elderly person who is lonely and depressed due to the recent loss of his or her spouse. Good Answer!

17. Types of Communication • Positive or negative • Verbal or non-verbal • Written (Chapter 7)

18. Positive Verbal Communication • Communication promotes the patient’s comfort and well-being • Set the stage for positive communication • Encourage patients to ask questions • Speak slowly and clearly

19. Negative Verbal Communication • Curb negative communication habits • Mumbling • Speaking brusquely • Avoiding eye contact • Interrupting patients as they speak • Rushing explanations • Forgetting common courtesies • Showing boredom • Treating the patient impersonally

20. Non-Verbal Communication • Facial expression • Eye contact • Posture • Open • Closed • Touch • Personal space In many instances, people’s body language conveys their true feelings, even when their words may say otherwise.

21. Apply Your Knowledge YEA! Mr. Garcia comes to the desk to check in and asks if he will be seen on time. The receptionist continues with her paperwork, points to the sign-in sheet, and tells Mr. Garcia: “Just sign in. The doctor will be with you when he can.” Explain why this is an example of negative communication. • ANSWER: This is an example of negative communication because the clerk • Did not stop what he or she was doing – was not friendly or attentive • Did not greet Mr. Garcia or make eye contact with him • Did not give a satisfactory answer to Mr. Garcia’s question • Did not make sure Mr. Garcia understood when he would be seen

22. Listening skills Passive listening Active listening Improve listening skills Prepare to listen Relax and listen attentively Maintain eye contact Maintain personal space Think before you respond Provide feedback Improving Communication Skills

23. Improving Communication Skills (cont.) • Interpersonal skills • Warmth and friendliness • Empathy • Respect • Genuineness • Openness • Consideration and sensitivity

24. Therapeutic Communication • The ability to communicate with patients • In terms they can understand • So they feel at ease and comfortable • The ability to communicate with other members of the health-care team • Technical terms • Appropriate to the health-care setting

25. Involves Therapeutic Communication (cont.) • Silence • Accepting • Giving recognition • Offering self • Giving a broad opening • Offering general leads • Making observations • Encouraging communication • Mirroring • Reflecting • Focusing • Exploring • Clarifying • Summarizing

26. Roadblocks Ineffective Therapeutic Communication • Reassuring • Giving approval • Disapproving • Agreeing/ disagreeing • Advising • Probing • Defending • Requesting an explanation • Minimizing feelings • Making stereotyped comments

27. Defense Mechanisms • Unconscious, designed to protect self • Patients may display • Compensation • Denial • Displacement • Dissociation • Identification • Introjection • Projection

28. Assertiveness Skills • Assertive – people who are firm and stand by principles while still showing respect for others • Requires • Openness • Honesty • Directness • Aggressive – people who try to impose their position on others or try to manipulate them

29. Apply Your Knowledge What is the difference between being aggressive and being assertive? ANSWER: Assertiveness means standing by your principles while showing respect for others. You trust your instincts, feelings, and opinions and act on them. An aggressive person tries to impose his or her own position on others or tries to manipulate them. He or she is bossy, may be quarrelsome, and does not consider others’ feelings, needs, thoughts, ideas, or opinions. Good Answer!

30. Communication – Anxious Patient • Can interfere with communication process • May not listen well or pay attention to what you are saying • Observe for • Tense appearance • Increased blood pressure and breathing • Sweaty palms • Irritability and agitation

31. Recognize anger and its cause Remain calm and demonstrate respect Focus on physical and medical needs Maintain adequate personal space Do not take anger personally Ask patient to be specific concerning cause Present your point of view Avoid breakdown of communication Leave if you feel physically threatened Communication: – Angry Patient • Goal is to help the patient express anger constructively • Steps in communicating with an angry patient

32. Communication –Patients from Other Cultures • Each patient has his or her own behaviors, traditions, and values • Strive to understand and be tolerant • Stereotyping • Negative statement about specific traits of a group applied to an entire population • Generalization • Statement about common trends within a group

33. Attitudes about health care Beliefs about causes of illness Symptoms and what they mean Treatment expectations Language barriers Communication – Other Cultures (cont.)

34. Communication –Patients with Visual Impairment • Use large-print materials • Use adequate lighting in all areas • Use a normal speaking voice • Talk directly and honestly • Do not talk down to the patient • Preserve the patient’s dignity

35. Find a quiet area to talk Minimize background noise Position yourself close to and facing the patient Speak slowly Remember that elderly patients lose the ability to hear high-pitched sounds first Verify understanding Use written material Speak clearly but do not shout Communication –Patients with Hearing Impairment

36. Communication –Mentally or Emotionally Disturbed • Determine what level of communication the patient can understand • Suggestions • Remain calm if the patient becomes agitated or confused • Avoid raising your voice • Avoid appearing impatient

37. Communication – Elderly Patients • Be respectful • Do not talk down to elderly persons • Touch – communicates caring

38. Communication – Terminally Ill Patients • Often under extreme stress, so offer support and empathy • Kubler-Ross’s Stages of Dying • Denial • Anger • Bargaining • Depression • Acceptance

39. Communication –Young Patients and Their Parents • Recognize and accept their fear and anxiety • Explain all procedures • Use praise • Do not tell children that a procedure will not hurt if it will, or you will lose their trust • Reassuring and keeping parents calm will also help the child relax

40. Communication – Patients with AIDS/HIV • Stigma of disease • Guilt • Anger • Depression • You must have accurate information about the disease and the risks involved to answer the patient’s questions • Patients need human contact and to be treated with dignity

41. Communication –Patient’s Family and Friends • Provide emotional support to the patient • Acknowledge family members and friends • Keep them informed about patient’s progress • Remember to protect patient confidentiality • Ask the patient what information can be given to family or friends

42. Apply Your Knowledge What can you do to promote communication with someone who is visually impaired? ANSWER: Use large-print materials, adequate lighting in all areas, and a normal speaking voice. Talk directly and honestly, but do not talk down to the patient; preserve the patient’s dignity. Right!

43. Communication with Coworkers • Develop rapport with coworkers • Rules for the medical office • Use proper channels • Have a proper attitude • Plan an appropriate time for communication

44. Communicating with Management • Keep supervisor informed • Ask questions • Minimize interruptions • Show initiative

45. Do not gossip Do not jump to conclusions Set boundaries to limit undesirable behavior Do not “feed into” others’ negative attitudes Be personable and supportive Refrain from passing judgments Dealing with Conflict

46. Apply Your Knowledge What strategies can you use to avoid conflict in the workplace? • ANSWER: You can use the following strategies to avoid conflict in the workplace: • Do not “feed into” others’ negative attitudes • Be personable and supportive • Refrain from passing judgments • Do not gossip • Do not jump to conclusions Bravo!

47. Policy and Procedures Manual • Key written communication tool • Policies • Dictate the day-to-day workings of an office • Describe chain of command • Procedures • Detailed instructions for specific procedures

48. Office purposes Rules and regulations Job descriptions Office hours Dress code Insurance Vacation and sick leave Salary evaluations Maintenance of equipment Mailings Bookkeeping Scheduling appointments OSHA Policies

49. Procedures • Purpose of test, clinical application, and usefulness • Specimen required and collection method • Special patient preparations or restrictions • Reagents, standards, controls, and media used • Instrumentation • Calibration and schedules • Step-by-step directions

50. Good customer service is founded on providing or researching services to assist in attaining the goal of patient health and well-being Discuss with patient’s physician before referring patient Resources Alcoholics Anonymous Shelters Hospice Mental health services Meals on Wheels PASSPORT Easter Seals State agencies Support groups Community Resources