Using communication to improve patient safety

Most of the safer patients initiative's work on communications focuses on clinicians, but the lessons we draw from this are just as applicable to managers seeking to influence policy makers.

Good communication between patients and staff at all levels is particularly important if a patient's condition begins to deteriorate. Early detection and prompt and clear communication of the situation are necessary to save lives.

In a recent conversation, Julie Smith, head of nursing for the medical directorate at North East Wales trust, pinpointed differing communication styles as the root cause of miscommunication between staff.

In situations where patients' lives are at stake, this can become a critical obstacle to effective and safe care.

The safer patients initiative is training nurses, doctors and physiotherapists in North East Wales trust and 19 other hospitals across the UK to use a communication tool to help them overcome their differing communication styles.

The Situation – Background - Assessment – Recommendation (SBAR) tool acts as a reminder to health professionals to describe the situation, the background, their assessment and their recommendation. The tool gives a structured format that allows essential patient information to be clearly communicated and then questioned by the listener, with the end result of the conversation being a decision on the best course of action. It can be used when communicating in person, over the phone or even online.

Management applications

The principles of the tool were adapted successfully from the military to the NHS, and they could also be adapted for health service management.

In the face of rapid change, managers need to communicate numerous issues to people with influence. There are many opportunities to communicate with policy makers. Unfortunately, unlike the participants in the safer patients initiative, we are unlikely to find ourselves in a position where we can train policy makers to improve their communication with us.

Managers need to communicate in a way that gives them the best chance of being listened to and understood.

The SBAR tool can help managers structure their communication. Here are five golden rules managers should consider when seeking to communicate effectively with those in positions of influence:

• Timing - if you have the luxury of choosing your moment, do so carefully.

• Target - choose the person or organisation with whom you want to communicate based on an assessment of who has the power to carry out your recommendations and to whom you can gain access.

• Clarity - communicate clearly and simply, bearing in mind that the recipient may not share your knowledge or experience. Make it clear what action you would like to be taken.

• Evidence - where possible, ensure your messages are supported by evidence so they are difficult to dispute.

• Repeat - be prepared to repeat yourself and, while making necessary adaptations to the method of communication, continue doing so with determination.

By adapting techniques used by clinicians in the safer patients initiative, managers hold the power to strengthen their influence over the health service's policy makers.