Risk Management Tip: Effective Communication with Patients

MLMIC Risk Management Tip #9 addresses medical professional liability risks related to “Effective Communication with Patients.”

The Risk

Effective communication is the cornerstone of the doctor-patient relationship. Patients’ perceptions of physician communication skills may impact the potential for allegations of malpractice. The following are some suggestions that are designed to promote open communication and enhance your ability to reach an accurate diagnosis and develop an appropriate plan of care.

Recommendations

1. Employ active listening techniques and allow the patient sufficient time to voice their concerns.
2. Sit at the level of the patient and maintain eye contact.
3. Assess the patient’s literacy level. This may be as simple as asking what is the highest grade level the patient attained.(http://www.ahrq.gov/professionals/qualitypatient-safety/quality-resources/tools/literacy/index.html)
4. Use lay terminology when communicating with patients and their families.
5. Develop plans for communicating with patients who are hearing impaired, deaf, or have limited English proficiency (https://www.ada.gov/effective-comm.htm).
6. Utilize the teach-back method when providing patients with instructions and information. This technique requires that patients repeat the information provided in their own words. The teach-back method is particularly useful in assessing patients’ understanding of:
   • Informed consent discussions
   • Medication instructions including side effects and adverse reactions
   • Test preparation
   • Follow-up instructions

If the patient is unable to convey the information, it should be restated in simpler terms, perhaps utilizing pictures and/or drawings.

7. Evaluate your educational tools and consent forms to determine the grade level at which they are written. This will allow you to provide written materials that will be understandable to the majority of your patient population. Techniques that determine the readability and comprehension levels of documents are available from numerous sources including:
   • http://www.cms.gov/Outreach-and-education/Outreach/writtenMaterialsToolkit/downloads/toolkitpart07.pdf
   • http://www.readabilityformulas.com/
8. At the conclusion of your patient encounter, ask the patient/family if they have any questions or concerns that have not been addressed.
9. Medical record documentation should reflect all aspects of patient interactions and comprehension. This will demonstrate the effectiveness of your communication skills and promote patient satisfaction, which may reduce your potential exposure to claims of malpractice.

This MLMIC Risk Management Tip is available here as a PDF: “Effective Communication with Patients.”