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Interactive Practice, and Then More Practice

The science of medicine is never static. Thus, Healthcare providers are challenged constantly to adopt and integrate new procedures, new protocols, new devices, and new technologies into their service offerings. To do so, staff continuously must perfect additional skills.  Thus, organizations offer internal educational programs – think “in service” sessions. Or employees seek out continuing education workshops or seminars offered by licensing boards or professional associations.

For clinical skills, typically the format follows what is used in medical and nursing schools – explain the theory, demonstrate the proper procedure and then send students off to practice on a simulator, or at times, on a real patient. “Only practice makes perfect” as the saying goes.

But acquiring or enhancing communication skills is typically less refined. Why should that be when research conducted during the 10 year period of 1995-2005 has demonstrated that ineffective team communication is the root cause for nearly 66 percent of all medical errors during that period?*

Most healthcare organizations do insist on specific models of language to be used in a pre-defined situation, such as SBAR  (Situation – Background – Assessment – Recommendation), a format used in daily interactions between nurses and physicians. SBAR creates a shared mental model for effective information transfer by providing a standardized structure for concise, factual communications.

But using communication models for dealing with day-to-day conflicts caused by differences in technical styles or approaches,  as well as personality differences between staff members, is still rare in healthcare. Organizations assume that their staff consists of learned professionals who will creatively resolve conflicts in a “mature” manner. However, dealing with conflict is never easy. Since a vast majority of adults learned to behave in difficult situations by modeling adult role models with varying degree of conflict management skills, there is no guarantee that staff members can navigate these situations to a healthy conclusion on a consistent basis.

“What You Permit, You Promote”  Over the past decade, we have seen a significant increase in incidences of uncivil or disruptive behaviors in the general population, at times a result of unresolved conflict, other times simply a demonstration of a tolerance of “bad manners.”  For Healthcare, this trend is not just an annoyance – it’s a matter of safety for both patients and staff.   According to the Joint Commission, disruptive behaviors threaten a culture of safety. Unfortunately, many factors can stand in the way of having the right words, tone and approach needed to create an environment where aggressive language and behaviors are not used to achieve a goal or “win” a conflict.

Best Practice: Communication Model.  Without a communication model for dealing with incidents of incivility, an organization cannot be certain of a uniform, effective approach for dealing with such behavior. And as Management guru Stephen Covey concluded, “We cannot think our way out of situations we have behaved our way into.”  So this communication model has to be explained and demonstrated, but most importantly practiced in a safe environment for the approach to become ingrained as part of the culture, actually sifting the culture to one of greater safety in most instances.

Awareness comes first. Civility training must help staff appreciate the severity of allowing disruptive behaviors to continue.  Does everyone know which behaviors are classified as disruptive and why? Do they recognize these behaviors when they see an incident? Are they aware of the negative implications, some life-threatening, of allowing incivility to fester throughout the healthcare system? Are there simple approaches that can be used to resolve conflict with a team member who has a different conflict style so to avoid the rise of uncivil behavior? Explaining the theory and gaining appreciation for the serious consequences of the status quo is the first step.

Practice Makes Perfect. The next step is providing a format that assures everyone is speaking a recognizable language and allows interactions without escalating a conflict.  This communication model must be easy to remember and have a degree of flexibility so to adapt to circumstances.  Once the model is understood, practice becomes the key. Staff must practice both interactively with colleagues in a safe environment and privately using a video training simulation that gives non-judgmental feedback as to words, tone and body language. It takes time and effort to shift thinking and behavior.

Once engrained, these newly acquired skills not only create a foundation for an organizational shift that embraces safety and respect throughout the healthcare system but also give staff members tools they can use to their advantage in other areas of their lives – an added employee benefit without additional impact to the bottom line.

Resource: Impact of Communication in Healthcare – Institute for Healthcare Communication.org/About Us