Bài giảng môn Medical Assisting - Chapter 4: Communication with Patients, Families, and Coworkers

4Communication with Patients, Families, and Coworkers4-*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 Outcomes4-*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.)4-*4.7 Discuss ways to establish positive communication with coworkers and management.4.8 Describe how the office policy and procedures manual is used as a communication tool in the medical office. Learning Outcomes (cont.)4-*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.Learning Outcomes (cont.)4-*IntroductionMedical assistants mustRecognize human behaviorsCommunicate effectively, with professionalism and diplomacyRecognize obstacles that affect therapeutic communication4-*Communicating with Patients and FamiliesYou are the key communicator between the physician and patientYour interaction sets the tone for the office visitDeveloping strong communication skills is just as important as mastering administrative and clinical skills Communication will influence how comfortable the patient feels in your practice.4-*Communicating with Patients and Families (cont.)Customer service Most important part of communicationTwo points fundamental to customer serviceThe patient comes firstPatient needs are satisfiedPatients are #1!4-*Communicating with Patients and Families (cont.)Examples of customer serviceTelephone techniquesWriting or responding to telephone messagesExplaining procedures to patientsAssisting with billing issuesCreating a warm and reassuring environment4-*Apply Your KnowledgeWhat 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.Good!4-*The Communication CircleThe communication circle involves an exchange of messages through verbal and nonverbal means.4-*Communication ProcessPatients often believe that health care has become impersonal due to Technological advancesManaged care organizationsMaintain a patient-centered approach4-*Apply Your Knowledge What are the three elements of the communication circle?ANSWER: The three elements of the communication circle are the message, source, and receiver.RIGHT!4-*Human Behavior: Stages of the Life CycleUnderstanding growth and development enhances communication skillsPhysical developmentPsychological and emotional growthGuidelines for communication based on developmental stageInfant ToddlerPreschoolerSchool ageAdolescenceYoung, middle, old adult4-*Maslow’s Hierarchy of Human NeedsSelf-ActualizationEsteem NeedsLove/Belonging NeedsPhysiological NeedsDeficiency (Basic) NeedsSafety Needs4-*Apply Your Knowledge 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 of his or her spouse. Good Answer!4-*Types of CommunicationPositive or negativeVerbal or non-verbalWritten (Chapter 7)4-*Positive Verbal CommunicationCommunication promotes the patient’s comfort and well-beingSet the stage for positive communicationEncourage patients to ask questionsSpeak slowly and clearly 4-*Negative Verbal CommunicationCurb negative communication habitsMumblingSpeaking brusquely Avoiding eye contact Interrupting patients as they speakRushing explanations Forgetting common courtesiesShowing boredomTreating the patient impersonally4-*Non-Verbal CommunicationFacial expressionEye contactPostureOpenClosedTouchPersonal space In many instances, people’s body language conveys their true feelings, even when their words may say otherwise.4-*Apply Your KnowledgeMr. 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 seenYEA!4-*Improving Communication SkillsListening skillsPassive listening Active listeningImprove listening skillsPrepare to listenRelax and listen attentivelyMaintain eye contactMaintain personal spaceThink before you respondProvide feedback4-*Improving Communication Skills (cont.)Interpersonal skillsWarmth and friendlinessEmpathyRespectGenuinenessOpennessConsideration and sensitivity4-*Therapeutic CommunicationThe ability to communicate with patientsIn terms they can understandSo they feel at ease and comfortableThe ability to communicate with other members of the health-care teamTechnical termsAppropriate to the health-care setting4-*Therapeutic Communication (cont.)InvolvesSilenceAcceptingGiving recognitionOffering selfGiving a broad openingOffering general leadsMaking observations Encouraging communicationMirroringReflectingFocusingExploringClarifyingSummarizing 4-*Ineffective Therapeutic CommunicationRoadblocksReassuringGiving approval DisapprovingAgreeing/ disagreeingAdvisingProbingDefendingRequesting an explanationMinimizing feelingsMaking stereotyped comments4-*Defense MechanismsUnconscious, designed to protect selfPatients may displayCompensationDenialDisplacementDissociationIdentificationIntrojectionProjection4-*Assertiveness SkillsAssertive – people who are firm and stand by principles while still showing respect for othersRequiresOpennessHonestyDirectnessAggressive – people who try to impose their position on others or try to manipulate them4-*Apply Your KnowledgeWhat 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.GoodAnswer!4-*Communication – Anxious PatientCan interfere with communication processMay not listen well or pay attention to what you are sayingObserve for Tense appearanceIncreased blood pressure and breathingSweaty palmsIrritability and agitation4-*Communication: – Angry PatientRecognize anger and its causeRemain calm and demonstrate respectFocus on physical and medical needsMaintain adequate personal spaceDo not take anger personallyAsk patient to be specific concerning causePresent your point of viewAvoid breakdown of communicationLeave if you feel physically threatenedGoal is to help the patient express anger constructivelySteps in communicating with an angry patient4-*Communication – Patients from Other CulturesEach patient has his or her own behaviors, traditions, and valuesStrive to understand and be tolerantStereotypingNegative statement about specific traits of a group applied to an entire populationGeneralizationStatement about common trends within a group4-*Communication – Other Cultures (cont.)Attitudes about health careBeliefs about causes of illnessSymptoms and what they meanTreatment expectationsLanguage barriers4-*Communication – Patients with Visual ImpairmentUse large-print materialsUse adequate lighting in all areasUse a normal speaking voiceTalk directly and honestlyDo not talk down to the patientPreserve the patient’s dignity4-*Communication – Patients with Hearing ImpairmentFind a quiet area to talk Minimize background noisePosition yourself close to and facing the patientSpeak slowlyRemember that elderly patients lose the ability to hear high-pitched sounds firstVerify understandingUse written materialSpeak clearly but do not shout4-*Communication – Mentally or Emotionally DisturbedDetermine what level of communication the patient can understandSuggestionsRemain calm if the patient becomes agitated or confusedAvoid raising your voiceAvoid appearing impatient4-*Communication – Elderly PatientsBe respectfulDo not talk down to elderly personsTouch – communicates caring 4-*Communication – Terminally Ill PatientsOften under extreme stress, so offer support and empathyKubler-Ross’s Stages of DyingDenialAngerBargainingDepressionAcceptance 4-*Communication – Young Patients and Their ParentsRecognize and accept their fear and anxietyExplain all proceduresUse praiseDo not tell children that a procedure will not hurt if it will, or you will lose their trustReassuring and keeping parents calm will also help the child relax4-*Communication – Patients with AIDS/HIVStigma of diseaseGuiltAngerDepressionYou must have accurate information about the disease and the risks involved to answer the patient’s questionsPatients need human contact and to be treated with dignity4-*Communication – Patient’s Family and FriendsProvide emotional support to the patientAcknowledge family members and friendsKeep them informed about patient’s progressRemember to protect patient confidentialityAsk the patient what information can be given to family or friends4-*Apply Your KnowledgeWhat 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.Right!4-*Communication with CoworkersDevelop rapport with coworkersRules for the medical office Use proper channelsHave a proper attitudePlan an appropriate time for communication4-*Communicating with ManagementKeep supervisor informedAsk questionsMinimize interruptionsShow initiative4-*Dealing with ConflictDo not gossipDo not jump to conclusionsSet boundaries to limit undesirable behaviorDo not “feed into” others’ negative attitudesBe personable and supportiveRefrain from passing judgments4-*Apply Your KnowledgeANSWER: 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 conclusionsWhat strategies can you use to avoid conflict in the workplace?Bravo!4-*Policy and Procedures ManualKey written communication toolPoliciesDictate the day-to-day workings of an officeDescribe chain of commandProceduresDetailed instructions for specific procedures4-*PoliciesOffice purposesRules and regulationsJob descriptionsOffice hoursDress codeInsurance Vacation and sick leaveSalary evaluationsMaintenance of equipmentMailingsBookkeepingScheduling appointmentsOSHA4-*ProceduresPurpose of test, clinical application, and usefulnessSpecimen required and collection methodSpecial patient preparations or restrictionsReagents, standards, controls, and media usedInstrumentationCalibration and schedulesStep-by-step directions4-*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 patientResources Alcoholics AnonymousShelters HospiceMental health servicesMeals on WheelsPASSPORTEaster SealsState agenciesSupport groups4-*Other ResourcesReference laboratoriesInsurance companiesOffice equipment suppliersMaintenance companies4-*Apply Your Knowledge 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!4-*Personnel ManagementEmployee RelationsBenefitsPerformanceOther administrative tasksHiringTrainingCompensation 4-*Personnel Management (cont.)Employee orientationStress competenciesTeamworkPolicies/proceduresCross-training4-*Personnel Management (cont.)Successful hiringFind the most qualified person for the jobScrutinize and check references carefullyHave a salary rangeDiscuss policies and procedures earlyTrain properly and re-train4-*Apply Your KnowledgeWhat is employee orientation essential to?What should be stressed during employee orientation?ANSWER: Personnel managementANSWER: Competencies of teamwork, policies and procedures, and cross-trainingGood Answers!4-*Managing StressStress can be a barrier to communicationStress can occurDue to a feeling of being under pressureAs a reaction to anger, frustration, or change in routineStress is normal MotivatingMore productive4-*Managing Stress (cont.)Ongoing stress OverwhelmingPhysical effectsReducing stressConsider your strengths and limitationsBe realistic about commitments both at work and in your private lifeTechniques to reduce stress4-*Apply Your KnowledgeList 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 overreactRight!4-*BurnoutBurnout is the end result of prolonged periods of stress without reliefType A personalityHighly driven, perfectionist-type personMore susceptible to burnoutType B personalityMore relaxed, calm, “laid back” Less prone to burnout4-*Burnout (cont.)Stages to burnoutHoneymoon Awakening BrownoutFull-scale burnoutPhoenix phenomenon4-*Preventing BurnoutTake time to rest and relaxBe realistic about job expectations, your aspirations, and your goalsCreate a balance in life4-*Apply Your Knowledge What are the phases of burnout?ANSWER: The phases of burnout are Honeymoon Awakening Brownout Full-scale burnout Phoenix phenomenonGood Job!4-*In Summary4.1 The communication circle involves a message being sent, a source, and a receiver that responds.4.2 It is important for the medical assistant to understand the development of the life cycle as it will assist in communication skills with patients. 4.3 Communication that promotes comfort and well being is considered positive communication. Medical assistants may not be aware of some of the signs of negative communication they display. 4-*In Summary (cont.)4.4 Listening and other interpersonal skills can be improved by becoming more involved in the communication process. 4.5 Assertive medical professionals trust their instincts. Aggressive medical professionals try to impose their positions through manipulation techniques.4.6 Learning about the special needs of patients and polishing your communication skills will help you become an effective communicator. 4-*In Summary (cont.)4.7 The quality of communication you have with your coworkers and your supervisor greatly influences the development of a positive or negative work climate.4.8 The policy and procedure manual is a key communication tool.4.9 Community resources are available in your local area to patients who may need additional outside resources.4.10 Stress can be good or bad. However, it is how we handle stress that makes the difference.4-*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)End of Chapter 4