Best Practices for Communication with Patients and One Another

Connect. Partner. Reflect.

While we all know CPR as the acro­nym for cardiopulmonary resuscitation, one CPR series means something quite different. At the Department of Service Excellence’s inaugural Patient Experience Grand Rounds last month, Lisa Allen, chief patient experience officer for Johns Hopkins Medicine, introduced how the Connect-Partner-Reflect model can im­prove our communication with patients and with one another.

“The Johns Hopkins Medicine name conveys high expectations,” she said. “Ex­pectations help shape experience, and ex­perience becomes a patient’s reality.” She explained that we all have a role to play in shaping the patient experience, from the moment patients check in for their appointment to the time of discharge.

“Connect” emphasizes introducing yourself and your role, asking patients and family members how they would like to be addressed, acknowledging patients medical history and encouraging them to use the communication board. “Partner” includes asking specific but open-ended questions, engaging the patient and their family members, and explaining concepts in writing or diagrams on the patient communication board. “Reflect” is an opportunity to summarize key points and ask for understanding, as well as to ask patients what they want to address before the next visit and to explain next steps.

Deborah Baker, senior vice president for nursing for the Johns Hopkins Health System, also moderated a panel discussion to discuss best practices for communicating with patients and their family members. Here are a few key takeaways from the conversation.

Be Present with Patients

Patients see health care workers at­tending to patient after patient, day and night. But they also expect to be the sole focus when it’s their turn to be seen. Pediatric surgeon Alejandro Garcia suggests that even if you only have a few minutes, ask the patient what their top concerns are at that moment, and be sure to address those concerns completely.

Be Present with One Another

Lisa Allen stressed that effective com­munication must happen always. James Ingram, assistant director of environ­mental care, agreed. “When we don’t speak the same language, we look disjointed and not cohesive,” he says. “Patients are listening and hear this dis­connect.” Ingram’s team holds huddles at the start of every shift to ensure that each housekeeper is fully armed with the information they need for the day.

Teach-Back Moments

After presenting new information, Deborah Baker encourages her nursing teams to employ a teach-back moment by asking a patient or caregiver to repeat back what was explained to ensure they understand. Nurse clinician Holley Farley employs a similar method using a patient’s communication board, first by walking patients through new informa­tion or a procedure, and then asking the patient or caregiver to retrace these steps.

Timing Is Everything

Make sure every member of the care team is in the loop. The start of the nursing shift is not the same as the start of the environmental care shift, but that shouldn’t prevent employees on either team from knowing the same informa­tion about patients. Holley Farley also suggests helping patients manage expec­tations: “Explain why a procedure can’t take place immediately, like if a special MRI is only available on Fridays and today is Tuesday.” Take a few minutes to arm the patient with information that may seem like common knowledge to health care workers.

Engage and Respect the Caregiver

After receiving an update from his care team, the first thing patient Larry Cohen will do is turn to his wife and ask, “Did you understand that?” His wife has served as his caregiver at every appointment and procedure throughout his cancer treatment. “Don’t just talk to the patient, talk to their caregiver,” Cohen says. “They are just as important, so treat them with the same respect as the patient.”