Run a Google search on caregiver communication, and you will find plenty of articles talking about how caregivers and family members can speak to doctors about the patient’s condition, but not much on how doctors can improve communication with a patient’s primary caregiver(s)—family members or otherwise.
However, it is extremely important to hone and apply this skill throughout the patient’s hospital stay. Although it's not always easy—some obstacles hinder communication (and the pandemic has only exacerbated the problem)—the benefits speak for themselves: better patient outcomes and higher caregiver satisfaction being just two.
Here, we discuss the need for effective caregiver communication, share some tips to help you improve this part of your practice, address the obstacles (including those imposed by COVID-19), and outline several benefits you will accrue as a result.
The Need for Effective Caregiver Communication
According to a survey from AARP Research, the overwhelming majority of healthcare providers agree that family caregivers play a vital role in the health of loved ones. The survey also found considerable room for improvement in the relationships between medical teams and those caring for aging parents or other relatives.
“Today, 40 million Americans are caring for aging parents, spouses, and other loved ones, and close to half of them are responsible for medical tasks like injections and wound care,” said Nancy LeaMond, AARP Executive Vice President and Chief Advocacy and Engagement Officer. “The entire healthcare system—from providers to hospitals to insurers—must recognize family caregivers’ critical role and understand that teaming up with them can improve health outcomes and quality of life for both patients and family caregivers.”
Hospitals need to have a reliable program that addresses how to communicate information to caregivers effectively, especially those with limited health literacy or knowledge.
Though caregivers should be considered an integral part of the care team, unfortunately they are not always treated that way. Establishing a partnership between caregiver and provider is crucial to patient success.
Effective Caregiver Communication During and After Discharge
Typically, when patients leave the hospital, their follow-up care doesn’t fall to a professional but rather, a family member. These caregivers may not have a medical background, which means they could be overwhelmed by what they have to do.
Also, they sometimes don't fully understand their role in the recovery process. Even if a doctor or nurse gives them written instructions, they often come with little explanation.
To change that dynamic, as part of its overhaul of the hospital discharge process, CMS requires hospitals to make caregivers fully aware of what they must do to care for the patient after leaving the hospital.
Several states have passed laws that require hospitals to ask patients if they have a specific person they’d like to designate as their caregiver. The caregiver must get clear discharge instructions.
California is the latest state to introduce one of these laws. As part of the new regulation, the state’s hospitals must:
- Give patients the chance to identify a caregiver;
- Let the caregiver know when the patient will be discharged;
- Provide the caregiver with clear discharge instructions that include information about the patient’s medications and specific post-discharge needs.
Laws in other states have similar requirements, and with CMS’s encouragement, more states could pass comparable regulations over time.
Becker’s Hospital Review highlighted two areas where physicians and hospitals should pay special attention during and after discharge:
Medication mismanagement is one of the most common reasons for readmission, according to Becker’s. This often occurs because patients do not fully understand which medications to take. Educating patients and family members on their drugs and ensuring they fill their prescriptions can prevent readmissions.
Hospitals should also confirm the patient has a primary care physician who will manage the patient's health post-discharge. Hospitals should then follow-up with patients and family members by phone, electronically, or in-person to ensure the patient scheduled or had an appointment with this physician, Becker’s said.
At SCP, we help manage both of those critical factors using our Patient Engagement Solutions, which feature post-discharge coordination services, health information and nurse triage call lines, and more. (Contact our patient engagement team to get more details.)
Benefits of Effective Caregiver Communication
Effective caregiver communication can lead to several benefits for the patient, caregiver, and hospital alike.
Positive clinical outcomes. Practical physician interpersonal and communication skills that engage both the caregiver and patient can lead to positive clinical outcomes and help avoid dissatisfaction that results from communication breakdowns in the physician-patient relationship.
Patient follow-through. Conversations between doctors and caregivers are important because patients are more likely to follow through with a doctor’s plan if their caregiver is on the same page.
Better understanding. Patients and caregivers who feel their doctors listen to them better understand their condition, treatment, and prognosis. Also, family caregivers who have detailed conversations with doctors and nurses where they’re free to ask questions are more likely to understand how they should help their relatives after discharge.
Reduced readmissions. Better patient outcomes decrease the chance of readmission and other complications that can hurt a hospital’s quality ratings and bottom line.
Patient satisfaction. Positive rhetoric around the hospital experience can meaningfully impact how a patient ultimately scores your hospital in formal evaluations and in online reviews—which in turn impacts your reputation.
Barriers to Effective Caregiver Communication
Most healthcare providers recognize caregivers' value and know that working with them is the best way to ensure their patients' quality outcomes. Yet physicians find that establishing communication with caregivers can be challenging, with time to connect and other logistical issues getting in the way, an AARP survey revealed.
About half of providers surveyed (54%) say a patient having multiple caregivers was a barrier; 44% are not aware who the caregiver is; 44% say there is fluctuation in caregiver involvement; and 39% felt interacting with caregivers was too time-consuming. Among those who believed communication was difficult (20%), most said the inability to reach the caregiver was the primary issue.
On the caregivers' side, faith in doctors as "all-knowing" could hinder communication, especially among the elderly who were brought up to respect physician authority. Demographic factors may also influence caregivers’ experiences, according to research by BMC Health Services.
The research found that communication expectations were exceeded more among caregivers with a college education and more among white caregivers than with lower-educated or minority caregivers.
Other communication barriers include interpersonal issues, such as physician behaviors, patient or family behaviors, and situational factors at the clinical interaction time. If clinicians feel that a patient or their family members are difficult, they may be more inclined to refrain from spending a lot of time on open and transparent communication.
Tips on Effective Caregiver Communication
We can draw tips on effective caregiver communication from a "playbook" on improving patient experience we wrote in 2018. It contains practical advice on patient and caregiver communication, including:
See your patient as quickly as possible and immediately introduce yourself (to both the patient and family members);
- Be present, sit down, acknowledge everyone in the room, and make sincere eye contact;
- Continually communicate your thoughts with patients and their families regarding things like differential diagnosis (and how you'll narrow it down), admission, or discharge;
- Explain test results clearly with the patient and family;
- Ask if they have questions and respond until they run out of items.
Two other essential elements of patient and caregiver communication include displaying empathy and simplifying "doctor speak."
Express empathy in how you speak to patients and their caregivers, then ask for feedback and listen to their responses with minimal interruption. Empathy is often thought of as an inherent trait, but it is also a learned skill.
Simplifying medical terminology isn’t always easy but using straightforward language with patients and their caregivers pays off. They are more likely to ask questions, follow recommendations, and feel less intimidated, making for a better overall experience. (If you need help trading complex terms for simple ones, refer to this SCP Health “cheat sheet.”)
COVID-19 and Effective Caregiver Communication
Even with these tips in hand, situations outside of your control can significantly impact the feasibility and efficacy of your caregiver communication practices. A timely example is the COVID-19 pandemic. A combination of fear, misinformation, restricted visitation, and many other factors has been impacting the way patients perceived healthcare during the onset of the pandemic.
This has amplified the need for hospitals and clinicians to explain the situation, symptoms, and treatments to patients clearly and to stay in touch with patients' loved ones, providing updates, often virtually via electronic means.
Related Resource: What We’ve Learned About Patient Experience from COVID-19
While clinicians need to communicate effectively with patients and their families during these stressful times, it’s just as important for patients and family members to stay in touch.
Press Ganey lists two specific ways clinicians can connect COVID-19 patients with their loved ones.
Provide tips and talking points to ease patients’ suffering.
Develop quick tips and talking points to help families find words or ways to demonstrate that they are “present” with their loved ones and help clinicians be “in the moment” with families.
Leverage existing mobile communications technology.
“Many hospitals have stockpiles of older-generation tablets, laptops, and smartphones that they can reactivate and repurpose to help families communicate with their loved ones—whether through email, FaceTime, Zoom, Skype, or phone call,” notes Press Ganey.
Despite the challenges COVID-19 presents, hospitals can use these approaches to keep communication lines open for patients, their families, and clinicians, easing their stress and anxiety.
Effective caregiver communication is essential to long-term patient health and loyalty, particularly in light of the current pandemic. Make it a priority to learn better ways to communicate with family members and other caregivers, compassionately and transparently.
Your patients will benefit from better outcomes and fewer readmissions, and the hospital will profit from increased trust, ensuring higher patient satisfaction scores and return visits when and if the time comes.
At SCP Health, our clinicians are regularly provided with practice advancement tips and training opportunities, many of which help advance their communication skills. As mentioned earlier, SCP extends this high standard for communication outside of the hospital’s four walls by proactively engaging patients and caregivers in scheduling follow-up appointments, managing medications and devices, finding a new PCP, and more.
If you’re interested in learning more about SCP’s overall approach to practice management and patient care, reach out to our team to get the conversation started.
If you’re hoping to work for SCP Health, explore our clinician jobs to find the right fit for you.