In the healthcare organization, there are numerous delivery processes like patient handovers and interfaces among the healthcare professionals. One has to interact with numerous employees in the same organization like nurses, doctors, physicians and most importantly, patients. For this efficient interaction in clinical practice, effective communication is important where every piece of critical information should be accurately communicated between the stakeholders (Rider et al. 2014). A comprehensive organizational communication change is required in the healthcare organization to ensure conveying of critical information between the healthcare professionals and clear orders of clinical handover (Eklof and Ahlborg Jr 2016). As a newly appointed research manager in a healthcare organization, one realized that there is communication problem in the organization that requires change. There are ethical principles associated with communication that have an influence on risk and benefit in healthcare like respect for personal autonomy, non-maleficence, beneficence and justice. Therefore, the following essay involves the discussion of ineffective communication among the organization, barriers witnessed and understanding of the ethical implications associated with implementation of the recommended solutions for organizational communication change.
In a healthcare organization, effective communication acts as an important tool for improving patient satisfaction and enhances quality of care. If there is lack of communication witnessed in the organization, it can lead to poor patient satisfaction, medication errors and illness that might cause sudden death. In the recent, article by Khan et al. (2017) more than half the number of hospital readmissions are due to miscommunication and can be avoided with effective communication among the healthcare professionals and patients. To address the patient needs, it is important for the healthcare providers as frontline workers to have efficient communication with the patients to determine their needs and provide solutions in a proactive manner. These events can help to have a positive impact and enhance patient satisfaction. According to Silverman, Kurtz and Draper (2016) no matter how knowledgeable a physician is, he or she cannot help until unable to have good and open communication with the patient. Lyles et al. (2013)suggests that strong therapeutic relationship between the health provider and patient can only be formed when they exhibit effective communication skills and on the other hand the patient’s ability to follow the medical recommendations. The benefit of effective communication in a healthcare system has positive health outcomes for the patients and healthcare members as stated by Kourkouta and Papathanasiou, (2014). Effective communication is required between physician-nurse, nurse-patient and interpersonal communication skills among the members of healthcare organization.
Poor communication is manifested among the physician that is responsible for the patient care and hampering of medical progress. It also hinders collaborative care retarding the patient treatment process and recovery progress. Clear background information about the patient is important to provide referral to the consultants. Physician-nurse relationship is also important, as nurses have to understand and follow the instructions given to them. Missing of any critical information of patient can risk his or her life in danger. Delayed communication is another instance where the medical progress is hampered and failure to convey timely information between the doctors. Nurse-patient communication is also important as effective interaction help to assess their important concerns and needs (Nursingmidwiferyboard.gov.au. 2017).
At the Darwin Private Hospital, in high dependency unit (HDU) it was found that it does not comply with Australian system. A serious failure of medical staffs led to the breakdown of the hospital procedures leading to death of Irene Magriplis, 75-year-old woman. The nurses and medical staffs did not communicated regarding the fluid chart of the patient about the leaking of bile and ended in providing sub-optimal care, eventually leading to death.
As a research manager, I witnessed that the nurse practitioner communicated with the patient comprehensively about the plan of care. In a while, I noticed that hospitalist visited the patient and outlined the changes that are required in the plan. In this way, the nurse lost credibility with the patient and left the patient wondering that entire hospital is providing them a high level of care. Moreover, while conveying the information, patient and his family did not ask questions and the nurse also did not seek feedback to assess the information conveyed. I noticed various barriers hinder effective communication in the healthcare organization. There is absence of a systematic communication method that promotes healthy communication between the healthcare professionals and patients. Another barrier observed is that one fear to question the higher authority and their medical ability (King et al. 2013). As a result, nurses and patients are unable to raise their concerns when appropriate and it is manifested in the whole organization. Language acts as the biggest barrier where the client or patient does not understand English (Taylor, Nicolle and Maguire 2013). It is not always possible to have an interpreter available in such a demanding and stressful hospital environment. This results in patient dissatisfaction with poor health outcomes. Ethnic and minority groups are the most disadvantaged and face language barrier in seeking healthcare services and facilities. Workload and nurse shortages are also barriers where they do not have time to establish a healthy therapeutic relationship with the patients. In addition, clinical handoffs or delegation occurs on a daily basis in the healthcare organizations. Poor communication between delegations can hamper the patient safety, as there is lack of conveying of critical information endangering the overall aspects of care of the patient (Fujimori et al. 2014).
Literature suggests that evidence-base practices are the best approaches to improve communication skills, bring communication change in the organization, and prevent medical errors. Firstly, there should be fostering of a healthy, therapeutic relationship that can enhance effective communication between the healthcare providers and patients (Brock et al. 2013). Secondly, there should be gathering of adequate information about the patient to avoid communication gap and lack of conveying critical information during clinical handovers (Manser et al. 2013). In the same way, information should also be provided to the concerned stakeholders regarding the patient during delegation or plan diagnosis or treatment. Various frameworks for communication are also employed by the healthcare organizations.
Vethical principles are associated with communication in health between the healthcare professionals and patients. As the healthcare profession deals with combating illness and improving one’s life, they have to work in accordance with the ethical principles. As a ethical advisor, I witnessed that non-adherence to these principles can have ethical implications like respect for autonomy, beneficence, justice and non-maleficence for the application of the recommendations. It is highly recommended that healthcare professionals and focused groups like patients have to understand the ethical implications and considerations required to implement effective communication. The communicator in this communication network has the ethical liability to provide effective information about the disease, treatment, management, prevention and health promotion with seeking of feedback from recipient to assess whether important messages are properly accepted and understood.
Healthcare professionals have the ethical obligation to respect for autonomy of patients where they have to seek informed consent regarding diagnostics, therapeutics and interventions. This explains that patients need to be informed about purpose and interventions in a respectful and proactive manner. According to Nursing and Midwifery Board of Australia (NMBA) They should employ simple and suitable language to make them informed and keeping in mind that communication acts as the main component for diagnosis and treatment. These ethical principles need to be applied in the healthcare system to avoid medical errors and ensure patient safety and positive health outcomes (Nursingmidwiferyboard.gov.au. 2017).
Justice is also an ethical principle that needs to be followed by the healthcare professionals that there should be fair and equal resource distribution and should have ethical decision-making. For the equality to healthcare services by users, the underlying ethical principle is justice that ensures to provide equity of care and services irrespective of caste, creed, religion or racial background. It is important there should be justified and ethical decision making that work for the benefit of the patients ensuring safety (Nursingmidwiferyboard.gov.au. 2017).
Non-malificence is also a guiding ethical principle that guides the healthcare organizations in exhibiting effective communication in medical and nursing care. It is defined as a way where one should be obliged to not inflict any intentional harm and provide clear and efficient communication in succinct language that is understood by the patients. The main focused group would be the patients who experience language barrier and do not understand English. The healthcare professionals should abide by ethical principles like there should be no harm and an act, which is intrinsically wrong, should not be practiced and should work to promote positive health outcomes for the service users. In this, it is recommended that proper information should be conveyed to the patient that is relevant to his or her treatment avoiding all unnecessary information (Nursingmidwiferyboard.gov.au. 2017).
Beneficence, the ethical principle is practiced in the health communication. The information should be gathered and provided to the recipient in a way where healthcare providers should avoid harm. They should remove harm and promote good by addressing the communication barriers and working in providing a collaborative care for the patients ensuring highest quality of care. When communication takes place in an efficient manner, healthcare providers reduces the gap for irrelevant information and issues of miscommunication among the conveyer and recipient (Nursingmidwiferyboard.gov.au. 2017). This promotes positive health and well-being of the patient as there is no scope for medical errors or hampering of patient safety. It is crucial that for providing health information among the providers and in between them and service users, accuracy, balance and completeness of information should be there to avoid missing of critical information and hampering patient safety. This is also crucial during patient handovers as there is involvement of responsibility and accountability of the healthcare providers as miscommunication can endanger patient’s safety and their adaptability to the illness, treatment and management of the disease. Although, it is challenging to implement communicational change in the organizations, it is important to address the communication barriers and promote efficient communication in the organization.
Effective communication is a crucial tool in healthcare that determines patient safety and medical error rates. Every piece of information need to be communicated efficiently to avoid communication gaps and ensure patient safety with positive health outcomes. Efficient communication with the patients helps to determine their needs and provide solutions in a proactive manner. Communication barriers like language is witnessed that hamper patient safety. There are ethical principles associated with communication that have an influence on risk and benefit in healthcare like respect for personal autonomy, non-maleficence, beneficence and justice. These have ethical implications on the communication and healthcare organization as a whole. Addressing these barriers and applying these ethical principles promotes positive health and well-being of the patient as there is no scope for medical errors or hampering of patient safety.
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