HealthCare Communication: The Cornerstone of Quality
Dr. Alexander Thomas is a Founder-Member and the Executive Director of the Association of Healthcare Providers of India (AHPI), President of the Association of National Board Accredited Institutions (ANBAI), President of the Consortium of Accredited Healthcare Organisations (CAHO), Consultant to the World Bank and Member-Secretary of the Task Force on Policy on Public Health, Govt. of Karnataka.
Divya Alexander is co-author and a research associate.
The author talks about on how an innovation in communication training started a revolutionary healthcare communication movement across the country
The Bangalore Baptist Hospital (BBH) is a 300-bedded mission hospital in Bangalore, India. After many years of holding soft-skills training to help its employees communicate better, both with each other and with patients, it became obvious that the skills imparted in these expensive sessions were forgotten in a few weeks. Many inter-departmental and patient-related incidents took place due to lack of proper communication, greatly impacting the quality of care being delivered by the institution.
It was realized that the situation begged the adoption of a sustainable, cost-effective model based on building expertise and experience in hospital staff. In a healthcare context, no communication training is provided as a part of the curriculum in most medical, nursing or allied healthcare education programs. Therefore, it was decided that it was time for an innovation to fill this niche. A team was deputed from the hospital to work with communication experts to develop a training program specifically for the healthcare context.
A team from the Mudra Institute of Communication, Ahmedabad (MICA) with Professor Nagesh Rao, worked with a team from BBH to research on the impact that communication could have on the quality of care provided by a hospital. First, a one-day needs’ assessment was conducted by speaking with BBH doctors, nurses, pharmacists, chaplains, security guards and many other staff members. Second, a train-the-trainer communications training program was designed for BBH – an intensive, two-day seminar for 20 participants from BBH – administrators, senior physicians and nurses, pharmacists, chaplains, customer care personnel et al. At the end of the seminar, each participant was given the task of creating a specific training program for their respective groups – doctors training doctors, nurses training nurses and so on. After a few weeks, this training design was reviewed before being implemented. As with any new initiative, implementation was not easy. However, eventually, all the hospital employees were trained, and the impact was eye opening! The staff felt empowered; there was much less interpersonal conflict; and, most importantly, patient satisfaction had improved (graphs below*).
* “Attitude” refers to the general demeanour of the healthcare professional while interacting with the patient. “Explanation” refers to the way they imparted medical advice regarding the patient’s diagnosis and treatment.
These results were very encouraging. It was apparent that this model could be replicated in other hospitals, so the next step was to disseminate the information for other healthcare institutions to use.
The modules of the training workshop were collected and synthesized into a volume titled Communicate. Care. Cure. A Guide to Healthcare Communication. Before 2012, there was no single publication in India on the role of effective communication for patients, healthcare providers and healthcare administrators. This book aimed to be that publication, capturing the experiences of the different stakeholders involved. It was an immediate success, leading to the publication of a second edition in 2014. The second edition has 14 chapters dealing with all aspects of healthcare communication. Copies have been distributed widely, both in India and internationally.
National Communication Workshops
This has mushroomed into a dynamic healthcare communication movement in the country in the form of national training workshops. Building on the success of the book, BBH partnered with the Consortium of Accredited Healthcare Organisations (CAHO) to train hundreds of master trainers from all over the country, who, in turn, trained professionals within their institutions in effective healthcare communication. More workshops have been facilitated abroad through CAHO.
After the success of the national workshops, an e-learning course titled Communication for Better Healing was developed in partnership with CAHO and Wolters Kluwer India, leading publishing and health information services company. This e-learning course, based on the book, is the next step in meeting the urgent need for increased awareness of healthcare communication. Offering practical solutions to communication issues in healthcare environments, it addresses the challenges faced by the patient, the patient’s family, the healthcare providers, the healthcare administrators and the support staff. Each module or chapter is replete with examples from the healthcare setting, brought to life through videos and animations. There are assessments at the end of each module to test the user’s understanding of the course concepts and to demonstrate their application.
Endorsed by the National Accreditation Board for Hospitals and Healthcare Organizations (NABH) and the National Board of Examinations, the book and training workshops are also recommended by the Nursing Council of India, the Association of Healthcare Providers of India, and the Government of Karnataka, among others. This communication movement has been recognized nationally and has received the prestigious Quality Council of India-DL Shah Awards for Excellence in Healthcare for two consecutive years (2013 and 2014).