"I WILL" Principles for effective clinical communication.
First Principle: Intention to Pay Attention
The attitude of intention to pay attention enables you to put aside everything that is happening in your mind and focus on the patient’s narrative.
It shows to the patient that—
When you are present with an intention to pay attention, the patient feels safe and secure and want to share their true story with you. This will not only build rapport but also establishes humane connection with the patient.
Apply this principle of Intention to pay attention in clinical practice and reap the benefits.
Practise; Practise; Practise.
Being present with a welcoming attitude helps us (healthcare professionals) to establish and maintain humane connections with patients and families.
So, what do I mean by "Welcome?" Dictionary definition of Welcome is "accept gladly," "receive." In medical consultation, it takes the following forms:
I, therefore, request you to adopt the welcoming attitude when consulting with patients and their families.
W.A.I.T: Why Am I Talking (Adam Bryant)
W.A.I.T: Why Am I Tempted to Interrupt (Krishna Naineni)
Facilitation Strategies to encourage patients to expand their narrative
A: Ask Open Questions. May I request you to begin at the beginning and tell me all about ‘X’
E: Encourage. Tell me more. Uh, Uh. Go on. Anything else you want to add.
I: Invitational. Show that you are interested with your body language.
O: Observe. Observe patients’ facial expressions, body language, tone of voice etc.
U: Use Silence/Pause. Brief pause after patient finish talking shows that you’re not rushed. Ask questions like—
Can I pause little longer before I speak?
How can I hold silence longer than I normally would?
Importance of Clear Introduction in Clinical Practice
Clear introduction is essential for establishing rapport with patients and families. I cannot emphasize enough how important introduction is in healthcare. Common sense and thousands of years of our tradition tells that it is not only customary but also respectful to introduce and greet the other person when we first meet; in clinical practice, however, this behaviour is not consistent.
Why, I wonder? Whatever may be the reason(s), I am sure you agree with me that the current practice, of not introducing properly, cannot continue. As we are all serious and committed to improve relationships with patients, families and public--we must follow our traditional wisdom and start introducing clearly, whenever we consult with patients and families.
This small investment will yield you huge returns.
This simple act of kindness at the start of consultation shows that you care.
Yes, time and workload are the biggest challenges. It is likely that these challenges are here to stay.
I think we should be creative in the ways we can introduce to the patients. You may want to have a look at Glocal Academy Instagram page (@glocalacademyuk) where students are creating and posting innovative name badges as a means to enhance their introduction to patients.
As we are serious about enhancing healthcare communication, we need to practice introducing to patients.
Did you know that you could introduce effectively in just 5 seconds? That 5 seconds are the best investment a healthcare professional can make.
Be part of "I WILL" campaign. Always Introduce.
Listen to Understand (Author: Taranjot Kaur)
Listening is an active task, where one must club his ability to hear with a purpose to understand in order to establish a two-way communication. However, most of the times in the consultations rather than listening to understand, we listen to reply or to reach a diagnosis. Thus, jeopardizing the strength of the doctor-patient relationship.
Understanding is to realize what the other person feels and why does they feel that way. It is about empathizing. To understand one must listen to the unsaid. So, to understand what is not said listen to the gestures and the body language of the patient. Make an eye contact while talking, try picturing what they say. Before responding try repeating what they just said. Rather than interrupting, let them finish their narrative first and then ask the "right" questions. Be considerate and seek to relate to their emotions. Practice to perceive process and express simultaneously while listening to the patients. This way the patient will feel heard, seen, understood and satisfied.
Hence, rather than listening to just to reply, try “Listening to Understand.”
Questions to check whether you are listening:
Language (Author: Roshni Kharbanda)
We have limited time and we need to make it count. The patients might be feeling stressful and emotional when they approach us. Therefore, our aim should be to speak in a local language without using medical terms. Speaking in local language comforts patients and helps them to understand, absorb and remember better. We need them to understand our points, as much as we want to understand their perspective. Using medical jargon in our conversation with the patient will hamper the smooth process of understanding. On the contrary using simple words allows better understanding.
Key points to keep in mind while giving information to patients:
I encourage you to speak in a clear and simple language so that the patient and family understands. It is all about them; not about us.