Communication I

Anderson and Anderson Executive Coaching/Anger Management for Physicians and related health care professionals and workers offers the following series on improving communication skills as a response to The Joint Commission Alert below. Adapted and posted by Anderson faculty member, Tom Wentz, Ph.D., C.A.M.F.

Excerpts from, The Practice of Control: Executive Coaching/Anger Management for Physicians by George Anderson, BCD, CAMF and John Elder, MA; Editor, Tom Wentz, PhD, CAMF. © 2008.

Joint Commission Alert: July 9, 2008.

Stop Bad Behavior among Health Care Professionals: Rude language, hostile behavior threaten safety, quality.

(OAKBROOK TERRACE, Ill. – July 9, 2008) Health care is a high-stakes, pressure- packed environment that can test the limits of civility in the workplace. A new alert issued today by The Joint Commission warns that rude language and hostile behavior among health care professionals goes beyond being unpleasant and poses a serious threat to patient safety and the overall quality of care.

Intimidating and disruptive behaviors are such a serious issue that, in addition to addressing it in the new Sentinel Event Alert, The Joint Commission is introducing new standards requiring more than 15,000 accredited health care organizations to create a code of conduct that defines acceptable and unacceptable behaviors and to establish a formal process for managing unacceptable behavior. The new standards take effect January 1, 2009 for hospitals, nursing homes, home health agencies, laboratories, ambulatory care facilities, and behavioral health care facilities across the United States.

Health care leaders and caregivers have known for years that intimidating and disruptive behaviors are a serious problem. Verbal outbursts, condescending attitudes, refusing to take part in assigned duties and physical threats all create breakdowns in the teamwork, communication and collaboration necessary to deliver patient care. The Institute for Safe Medication Practices found that 40 percent of clinicians have kept quiet or remained passive during patient care events rather than question a known intimidator. To help put an end to once-accepted behaviors that put patients at risk, The Joint Commission Sentinel Event Alert urges health care organizations to take action.

The Joint Commission Media Contact: Ken Powers, Media Relations Manager

“The single biggest problem in communication is the illusion that it has taken place.”

- George Bernard Shaw

Improving Communication with Others

Lack of communication is the root of many troubles, such as hurt feelings, mis- understandings, missed deadlines, and unsuccessful connections. Healthy communication in its broadest form is important in developing positive healthy relationships between family members and others. Skills for acquiring good communication techniques are emphasized in this series of blogs on improving communication skills.

Basic skills are very important and many people do not use them well. Poor communication skills result in unnecessary problems and misunderstandings in relationships.

Good communication requires two sets of abilities:

1. Ability to hear the other person (Receiving – active listening).

2. Ability to articulate messages accurately (Sending – assertive communication).

Four key communication skills for improving interpersonal relations are:

1. To listen without judgment.
2. To comprehend and acknowledge what has been said.
3. To acknowledge the other person and their point of view (does not imply agreement, however it does require recognition of the person and their message).
4. To not impose your personal beliefs on someone else.

Good communication skills take patience and time to acquire. We encourage participants to use all of their newly learned skills in developing positive healthy relationships.

I. What is Communication?

Communication Defined: At its root, communication is about clearly and respectfully articulating our needs and caring enough to listen to and understand the needs of others.

Human beings live in a single world of communication but divide that world into two parts: words and behavior (verbal and nonverbal). Words represent perhaps 10 percent of the total while behavior the other 90 percent.

The words used in communication, representing 10% percent of the total, emphasize the unidirectional aspects of communication, while behavior, the other 90 percent, stresses feedback on how people are feeling, ways of avoiding confrontation, and the inherent logic that is the birthright of all people. Words are the medium… which in the final analysis deal in power, so that words become instruments of power. The nonverbal, behavioral part of communication is the provenance of the common man and the core culture that guides his/her life.” (E. Hall, 1983.)

Hall’s Three key points:

1. Communication is 90% nonverbal and 10% verbal.
2. Words are instruments of power.
3. The purpose of communication is as much to conceal thought as it is to reveal it.

Just as stress underlies all anger, stress also underlies most communication, whether it is the internal dialogue we have with ourselves or the interactions we have with others. Without good communication skills, we can not have healthy or productive relationships with ourselves or others.

Too often, we listen only to ourselves or fail to be aware of our stressors and related feelings. With others, we fail to recognize the important verbal and nonverbal signs that people are sharing about how they feel and what they need. When this happens, no one is heard. Communication breaks down. Assumptions are made. Worst, our needs and the needs of our family or colleagues go unmet and we all fail to perform at optimal levels. “Empathy builds on self-awareness; the more open we are to our own emotions, the more skilled we will be in reading feelings. Knowing our emotions; self-awareness, recognizing a feeling as it happens – is the keystone of emotional intelligence.”