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Communication drives positive relationships for healthcare employees and patients’ experience of care

Coauthored by Ingrid Summers, MHS, Manager, Press Ganey. 

In healthcare, communication is critical to safety, quality, and compassionate care. It matters for all our relationships, personally and professionally. But communicating itself is complicated, and rarely easy. Some still speak about it as a “soft skill.” I would argue that this “soft skill” is actually the “hard skill.”

Caregivers’ professional success is measured by their communication skills. It directly impacts the patient experience, their relationships with colleagues and leadership, and even their personal life. 

So, why do so many struggle to communicate?

The challenges of communicating in healthcare

Healthcare is inherently uncertain and interdependent—an environment that makes communication more difficult and complex. High reliability organizations (HROs) work to prevent accidents and make sure their systems are as safe as possible.

In an HRO, high-functioning teams are focused and engaged, working toward a common goal with shared values and complementary skill sets. Teams give each other feedback and cross-check work to catch mistakes and improve performance. This is why we embrace the reliability phrase “can I get a cross-check?” and thank others for doing so.

The consequences of error can be catastrophic. Organizing for reliability is an ongoing journey with no end point. We must—and will—keep learning how to make our systems safer and safer. Clear communication is key to our relentless pursuit of zero harm Which is why we standardize processes. For example, when we write about medication, we always use a leading zero before a decimal (e.g., 0.2 mg) while trailing zeros are forbidden: It’s always 2 mg, never 2.0 mg.

How can we improve communication in healthcare?

Building positive connections and trusting relationships will help encourage your workforce to speak up and ask clarifying questions without fear of repercussions. And for people to ask clarifying questions, we must facilitate this. Listen carefully with intent to understand, not reply. Pause between sentences. Welcome questions and provide safe spaces for people to ask these questions: huddles, forums, 1:1s scheduled to allow these questions that people will not ask in a group setting.

We know that when employees feel cared for and a sense of belonging, safety, quality, and experience improve. When we round on patients and employees, and make a human connection with them, they feel cared for, we learn, and it creates a place of psychological safety for our caregivers and our patients. The order is important: We care first, then we can learn.

Leader rounds as strategy to improve healthcare communication

Recent Press Ganey data continues to show that leader rounds with patients and caregivers improves communication, connection, well-being, loyalty, and employee engagement, as well as patient experience HCAHPS scores. Implementing leader rounds also messages that you care about patients and caregivers as individuals.

Kicking off leader rounds is simpler than you think:

  1. Schedule it
  2. Plan and embrace it
  3. Use the 4C framework

Leader rounding is a proven strategy to connect and empathize. The way we communicate during rounds is key. A consistent framework for leader rounds facilitates standard work and promotes the high reliability journey. Press Ganey uses a 4C framework to promote standard work for leader rounds. 

The Press Ganey 4C framework stands for: 

  1. Connect first
  2. Check on how they are doing
  3. Are there any other concerns?
  4. Commit to next steps

The key is to connect first. Find out something about the person besides why they’re in the hospital. This approach is important to our workforce too: Know something about your colleagues and team besides their role at the organization. Ask for and use their preferred name. Our research shows that connecting takes less than 56 seconds—and is time well spent.

Maybe this sounds easy. But to many healthcare workers, it’s simply not intuitive—they’re comfortable performing their assigned role, but the connection part eludes them. This is what I’ll call transactional communication.

As we move from transactional communication to a more intentional, relational conversation, we see that building rapport fosters trust. An individual—patient or employee—begins to trust us. Patients stop feeling like a diagnosis. A healthcare worker feels like they’re more than their job. They feel cared for as human beings.

I invite you to view a short video on the 4C framework for leader rounds here.

Finding joy in the art of communication

Something else special happens when we make these connections and embrace a more relationship-based style of communicating. We find joy. For those of us in healthcare, it reignites our passion for this noble calling. It gives us reason to come back tomorrow and do this extremely hard, albeit rewarding, work. 

I’ll close with a short story about a nurse manager who was new to leadership. She was beginning to question if leadership was the right path for her. “I am missing some of the joy in this new role,” she explained.

Press Ganey introduced the organization to leader rounds as a standard practice, emphasizing that making a connection with staff first makes them feel cared for—and feel that their voice truly matters. Several weeks into this, one long-term employee (who was somewhat cynical) thanked her for her work as a nurse manager and said they were happy she was there—that she was making a difference. That was the joy she needed to reaffirm that she wanted to continue in this leadership role, despite its challenges.

To learn more about leader rounds and Press Ganey’s other tactics for improving connection and communication, reach out to a member of our strategic consulting team

About the author

Gail is a Senior Consultant at Press Ganey. She has more than 40 years of experience as a nurse leader, trainer, and change agent. She is recognized in the healthcare industry as a thought leader, teacher, and ambassador for diversity.

Profile Photo of Gail Avigne