COMMUNICATION IN HEALTH AND SOCIAL CARE SETTING

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Introduction

Communication skills are the basis by which health and social care services are delivered (Corcoran (2007). Lack of proper communication skills such as those demonstrated by NHS in the in the medical research council report, about user complaint in NHS, May result to ineffective delivery of health and social care services. The aim of this essay is to understand chow communication can be effectively used in health and social care services to improve service and outcomes.

1.1Applications of relevant theories of Communication in health and social care setting

Suresh (2003) defines communication as the process of sharing information, ideas, feeling, suggestion are passed from one individual to another. There are several theories of communication, which tries to explain what communication is. These theories can be broadly classified under five categories i.e. structural and functional theories, cognitive and behaviors theories, interpretive theories, integrationist theories and critical theory (Suresh, 2003).

Theories of communication are very useful in health and social care practice. If well applied, they can result to effective communication, which in turn result to effective diagnosis and treatment. For example, application of social learning theory may help health practitioner improve their communication skills. According to social learning theory, people learn through observation, imitation and modeling (Rorke, 2005).This theory for instance, can be used to help Jessie’s doctor, who by his action demonstrates lack of proper communication skills, to acquire good one. He can be made to observe interaction between a skillful doctors and patients to learn the importance of effective communication in achieving better outcome. This would help him change his attitude, approach and conduct toward patients.

Another theory that can be applied is the Shannon- weaver model. According to this theory, communication system comprises of six important components, which are source, message, encoding, channel decoding and receiver. Source refers to the origin of the message. Message refers to the subject matter of the communication .encoding refers to the process of organizing the message in a way that make it easier to understand. Channel is the media of message transmission. Decoding is the process of analyzing the message with the aim of understanding the message and the receiver is the person to whom the message was direct. Failure or lack of one of these component result to ineffective communication (Suresh, 2003). In the hospital scenario, this theory would have help identify what was hindering the communication process. The nurse and the doctors inability to decode, Jessie’s message would have been avoided if a language interpreter was involved.

1.2Use of communication skills in health and social setting

Communication is widely used in health and social care setting. People use various communication techniques to pass their message. These techniques include verbal, non-verbal and written communication. For instance, in the hospital scenario all these techniques were used. Jessie used Verbal communication to seek help from her fellow Chinese. She also used non-verbal skill when she point her stomach to signal that something wrong. The nurse also used nonverbal skill. By starring and ignoring Jessie, she demonstrate uncaring attitude.

Communication skills play a very important role in health and social care setting. According to Corcoran (2007), communication skills are the basis in which effective diagnosis, treatment and health promotion take place. The exchange of information between health practitioner and patient and society is essential in achieving health and social care objective I.e. health and wellbeing. In health and social care setting, communication take place at individual level, organization level, community level. At individual level, communication is used for diagnosis, treatment, counseling, breaking bad news, educating, explaining treatment etc. At organizational level, communication is used for recording keeping; explain expectation, negotiating, team building, etc. At community level, communication is used to pass health messages to the community such as prevention of disease, public health warning, educating, advocacy etc (Corcoran 2007).

I have never thought about the usefulness of communication skills until recently when I was working as a volunteer in a health care facility in London. I was working alongside my colleague at the front desk. A service user who had some dissatisfaction with services provided had come to our desk to make complain. She was so unreasonable and demanding. My colleagues on realizing her demand were unreasonable started making an argument with her. Unfortunately, the communication changed it objective and it was now highly personalized with each accusing each other. I offered to help the service user once i realized my colleague was getting irritated by the words of the lady. By calmly listening to the lady and persuasively talking to her, it only took me few minutes to let her understand her demand were unreasonable. She walked out as happy customer and thanks me for letting her understand the real situation. Proper communication in this case, helped me solve service user dissatisfaction.

During that period as a volunteer I also used communication skills in other instance. For example I prepare letter and send them on behalf of care organization. I also prepared report such as number of inquiries made per day at the front desk, answering phone from customer, directing visitor to the right departments.etc

 

1.3 Method of dealing with inappropriate interpersonal communication in health and social care setting

In some cases, doctor, patient and social care worker may use inappropriate interpersonal communication. According to kragen (n.d)Inappropriate interpersonal skill refer to a communication that does not take into account the other persons background include sex, beliefs, religion, language etc. it involve the use of inappropriate language, breaching confidentially, use of insensitive comment, in appropriate use of power etc. The uses of inappropriate interpersonal communication not only affect the current communication but also the future communication between the individual involved. (Kragenn.d). In the hospital scenario, the doctor demonstrated the use of inappropriate communication when he used his power to dismiss Jessie out of the room. Also his comment “good gracious, not you again” to Jessie demonstrated his unwillingness to attend to her. The doctor also used his power to dominate the interaction; Jessie was given no attention to express herself. Generally, the whole communication process between Jessica and hospital staffs was inappropriate because the both doctor and nurse failure to recognize and respect the fact that Jessie was different from them.

Inappropriate communication such as that demonstrated in the hospital scenario can be avoided if the hospital had put in place proper communication system and policies. For example, the communication system in the hospital does not take into account differences in language, this lead to Jessie being humiliated. To avoid such situations, the hospital should use language interpreter, which can be either a person or software. By doing so, patients like Jessie, would easily communicate in their preferred language. In addition, the lack of proper communication skills between the hospital nurse and doctor can be dealt with through training, workshop, seminars etc. This would help them acquire proper skill as well as change their attitude, which were major hindrance to effective communication. Polices such as those against racism, sexism etc. Also need to be in place. Complaint polices can also help to the hospital in identifying uses of inappropriate communication.

 

1.4 uses of strategies to support health and social care user with special communication needs

Several strategies can be used to support people with special communication needs. People with special communication need include those who cannot speak local language, those with speech problem, those with hearing and vision impairment, among others (NHS choice, 2015). Several strategies are available to be used by to support these people. Tools and techniques are available to support these for effective communication.

One of special communication needs is language problem. Language problem arises where the patient is unable to speak the local language used in that specific region. People with language problem can be supported by the use of translator and interpreter or by use of an alternative language that both doctor and patient are familiar with (NHS choice, 2015). For example, in the hospital scenario, an interpreter could have helped improve the communication between Jessie and nurse and doctor. Speech problem is another common problem that affects communication. Speech disorder is mainly caused by cleft palate, brain injuries hearing loss, stammering etc. sign languages can be used to support people with speech disorder. Several sign languages can be used. They include MAKATON and BSL. MAKATON is a language program of using signs and symbols designed to support spoken language (MAKATON charity, 2015). British sign language (BSL) is a sign language that is used by deaf people in UK it involves the use of hand gesture and finger spelling to communicate (NHS choice, 2015). Speech and language therapy can also be used. Use sign language can also to communicate to people with hearing impairment. When communicating with people with vision impairment or low vision, Braille can be used. Braille is a tactical reading system that used to help blind and people with low vision to read.

Some people suffer from what is known as selective autism. Selective autism is an anxiety disorder, in which a person who normally has the ability to speak is unable to do so in certain environment or to certain people. the inability to express themselves can easily be deal by the use SOLER approach (sit alternatively at an angle, open posture, leaning forward, eye contact and relaxed body posture).this approach is a very effective strategy of making them feel relaxed and comfortable in sharing information.

2.1understand how various factor affect communication process in health and social care

Several factors affect the communication process. As discussed earlier in this essay, legislation is one of those factors. They put statutory obligation on the health practitioner on how to communicates, store information, share information electronically and access to information. In addition to legislation cultural plays a very big and important role in communication. As mention by Hall (1990), culture is in communication, communication is in culture, and the two can never be isolated from each other. According to Hofstede (1994), Culture refers to the set of belief, customs, value, and norms that are shared by a group of people. Culture is a very powerful factor that determines how we see ourselves and other, how we choose to communicate, and the way we interact we the world around us. (Fay, 2000). When two people interact with each other their culture background, play very important part in determining and shaping their interaction more specifically their communication. Failure to understand the other person cultural may lead to miscommunication (Hofstede 1994) .for instance, Jessie and the hospital staffs failure to have good communication between them because of culture difference. According to Barnlund (1994), culture exists to give meaning to symbols and sign of communication. Similar view is expressed by (Fay, 2000), who noted that Culture give meaning to words and the whole communication. It is the difference in meaning rather that the differences in vocabulary that lead to miscommunication. The use of non-verbal skills as noted by Hall (1990) is one area of the communication that is influenced by culture. The same body expression or language may carry different meaning in different culture.

The key factor in eliminating miscommunication resulting from culture difference as noted by Barnlund (1994) is being culturally competent. Culture competency refer to the ability to identify other people culture assumption, being sensitive to them and responding in a way that does not violated them. When we see communication from other people point of view, our understanding of the message is improved

2.2 The impact of legislation, code of practice and charter on communication in health and social care setting

Communications in health and social care does not take place in a vacuum. Several laws, NHS code of practice and charter do affect it. The main aim of laws is to protect patient and promote good practice. The existence of laws and code of practice has help in achieving patient doctor confidentiality. Laws that have affect communication in healthcare setting include Data protection act 1998, equality act 2010, and anti- discrimination act. Data protection act 1998 requires protection of patient information. Patient information should never be used for purpose such as marketing or research without the patient information. The Acts also give right of access to the patient. Patient can access their information at any time. It also gives patient rights to change some of the information especially the identification one such as residences; next of kin etc. giving a third party access to patient data is also prohibited. Anti-discrimination laws also have affected communication. This law prohibits any form of discrimination on ground such as race, sex, disability; religious etc. health and social worker are therefore under statutory obligation to refrain from engaging in communication with patients, which may promote racism, sexism, or those, insensitive to disabled person. The NHS code of conduct is a powerful tool for regulating behavior of the health and social care worker. The code has some section, which relates top communication in health and social care setting. It requires doctor and other health staff to maintain doctor patient confidentiality. Health and social care worker are also required to observe patient privacy, and interact with them in a way that respect them and preserve their dignity.

2.3The effectiveness of organizational systems and policies in promoting good practices in communication

According to Jone and Barret (N.d), the relations between good communication practice and quality service is very strong. It is therefore very important to have organization policies that promote good communication practice. As mention by Jha (2010), the use of policies in health and social care setting is very important in promoting good communication practice. They are very instrumental in building the key components of good communication which include trust, confidentiality, respect and mutual understanding between patient and health worker. As mentioned by Thompson et al (2011) organization policy help remove communication barriers. For example, policy that clearly state the channel of communication to be used in a given environment may help break barrier associated with the choice of communication media. Communication policy such as those prohibiting racism, sexism and any other form of discrimination help an organization to serve people of diverse background.

System especially the use of ICT in health and social care setting, has been very effective in improve services delivery. ICT has been very instrumental especially in storing, retrieving, accessing and disseminating information. Fast and accuracy are the two major benefits the use of computer has on communication. This in turn has led to delivery of high quality services (Guttmann, 2010)

3.1 How to improve communication in healthcare setting

As already seen in this essay, communication is very essential in delivery of health and social care services. Care organization should therefore make sure good communication is in place. As noted by (Suresh 2013), Communication is a process that comprises six elements, which are sender, message, encoding, channels decoding, receiver and feedback. Failure or inability of any of this component led to communication breaks down. Care organization ensure all the components of communication are competent by training their worker on keys communication skills include active listening, cultural competency, critical thinking, writing, message presentation etc. Choosing the rights channel of communication is also paramount. Channels that are accommodate communication need of patients with varying characteristic such as age, cultural background; literacy level should be adopted to make it easier for every patient to communicate. Additionally, organization should make good use assistive tools and aids to support to meet the communication need of people with special communication need.

Good communication practice can also be achieved by hiring the right people. Communication skills should be one of the criteria used to select candidates. Finally, good communication practice can also be encouraged through reward and punishment. Good practice should be recognized and rewarded. For example, when effecting promotion, people who have demonstrated good communication should be given priorities.

3.2. Standard ICT packages to support work in health and social care

There are several standard ICT package available to support work in health and social care setting. This package service health and social care need such as information gathering, record keeping, billing, and communication among other. Example of these software include word processing for making electronic copies document such as letters, contract, agreement etc. spreadsheet program are also available for easier calculation of figure. It can be very helpful especially in calculating cost per patient/ billing. Database program such as Microsoft access are easily accessible. They can be very useful in data storage. Accounting soft ware’s are also easily accessible and are very easy to use. In addition, other standard software packages enable video and web conferencing (Guttmann, 2010). For example, Face book video chat and Email services are easily accessible to transmit information online.

As a volunteer in one of the health care facilities in London, my job entailed drafting letters, prepare contract document, and capturing patients’ data from forms for electronic storage. I used word processing such as one shown below to carry out this function. The software made my work very easier and faster. It could clearly highlights words that are misspelled or where I have used incorrect grammar. It also provided suggestion of what should be done to correct those errors. Not only that the software helped me capture and prepare more document but it also help me prepare document with professional touch as spelling mistake and grammar were easily corrected

Figure 1.word processing software

 

(Source: sourceforge.net)

3.3Benefits of ICT in health and social care for users of services, care workers, and care organizations

The use of ICT in health and social care setting has benefit services users, care organization and the care organization. As note by Guttmann (2010), ICT has made it easier to store, retrieve, process and pass patient information more quickly and accurately. In turn, this result to quality services. Unlike the paper system, ICT has helped patient to receive the health and social care service quickly than ever before. For example, a previous discharged patient, who has returned to seek health care services, may be easily identified and his or her record quickly retrieved. It has also made self-help approach a reality. For example through the patient portal, a patient can easily access information and professional help to manage her /his condition.

Care worker has also benefit from ICT. It has eliminated paper work, which was tedious. In additional, it has provided them with a platform to share, seek and give professional advices, information, tips etc. As noted by Guttmann (2010), the internet has proved to be a very useful source of information for doctors and social worker. When in doubt, internet helps them clear out these doubts. In addition, ICT has made administration work more effective and efficient. It has also enabled processing and producing information in a form suitable for making decision. This has helped, not only the care worker but the also the care organization in making informed decision.

 

The use of ICT eliminates the need for paper work .This save the care organization money, and space. It also helps the organization to deliver quality services to its clients/patient. This result to increased customer satisfaction and reduced complains (Guttmann, 2010)

In conclusion, ICT has increased access to accurate and relevant information for care worker, fast and improved service to patient and financial saving and quality service delivery to care organization.

3.4 Legal consideration in the use of ICT in health care

Several legal considerations must be taken into account when using ICT in health and social care. These considerations include confidentiality of patient information, unauthorized access and the healthy and safety in the use of ICT. The data protection act 1998 requires, patient information to be safely kept and should not be accessed by any third party without the patients consent. The use of ICT bring with it some challenges when it comes to data safety. Care should therefore be taken to ensure that, patient information remain confidential. The use of password encryption can be used to prevent unauthorized access to information. The occupation healthy and safety Act 1974 requires the organization to protect their worker from health and safety risk in their organization. The use of ICT has been associated by some health and safety risk such as visual problem, hearing problem and stress (Bernardo, 2008)). Measure should therefore be put in place to ensure the ICT does not pose any safety or health risk to worker as well as users.

Conclusion

Communication in health and social care is not only important but also essential. Without communication, the delivery of health and social care services would be impossible. Poor communication system in health care may lead to inequality in access of services. It is therefore important to put system and organization policies in place to promote good communication practice. The communication system including policies should also address the communication need for people with special needs.

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