Are We Talking but Not Being Heard?

Abstract

Objectives & BackgroundPoor communication is at the heart of most complaints within the NHS. Failure to understand what a healthcare professional is saying can lead to confusion, fear, and complaints. We constructed a pilot study to understand the level of patients' comprehension of common statements heard in the emergency department setting.MethodsOver one week in 2015 we surveyed patients about their understanding of commonly heard medical expressions at a MTC in the W. Midlands. This was a convenience sample (due to team availability), but not restricted to any specific time of day/night.We identified five statements that represented procedures, processes within hospitals, and diagnosis. The questionnaire was given out after the medical consultation. Following completion an answer sheet was provided along with the opportunity to ask any further questions that there might be. Answers were written, with assistance where needed.The the data was collated using Excel. Answers to the common statements were divided into three categories; full understanding, partial understanding and no understanding. An a priori sample size of 30 was decided upon, largely because this is the number that our trust feels comfortable with when performing patient experience work. GAfREC approval was given.Results29 questionnaires were completed. Only one of our five statements (“you've got a fracture”) was understood by over 50% of the sample.Statements most poorly understood appear to involve hospital specific process involving acronyms such as ‘You're going to AMU’ (90% had no understanding) and ‘The ITU Reg is going to come and see you’ (76% had no understanding).Patients understand little of what we say to them and this gets worse the more acronyms we use.Despite this most patients felt the doctor and the nurse explained things well. This may reflect staff taking the time to explain medical terminology in the context of the patient's specific problem or pathology. Patients and relatives also reported that they were asked if they had any questions.ConclusionIt is unreasonable to assume patients understand commonly used medical terminology, Although medical terminology may be ubiquitous in a place of work it has the potential to be both profession and location specific. It is easy to forget this. As healthcare professionals we need to communicate using language the patient can understand and allow the patient an opportunity to ask for clarification.