From Dialogue to Healing: The Influence of Communication in Healthcare

Background

Effective communication within healthcare teams is essential for delivering high-quality patient care and ensuring safety. Team communication can encompass verbal, non-verbal, and written exchanges that occur between all members of the healthcare team, including physicians, nurses, specialists, support staff, and patients. Errors, delays, and even patient injury can result from poor communication.¹ Communication frameworks and adaptable strategies are frequently utilized to standardize and improve information sharing to avoid these problems. Key communication methods, such as ISBAR² and SHARE Approach,³ are just a few essential tools in clinical environments. Additionally, recent studies emphasize that clear communication correlates with not only positive patient outcomes and reduced errors but also increased staff satisfaction. Our post explores varying communication norms as well as key tools and strategies to improve team communication in healthcare settings.

Acknowledging the Variation of Communication Norms Across Different Healthcare Settings

Effective team communication norms adapt based on the pace, acuity, and patient population of the healthcare setting. For example, in acute care environments like emergency departments and intensive care units, communication must be direct, concise, and time-sensitive, and often use standardized tools such as ISBAR to relay critical information efficiently.⁴ In inpatient units, communication can involve detailed shift reports, interdisciplinary rounds, and an emphasis on maintaining an open feedback culture to improve care coordination. Meanwhile, public health and community-based care settings emphasize inter-agency collaboration and culturally sensitive communication and have data-driven discussions to support population health. Mental and behavioral health environments require empathetic, therapeutic communication techniques, active listening, and attention to non-verbal cues to aid in a supportive atmosphere.¹ Across all settings, adaptability, clarity, and mutual respect remain foundational for fostering effective teamwork and enhancing patient care outcomes.

Structured Communication Among Healthcare Professionals: ISBAR as a Model for Effective Collaboration

Interprofessional collaboration and clear communication among healthcare professionals are critical to improving clinical outcomes and enhancing patient safety. Communication gaps are significant contributors to adverse events across various healthcare settings. The ISBAR approach—an acronym for Investigate, Situation, Background, Assessment, Recommendation—along with its variations, SBAR (Situation, Background, Assessment, Recommendation) and ISBARR (Identify, Situation, Background, Assessment, Recommend, Recap), was developed as a communication tool to streamline discussions among team members and enhance patient safety by providing structure to professional exchanges. Initially designed for acute care, the ISBAR framework has since been integrated into various clinical and non-clinical settings, driven by its impact on patient satisfaction, outcomes, and interprofessional communication. These outcomes highlight the critical role that structured communication tools, such as ISBAR, play in enhancing healthcare quality and fostering effective teamwork.⁴

Patient as Part of the Healthcare Team: SHARE Approach as a Model for Enhancing Communication

A healthcare team that excludes the patient is an incomplete one, as the patient’s involvement is fundamental to not only the patient-centered care framework but also the decision-making process that directly affects them.⁵ This involvement cultivates effective partnerships and leads to better outcomes. One formalized tool designed to enhance patient engagement in decision-making is the SHARE Approach, developed by the United States Agency for Healthcare Research and Quality.³ The SHARE Approach provides a structured five-step process: Seek the patient’s participation, Help them explore options, Assess their values, Reach a decision together, and Evaluate the outcome. While particularly effective in situations where decisions are balanced between equipoise and evidence-based options, the SHARE Approach is also being adapted and implemented across various care settings to foster greater patient engagement and improve overall care delivery.⁶

The distinctive needs of each patient, coupled with the varying demands and nuances of clinical cases, are effectively addressed through the adaptable communication skills of the healthcare team. Recognizing diverse norms across medical settings and applying validated communication tools empower teams to navigate complex cases while balancing the art and science of medicine. Bridging potential communication gaps with versatile and insightful solutions ultimately transforms these clinical relationships into one of partnership and shared healing.

References

1. Leonard M, Graham S, Bonacum D. The human factor: the critical importance of effective teamwork and communication in providing safe care. Qual Saf Health Care. 2004;13 Suppl 1(Suppl 1):i85-i90. doi:10.1136/qhc.13.suppl_1.i85
2. Burgess A, van Diggele C, Roberts C, Mellis C. Teaching clinical handover with ISBAR. BMC Med Educ. 2020;20(Suppl 2):459. Published 2020 Dec 3. doi:10.1186/s12909-020-02285-0
3. The SHARE Approach. Content last reviewed October 2024. Agency for Healthcare Research and Quality, Rockville, MD.        https://www.ahrq.gov/sdm/share-approach/index.html
4. Chaica V, Marques R, Pontífice-Sousa P. ISBAR: A Handover Nursing Strategy in Emergency Departments, Scoping Review. Healthcare (Basel). 2024;12(3):399. Published 2024 Feb 4. doi:10.3390/healthcare12030399
5. Vincent CA, Coulter A. Patient safety: what about the patient?. Qual Saf Health Care. 2002;11(1):76-80. doi:10.1136/qhc.11.1.76
6. Hargraves IG, Fournier AK, Montori VM, Bierman AS. Generalized shared decision making approaches and patient problems. Adapting AHRQ's SHARE Approach for Purposeful SDM. Patient Educ Couns. 2020;103(10):2192-2199. doi:10.1016/j.pec.2020.06.022