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Effective Communication Among Hospice Doctors and Nurses


Effective communication among hospice doctors and nurses is a key factor towards the actualization of quality medical services to patients. However, poor communication strategies and channels among health care providers is a major challenge in the 21st century healthcare system. Thompson et al (2003) argues that the eighth cause of deaths among patients is preventable healthcare errors. Thomson et al (2003) also argues that lack of an effective communication channel between the healthcare providers is one of the major contributors to preventive medical errors. This therefore compromises on the quality of medical services that patients are entitled to as outline in the six aims of the IOMs health care report.

Aims of IOM

According to Ulmer (2010), due to a concern on the level of healthcare services provided for patients, the quality chasm report recommended the adoption of the six IOM aims. With reference to ensuring an effective communication channel among medical practitioners it is important to understand the implication of poor communication strategies on the six IOMs aims.

Firstly, IOM advocates for patients safety while undergoing any medical treatment. With an effective communication strategy, it is possible to ensure the patient’s safety through following a clear cut communication channel with respect to the client’s issues. Secondly, IOMs also recommends the effective use of scientific knowledge in order to provide quality medical services. The importance of communication strategies in this particular aim is to ensure that the patient is adequately directed to practitioners that can deal with their issues diligently and based on their specialty. Thirdly, another important aim of IOM is the need to properly manage the patient and the medical practitioner’s time in order to ensure that delays are avoided. This also calls for timely communication of emerging issues and ideas that are relevant to the patient well being (Ulmer, 2010).

IOMS also advocates for a patient centered system that caters for the patience needs, values and preferences. To be able to pass down such critical information it is important to come up with an effective communication channel. IOMs recommendations also include efficiency which is a very crucial aspect of medical care because it strives to ensure that resources and ideas are channeled to the appropriate course. Effective communication ensures the proper allocation of resources and flow of ideas among the medical practitioners for the benefit of the patient. According to Ray (2005) this ensures that all the parties involved in the dissemination of medical services play their roles appropriately.

The last aim of IOMs requires that the medical services system ensures equality in terms of service provision. This aim strives to eliminate discrimination by way of race, gender or economic status. By employing an effective communication channel among the hospice care givers, the hospice will be at a position to ensure that protocols and laws with regards to quality medical services provision are communicated to and adhered to thus preventing such cases of discrimination occurring among the medical practitioners or any form of discrimination directed to the patients.

Background information

Quaglini et al () defines communication as a means through which people share their perspectives about issues or ideas to the world. He further asserts that the ability to communicate is one of the major achievements that any intelligent practitioner can utilize to ensure quality services to their clients. He also asserts that the benefits acquired through effective communication channels are determined by the individuals conversing and the environment within which the information is being conveyed.

Therefore, developing an organizational culture that allows for swift ways of communicating among the medical care givers and other professionals in the medical sector plays a lot of emphasis on the level of services rendered to the patients.

Ray (2010) reports that the level of communication that takes place between the doctors and nurses has a bearing on the nature of prognosis prescribed to the patient and the necessary treatment measures that must be communicated between all the respondents that attend to particular patient issues. This is so especially when the patient has more than one medical issue that needs to be attended to.

Therefore wrong prescription or lack of monitored medical treatment that is associated with communication breakdown between the health care practitioners affects the quality of medical services provided to patients. Coombs (2004) reports that communication breakdown between doctors and nurse are a common challenge that occurs in medical centers. He further reports that such issues arise from preventable conflicts that are caused by lack of adherence to the medical hierarchical systems, power issues and gender issues. Paul (1990) asserts that the gap between primary health and secondary health care givers has widened through time especially with the inclusion of part time jobs for doctors and nurses as opposed to the rather traditional practice in medicine where most health care givers were employed on fulltime basis. Thus strengthening working relations and communication strategies.

Poor communication channels or the lack of an efficient communication system is a breach on the level of medical care quality rendered to patients in the sense that it can lead to improper prognosis and treatment of a patient leading to the recurrence of the medical problem, emergence of new medical issues or the fatal death of a patient. To measure the effectiveness of a communication channel, various authors have come up with assessments tools that assess the level of communication between members of a medical team. Such tools include the use of communication skills check lists that measure the degree and level of consultations that occur between members of a medical team and, interpersonal rating forms that seek to understand the level of interpersonal formal and informal conversations (Jasper & Jumaa, 2005).

Some of the costs to be incurred while accessing the communication strategies include: the amount of money to be spent in administering the assessment strategies, the amount of time incurred while conducting the activity and the amount of money required in accessing the effectiveness of the already identified communication strategies (Caywood, 1997).

Application of 5ps outcomes and performance measures

The 5ps framework is a structured application that strives to ensure that the group members and consequently the medical team working within an identified hospice work towards actualizing a new organizational culture that clearly identifies their roles and input in the medical practice. With reference to this study, the 5ps program will work to ensure that an effective communication channel is established among the team players in order to improve on the quality of medical services provided to the patients and thus avoid preventable medical errors.

The framework while include an outlined purpose that is patient centered in order to provide the best possible patient services that the hospice can afford. The framework will also cater for the needs of the various types of patients such as post partum patients, newborns and antepartums patients and the outlined roles of the various homecare givers that are to interact with the patient groups identified. The involvement of professional practitioners such as physicians, social workers, translators and lab technicians will also be vital towards the dissemination of scientifically based medical practices that are in accordance with the IOMs aims outlined earlier.

Another vital element of the framework will include the inclusion of rigorous processes that cover all the aspects of the care giving system. Such include; a process that assess the needs of all the clients that visit the hospice, the problems associated with each prognosis that is to be attended to at the hospice such as newborns complications and the eventual treatment plans with distinct specialized individuals who are to oversee the treatment plans. Further, within the treatment processes, it will be vital to include a follow up plan that is centered on ensuring that the patients are recuperating as anticipated and that post treatment complaints are attended to promptly.

To further emphasis on quality medical services provision to patients, it will be vital to include measurable patterns in to the framework. The purpose of such a pattern is to ensure patients safety, risks assessments and projections, the functioning process of the hospice, leadership patterns and organizational cultures that ensure every aspect of a treatment procedure is communicated effectively to both the patient and the entire medical team that is dealing with the patient in question(Ray 2005).

As Ray & Donohew (1989) make us understand, communication is key between a physician and his/ her patient, when one is not able to express their feelings or wishes, it becomes very hard for the other party to understand or even know what to do. The main problem on the doctor’s side is the fact that they have so many concerns but very minimal information regarding the issue. This is an issue that all the resident doctors are supposed to address regularly and also to introduce to the younger doctors but they never do until a serious issue arises. Now the older physicians sat together and decided to meet weekly to discuss the real ethical issues they had noted within the week so they could be able to counteract the main areas of concern. Counseling is also one of the main actions being applied in a medical setup to ensure that each of the physicians especially those new in the field are able to deal with their own issues before handling patients and also they are able to discuss the issue they encounter in their day to day practice as physicians. They also arrange for counseling sessions for some patient who seen distressed so as to ensure they are able to express themselves to a physician.

The physicians have also formulated avenues for healthcare providers to interact and be able to share their experiences such as self-help groups which help the health providers as individuals and also help improve the quality of their healthcare provision In most cases, patients have perceived doctors as bad news providers and this is a problem caused by communication, the way they deliver news to the patients. This is mostly learnt by the interns or new residents from those older in practice. This in most case causes the clients receiving the bad news to seek for second opinions and live to tell it, while the physicians never in most instances get to hear about nice ways of bad news delivery for the clients stuck to their physicians (Ray 2005).

Basically as many physicians have confessed, the many sessions that they took in school learning about formal ethics in medical practice were not so much helpful or applicable in the field. They require more facilitation with the residents who have a lot of field experience because it ended up being so frustrating for most of them (Ray, 2005). This is also evident in the power and conflict management between the doctors and nurses and how it is handled, it always differs from one institution to the next and at times it is a major problem. This provides the need for further trainings on conflict management and administration.


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Caywood, C. (1997). The handbook of strategic public relations & integrated communications. New York. McGraw- Hill.

Coombs, M. (2004). Power and conflict between doctors and nurses: breaking through the inner circle in clinical care. London: Routledge.

Paul, D (1990). Health, Culture and Community: Case Studies of Public Reactions to Health programs. New York: Sage foundation.

Ray E. B. (2005). Health Communication in Practice: A case study Approach. : New Jersey: Lawrence Erlbaun Associates inc.

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