4-1 © 2009 The McGraw-Hill Companies, Inc. All rights reserved Communication with Patients, Families, and Coworkers PowerPoint® presentation to accompany:

4-1

© 2009 The McGraw-Hill Companies, Inc. All rights reserved

Communication with Patients, Communication with Patients, Families, and CoworkersFamilies, and Coworkers

PowerPoint® presentation to accompany:

Medical AssistingThird Edition

Booth, Whicker, Wyman, Pugh, Thompson

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4.1 Identify elements of the communication circle.

4.2 Understand and define the developmental stages of the life cycle.

4.3 Give examples of positive and negative communication.

Learning Outcomes

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4.4 List ways to improve listening and interpersonal skills.

4.5 Explain the difference between assertiveness and aggressiveness.

4.6 Give examples of effective communication strategies with patients in special circumstances.

Learning Outcomes (cont.)

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4.7 Discuss ways to establish positive communication with coworkers and management.

4.8 Describe how the office policy and procedures manual are used as a communication tool in the medical office.


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4.9 Describe community resources and how they enhance the services provided by your office.

4.10 Explain how stress relates to communication and identify strategies to reduce stress.


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Introduction

Medical assistants must Recognize human

behaviors Communicate effectively,

with professionalism and diplomacy

Recognize obstacles that affect therapeutic communication

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Communicating with Patients and Families You are the key communicator between the

physician and patient

Your interaction sets the tone for the office visit

Developing strong communication skills is just as important as mastering administrative and clinical skills

Communication will influence how comfortable the patient feels in your practice.

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Communicating with Patients and Families (cont.)

Customer service Most important part of

communication

Two points fundamental to customer service The patient comes first Patient needs are satisfied

Patients are #1!

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Communicating with Patients and Families (cont.)

Examples of customer service Telephone techniques

Writing or responding to telephone messages

Explaining procedures to patients

Assisting with billing issues

Creating a warm and reassuring environment

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Apply Your Knowledge

What are the two key parts of customer service?

ANSWER: The two fundamental parts of customer service are that the patient comes first and you must satisfy patient needs.

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The Communication Circle

The communication cycle involves an exchange of messages through verbal and nonverbal means.

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Communication Process

Patients often believe that health care has become impersonal due to Technological advances Managed care organizations

Maintain a patient-centered approach

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What are the three elements of the communication circle?

ANSWER: The three elements of the communication circle are the message, source, and receiver.

RIGHT!

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Human Behavior: Stages of the Life Cycle

Understanding growth and development enhances communication skills Physical development Psychological growth

Guidelines for communication based on developmental stage Infant Toddler Preschooler School age Adolescence Young, middle, old

adult

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Maslow’s Hierarchy of Human Needs

Self-Actualization

Esteem Needs

Love Needs

Physiological Needs

Deficiency Needs

Safety Needs

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You can communicate with all people in the same way. Is this statement true or false, and why?ANSWER: The statement is false. Not all people are at the same place on Maslow’s hierarchy of human needs. To communicate effectively with a person, you need to understand what he or she is deficient in. For example, you would use different communication styles when talking to a homeless person who may have psychological and safety needs than when talking to an elderly person who is lonely and depressed due to the recent loss his or her spouse.

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Types of Communication

Positive or negative

Verbal or non-verbal

Written (Chapter 7)

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Positive Communication

Communication promotes the patient’s comfort and well-being

Set the stage for positive communication

Encourage patients to ask questions

Speak slowly and clearly

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Negative Communication

Curb negative communication habits Mumbling Speaking brusquely Avoiding eye contact Interrupting patients as they speak Rushing explanations Forgetting common courtesies Showing boredom Treating the patient impersonally

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Body Language

Facial expression Eye contact Posture

Open Closed

Touch Personal space

In many instances, people’s body language conveys their true feelings, even when their words may say otherwise.

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Mr. Garcia comes to the desk to check in and asks if he will be seen on time. The receptionist continues with her paperwork, points to the sign-in sheet, and tells Mr. Garcia: “Just sign in. The doctor will be with you when he can.” Explain why this is an example of negative communication.

ANSWER: This is an example of negative communication because the clerk

• Did not stop what he or she was doing – was not friendly or attentive

• Did not greet Mr. Garcia or make eye contact with him

• Did not give a satisfactory answer to Mr. Garcia’s question

• Did not make sure Mr. Garcia understood when he would be seen

YEA!

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Improving Communication Skills

Listening skills Passive listening

Active listening Improve listening skills

Prepare to listen

Relax and listen attentively

Maintain eye contact

Maintain personal space

Think before you

respond

Provide feedback

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Improving Communication Skills (cont.)

Interpersonal skills Warmth and

friendliness Empathy Respect Genuineness Openness Consideration and sensitivity

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Therapeutic Communication

The ability to communicate with patients In terms they can understand So they feel at ease and comfortable

The ability to communicate with other members of the health-care team Technical terms Appropriate to the health-care setting

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Therapeutic Communication (cont.)

Involves Silence

Accepting

Giving recognition

Offering self

Giving a broad opening

Offering general leads

Making observations

Encouraging communication

Mirroring Reflecting Focusing Exploring Clarifying Summarizing

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Ineffective Therapeutic Communication

Roadblocks Reassuring Giving approval Disapproving Agreeing/

disagreeing Advising

Probing Defending Requesting an

explanation Minimizing feelings Making stereotyped

comments

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Defense Mechanisms

Unconscious, designed to protect self

Patients may display Compensation Denial Displacement Dissociation Identification Introjection Projection

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Assertiveness Skills

Assertive – people who are firm and stand by principles while still showing respect for others Requires

Openness Honesty Directness

Aggressive – people who try to impose their position on others or try to manipulate them

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What is the difference between being aggressive and being assertive?

ANSWER: Assertiveness means standing by your principles while showing respect for others. You trust your instincts, feelings, and opinions and act on them. An aggressive person tries to impose his or her own position on others or tries to manipulate them. He or she is bossy, may be quarrelsome, and does not consider others’ feelings, needs, thoughts, ideas, or opinions.

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Communication in Special Circumstances

Anxious patient Can interfere in communication process

May not listen well or pay attention to what you are saying

Observe for Tense appearance Increased blood pressure and breathing Sweaty palms Irritability and agitation

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Angry Patient

Recognize anger and its cause Remain calm and demonstrate

respect Focus on physical and medical

needs Maintain adequate personal

space Do not take anger personally

Ask patient to be specific concerning cause

Present your point of view Avoid breakdown of

communication Leave if you feel physically

threatened

Goal is to help the patient express anger constructively Steps in communicating with an angry patient

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Patients from Other Cultures

Each patient has his or her own behaviors, traditions and values Strive to understand and be tolerant

Stereotyping Negative statement about specific traits of a group

applied to an entire population Generalization

Statement about common trends within a group

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Patients from Other Cultures (cont.)

Attitudes about health care

Beliefs about causes of illness

Symptoms and what they mean

Treatment expectations

Language barriers

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Patients with Visual Impairment

Use large-print materials

Use adequate lighting in all areas

Use a normal speaking voice

Talk directly and honestly

Do not talk down to the patient

Preserve the patient’s dignity

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Patients with Hearing Impairment

Find a quiet area to talk

Minimize background noise

Position yourself close to and facing the patient

Speak slowly

Remember that elderly patients lose the ability to hear high-pitched sounds first

Verify understanding

Use written material

Speak clearly but do not shout

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Mentally or Emotionally Disturbed

Determine what level of communication the patient can understand

Suggestions Remain calm if the patient

becomes agitated or confused Avoid raising your voice Avoid appearing impatient

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The Elderly Patient

Be respectful

Do not talk down to elderly person

Tips for communication Act as if you expect the patient to

understand Respond calmly to any confusion Tell the truth and use simple questions and terms Ask the patient to relax, speak slowly, and ask the patient to

repeat if you do not understand

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Terminally Ill Patients Often under extreme

stress, so offer support and empathy

Kubler-Ross’s Stages of Dying Denial Anger Bargaining Depression Acceptance

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Young Patients and Their Parents Recognize and accept their

fear and anxiety Explain all procedures Use praise Do not tell children that a procedure will not

hurt if it will, or you will lose their trust Reassuring and keeping parents calm will also

help the child relax

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Patients with AIDS/HIV Stigma of disease

Guilt Anger Depression

You must have accurate information about the disease and the risks involved to answer the patient’s questions

Patients need human contact and to be treated with dignity

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Patient’s Family and Friends Provide emotional support to the patient

Acknowledge family members and friends

Keep them informed about patient’s progress

Remember to protect patient confidentiality Ask the patient what information can be given to

family or friends.

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What can you do to promote communication with someone who is visually impaired?

ANSWER: Use large-print materials, adequate lighting in all areas, and a normal speaking voice. Talk directly and honestly, but do not talk down to the patient; preserve the patient’s dignity.

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Communication with Coworkers Develop rapport with

coworkers

Rules for the medical office Use proper channels

Have a proper attitude

Plan an appropriate time for communication

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Communicating with Management

Keep supervisor informed

Ask questions

Minimize interruptions

Show initiative

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Dealing with Conflict Do not “feed into” others’

negative attitudes

Be personable and supportive

Refrain from passing judgments

Do not gossip

Do not jump to conclusions

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ANSWER: You can use the following strategies to avoid conflict in the workplace:

• Do not “feed into” others’ negative attitudes• Be personable and supportive• Refrain from passing judgments• Do not gossip• Do not jump to conclusions

What strategies can you use to avoid conflict in the workplace?

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Policy and Procedures Manual Key written

communication tool

Policies Dictate the day-to-day

workings of an office Describe chain of

command

Procedures Detailed instructions for

specific procedures

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Policies

Office purposes Rules and regulations Job descriptions Office hours Dress code Insurance Vacation and sick

leave

Salary evaluations Maintenance of

equipment Mailings Bookkeeping Scheduling

appointments OSHA

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Procedures Purpose of test, clinical application, and

usefulness

Specimen required and collection method Special patient preparations or restrictions

Reagents, standards, controls, and media used

Instrumentation Calibration and schedules

Step-by-step directions

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Community Resources Good customer service is

founded on providing or researching services to assist in attaining the goal of patient health and well-being

Discuss with patient’s physician before referring patient

Resources Alcoholics Anonymous Shelters Hospice Mental health services Meals on Wheels PASSPORT Easter Seals State agencies Support groups

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Other Resources Reference laboratories

Insurance companies

Office equipment suppliers

Maintenance companies

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ANSWER: Policies dictate the day-to-day workings of an office and usually describe the chain of command. Procedures are the detailed instructions for specific procedures.

What is the difference between policies and procedures?

Right!

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Managing Stress

Stress can be a barrier to communication

Stress can occur Due to a feeling of being

under pressure As a reaction to anger,

frustration, or change in routine

Stress is normal Motivating More productive

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Managing Stress (cont.) Ongoing stress

Overwhelming Physical effects

Reducing stress Consider your strengths and

limitations Be realistic about commitments

both at work and in your private life Techniques to reduce stress

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List three things you can do to relieve stress.

ANSWER: Any of the following can help you reduce stress:

• Exercise regularly

• Eat a balanced diet

• Get enough sleep

• Set realistic goals

• Be organized

Change what you have control over

Keep focused

Identify sources of conflict

Maintain a sense of humor

Try not to overreact

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Burnout Burnout is the end result of prolonged periods of

stress without relief

Type A personality Highly driven, perfectionist-type person More susceptible to burnout

Type B personality More relaxed, calm, “laid back” Less prone to burnout

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Burnout (cont.)

Stages to burnout Honeymoon

Awakening

Brownout

Full-scale burnout

Phoenix phenomenon

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Preventing Burnout

Take time to rest and relax

Be realistic about job expectations, your aspirations, and your goals

Create a balance in life

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What are the phases of burnout?

ANSWER: The phases of burnout are

• Honeymoon

• Awakening

• Brownout

• Full-scale burnout

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In Summary

Medical Assistant

Communication Skills:Listening, interpersonal, and assertiveness

People with Special Needs:Anxious, angry, elderly, hearing and visually impaired

You are the key link between the office and patient

Develop working relationships and help office run smoothly.

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Often during life-altering experiences, patients and their loved ones need a shoulder to cry on or someone to comfort them. It is important for them to know support is there.

—Lindsey D. Fisher (The Healers Art)

Documents

4-1 © 2009 The McGraw-Hill Companies, Inc. All rights reserved Communication with Patients, Families, and Coworkers PowerPoint® presentation to accompany: