Communication With Doctors and Communication With Nurses are patient-reported experience measures (PREMs) that provide information on whether patients were treated with courtesy and respect by nurses or doctors, whether they were listened to carefully and whether nurses or doctors explained things in a way that the patient could understand.
I would give 10 stars to the hospital staff. They allowed me to FaceTime or at least put my wife on speaker on my cellphone and talk to her at the same time as they were talking to me. So, for the communications procedures, I gave it a 9 out of 10. — Kirk, Patient, Ontario
There is evidence that a clinician’s ability to explain, listen and empathize can have a profound effect on biological and functional health outcomes, as well as on patient satisfaction and experiences of care.Reference1, Reference2 In addition, a clear link has been established between better-quality communication from a health care provider and a patient’s capacity to follow medical recommendations, self-manage a chronic medical condition and adopt preventive health behaviours.Reference1, Reference2
While looking at communication with these 2 groups of clinicians in parallel is of interest, both patients and health system stakeholders noted that reporting communication with nurses separately from that with doctors is a vital distinction, due to the differences between their availability, responsibilities and workload.
Communication with doctors
| Province | Poor | Good | Very good | Number of respondents | |
|---|---|---|---|---|---|
|
Nova Scotia |
1% |
23% |
75% |
2,825 |
|
|
New Brunswick |
1% |
23% |
76% |
6,172 |
|
|
Ontario |
1% |
23% |
76% |
45,578 |
|
|
Manitoba |
2% |
27% |
71% |
10,959 |
|
|
Alberta |
1% |
21% |
78% |
22,048 |
|
Note
Data is shown for the most recent year of data submission (Ontario, Manitoba and Alberta, 2020–2021; New Brunswick, 2018–2019; Nova Scotia, 2017–2018).
Communication with nurses
| Province | Poor | Good | Very good | Number of respondents | |
|---|---|---|---|---|---|
|
Nova Scotia |
1% |
27% |
72% |
2,906 |
|
|
New Brunswick |
1% |
30% |
69% |
6,188 |
|
|
Ontario |
1% |
27% |
72% |
46,115 |
|
|
Manitoba |
1% |
30% |
69% |
10,997 |
|
|
Alberta |
1% |
23% |
77% |
22,048 |
|
Note
Data is shown for the most recent year of data submission (Ontario, Manitoba and Alberta, 2020–2021; New Brunswick, 2018–2019; Nova Scotia, 2017–2018).
You can explore your hospital results in the Your Health System: In Depth interactive web tool, alongside other measures of hospital performance. Details about each measure can be found on CIHI’s Indicators web page (Communication With Doctors and Communication With Nurses).
What other patient experience measures are strongly associated with these measures?
The following 3 key drivers have been identified for the Communication With Doctors and Communication With Nurses measures. A key driver is a patient experience measure that is strongly associated with or that influences results for these measures. Key drivers can potentially be used as areas of focus when planning quality improvement initiatives.
For more information on the methodology used in the key drivers analysis, please see Acute Care Patient-Reported Experience Measures — Methodology Notes. To learn more about CIHI’s other PREMs, see the Canadian Patient Experiences Survey — Inpatient Care: Patient-Reported Experience Measures.
Key drivers: Communication With Doctors
Received Information About Condition and Treatment
Whether patients felt they received all of the information they needed about their condition and treatment.
Internal Coordination of Care
Whether patients felt there was good communication between doctors, nurses and other hospital staff. This measure also looks at whether patients felt that hospital staff seemed informed about and up to date on their hospital care.
Communication With Nurses
Whether patients felt that nurses treated them with courtesy and respect, listened carefully to them and explained things in a way they could understand.
Key drivers: Communication With Nurses
Internal Coordination of Care
Whether patients felt there was good communication between doctors, nurses and other hospital staff. This measure also looks at whether patients felt that hospital staff seemed informed about and up to date on their hospital care.
Emotional Support
Whether patients felt they were supported and helped with any anxieties, fears or worries during their hospital stay.
Communication With Doctors
Whether patients felt that doctors treated them with courtesy and respect, listened carefully to them and explained things in a way they could understand.
Digging deeper: Using patient experience data to implement change
The following success story is an example of how health organizations have showcased the use and value of patient experience data to drive quality improvement.
Service delivery organizations in Manitoba have access to a performance measurement dashboard that includes data for overall patient experience from CIHI’s Canadian Patient Experiences Survey — Inpatient Care. Although this data gives an overall score for patient experience, each organization pinpoints which areas to focus on for quality improvement.
Choosing an area of focus
To help organizations focus their improvement efforts, Southern Health — Santé Sud annually prepares summary reports that highlight trends from year to year, comparisons with the regional average and key drivers of the overall patient experience measure, such as Communication With Doctors and Communication With Nurses.
“What we found we needed to do was to create a bit of a summary of the information that our sites could then use and kind of jump off from,” says Ales Morga, the director of Performance and Planning at Southern Health — Santé Sud. “This is so that they can understand what’s going on with the data and how it links together. Instead of just focusing on the questionnaire as a whole, what we do is focus on the ones that are most highly correlated to overall experience for the region. Otherwise, it’s just sending them a spreadsheet. It’s not very meaningful; we have found it has not been very actionable.”
Providing in-person demos has also helped organizations gather suggestions for improvement and develop an action plan.
“We would walk the sites through their data and give them some clues in terms of where the site is showing improvements and to be able to do that as a celebration, and then also highlight for them some of the areas for improvement that they might need to develop action plans around, especially if they’re noticing trends over time,” says Ms. Morga. “So it’s not just ‘Here’s the data. What are you going to do about it?’”
Implementing change
By leveraging patient experience data, Portage District General Hospital and Boundary Trails Health Centre focused on an area that highly affects the overall experience of their patients: support for anxiety and fears, which falls under Emotional Support (a key driver).
Using a patient-centred approach, they implemented a quality improvement initiative called “What matters to me?” This is a bedside tool meant to gather information from patients on what they find is most important to them during their hospital stay.
“The staff have reported that this has really made a huge difference for them and for the care that they provide to that patient. Sometimes those conversations will lead to fears and worries, but it’s also just an opportunity to ask and communicate with the patient about what concerns they might have and just to get to know them a little bit better,” says Ms. Morga.
This collaborative effort not only helped providers understand what aspects mattered most to patients during their hospital stay, but also nurtured valuable conversations and understanding between patients and providers.
“The biggest lesson is you can put a change in… but in order to sustain it, people have to understand why it’s important to the patients,” says Ms. Morga.
References
- 1.
- Back to Reference 1 in text
- Institute for Healthcare Communication. Impact of communication in healthcare. Accessed March 16, 2022.
- 2.
- Back to Reference 2 in text
- McDonald A. A Long and Winding Road: Improving Communication With Patients in the NHS. 2016.