Reflective Report and Essay

Reflective Report and Essay on Communication in Health and Social Care Organizations

Executive Summary

The report provides two sections about communication in the health care system. The first section describes the significance, theories, and aspects of communication in healthcare organizations. The second section is an account of the experiences and observations in a healthcare system that highlights the importance of communication.

Task 2: Essay on Communicating in Health and Social Care Organizations

Communication plays a vital role in all endeavors to improve the health of individuals. It may be difficult to demonstrate how various messages affect the health and functioning of health care.  It is with the help of theories and practice that we can demonstrate the value of communication in health care. We must recognize that human communication is a complex process and has multiple dimensions with a variety of influencing factors. In health care service, the successful exchange of messages and information between the caregiver and the target receivers depends on the quality of the communication. A review of communication is vital to the success of health care practice.

1.1 Application of relevant theories of communication to health and social care contexts

One of the basic requirements to expand the capacity to accommodate the range of healthcare issues is to examine the theoretical foundations of communication in healthcare. There is a wide range of theories available to explain the dynamics of communication within health care. The prominent classifications of theories include behaviorist theories, humanistic psychology, sociobiological approach, cognitive theories, and psychoanalytical theories. In this essay, only two types of theories are touched upon because the writer places a higher value on this approach. The theories chosen for this essay are important not because others are not useful or less effective, but because of the inclination, the writer has towards the chosen ones. The following theories have highly relevant and suitable applications for understanding the communication process. In practical ways, these theories can help a health professional write simple messages on notice boards to conduct an in-depth counseling program. The theories considered here are cognitive i.e. Theories of Planned behavior (TPB) and Health Belief Model (HBM).

The basic assumption behind these theories is that there is a continuum to human behavior, though it projects random causes to behavior (Rutter 2002) and there are a set of perceptions and beliefs underlying every behavior.

The TPB’s main assumption is that behavior depends on a person’s intention to perform a specific behavior, and intention, in turn, depends on three critical factors.

• Attitude towards the behavior: the person cognitively evaluates the  risks and rewards associated with the behavior and decides in favor of a particular choice
• Subjective norms: Awareness of significant others’ attitude i.e. family members, friends, and peers creates pressure on the person.
• Perceived behavioral controls: it is the extent of the feeling of ability to vary performance according to the situation.

According to this theory, a patient who has a positive attitude towards health, supportive subjective norms, and a feeling of ability to perform the task or follow the instruction is likely to have positive intentions towards the health care process and be prepared to put effort towards the health outcomes.

Similar Theory of Planned behavior, as per the HBM, four factors are critical for a behavior change.

1. The person must be attracted to the behavior change. For example, An ‘incentive’ for an elderly person to improve walking is the desire to attend the wedding of the granddaughter.
2. The person must be aware and feel to overcome the ‘risk’ of the existing behaviors.  For example, the patient is aware that not exercising, will aggravate the diabetic condition.
3. A strong belief in the positive outcomes of the change must be present. Those who believe that all their efforts are going to be futile; the health outcomes are likely to be weak. For example, a person who feels that there is no hope in the treatment of cancer is likely to neglect the instructions from the caregivers.
4. Confidence’ (self-efficacy) to bring out changes in one’s behavior. For example, A person who has the self-control to avoid sweets is confident in accepting the doctor’s On the other hand, a person who is not sure about one’s behavior may not take the suggestion seriously.

1.2 Using communication skills in the health and social care context

In many situations, especially in a healthcare context, the basic communication skills involved are questioning, listening, reflecting, paraphrasing, describing, explaining, summarizing, advising, coaching, counseling, etc. A good health caregiver is proficient in communication, which receives and sends messages with the right content, voice modulation, posture, gesture, nonverbal expressions, etc. Sometimes, the caregiver may use pictures and textual material to communicate the message.

There are many ways a healthcare professional can communicate with the stakeholders which include the use of printed documents, audio-visual resources, posters, books, etc.  Asking relevant and thoughtful questions is an important tool in health care service. Questions help the listener to direct the attention and bring focus to the vital issues. Along with verbal communication, the non-verbal aspects of the message also need to be managed such as the pace, volume, tone, eye contact, facial expressions, etc. Health care was given must be pleasant to the inmates and always give a posture of help to the needy. Appearance and conduct are very important for career success in health care because they communicate volumes to other persons, and communication as such is the most critical aspect of health care.

1.3 Methods of dealing with inappropriate interpersonal communication between individuals

Interpersonal communication is a tricky and elusive phenomenon. There are chances to derail interpersonal communication. Inappropriate interpersonal communication that is avoided by caregiving professionals is a lack of eye contact, negligence to the requests, lack of interest in the patient, using disapproval, lack of appreciation for the patient’s efforts, and indifference to the colleagues and the inmates. Many factors determine the effectiveness of interpersonal communication. The positive behavioral factors that influence healthy interpersonal communication are a smiling facial expression, open body posture, maintaining eye contact, nodding the head to acknowledge the message and ensure listening, etc. The health care professional also must develop internal conditions such as developing a positive attitude towards the job, and the service takers, developing empathy, and displaying authentic facial expressions. Sensitivity to others’ feelings, appropriate self-disclosure, and authenticity are the qualities most inmates expect from a caregiver.

1.4

In healthcare scenarios, each user is likely to display specific needs, which a caregiver is expected to sense and take appropriate action. A variety of strategies needs to be applied to tackle the elusive issue of specific communication needs. The users may have sensory deficiencies, language barriers, mental conditions that may make their cognitions worse, etc. Sensing the situation the health care professional must develop a communication strategy to help the individual to come out of the illness and move towards better health. Some of the strategies are given below.

• Make an observation and analyze the individual’s communication and language needs
• When faced with incomplete information, use methods to gather sufficient information about the user through legal and appropriate sources.
• In the beginning, observe the user’s behavior, communication style, and cues to arrive at an assessment of the individual. Find what kind of communication most suits the individual through trial and error.
• Apply complete attention to the individual during interpersonal interactions
• If the user cannot be understood, seek support from the relevant sources for interpreting the patient’s communication.
• After several interactions arrive at the most effective way of communication with the user and report the matter to other caregivers

2.1 Explanation of how the communication process is influenced by values and cultural factors

Cultural is transmitted from the family, neighborhood, peers, community, teachers, leaders, etc. It is expressed through ideas, thoughts, customs, rituals, and specific social behaviors. Symbols have a special place in the determinants of the culture, for example, some cultures consider number 13 as an unlucky number and may not prefer to stay in a room that is numbered 13. Through culture people acquire, beliefs, values, and norms, which need to be understood by the health care professional.

Communication is often considered as a means of conveying ideas and cultural symbols (Jandt, 2004). Ferraro (1990) suggested three types of communication for cultural displays i.e. verbal, para-verbal, and non-verbal. The verbal communication of culture uses words with specific meanings, para-verbal is determined by the tone and modulation of the voice, and non-verbal communication by the face and body postures. Cultural upbringing gives the individual to decode the symbols in specific ways and respond with a behavior pattern. All components of communication, encoding, message, channel, etc. have cultural influence acquired over some time. It would be disastrous if the values and the cultural sensitivity of the care user were violated.

2.2

The legislation is for regulating the functioning of people’s lives and improving it through the framework of policies and rules.  For example, the Data Protection Act of 1998 regulates how the personal information of a care user can be used and disclosed. Since every health caregiver is oriented to the laws, the communication process must be within the legal framework provided by the authorities.  Confidentiality is one of the aspects of legal rights, which prevents the caregiver from disclosing to irrelevant peers or individuals who are inquisitive about the information without the prior consent of the patient. The healthcare worker has the responsibility to comply with the laws which can sometimes put constraints on the manner of communication (Michie 2007).

2.3 Effectiveness of organizational systems and policies in promoting good practice in communication.

The policies and practices of the institutions have a profound effect on the process of communication within a healthcare setting. They must be enablers of healthcare inured to bring positive outcomes to the patients. The manner of governance, the style of decision-making, the extent of empowerment to communicate with all levels of professionals in the organization, etc. determines the communication climate of an organization. Open and issue-based communications bring positive results while a centralized decision-making system delays the action and thwarts communication among colleagues and departments.

2.4 Ways of improving the communication process in a health and social care setting.

Communication is a critical tool for the success of health care. Many important steps can be taken by the management of the institution as well as the health care staff to improve communication in the health care centers. Caring for someone demands communication that is clear, honest, and truthful. However, there is occasion when this might not be possible due to various constraints. In such situations, the following strategies may be used.

• Communicate when the service user is prepared to receive instructions and has a higher level of alertness
• Do not rush conversations with the service user, allow sufficient time and provide ample time for reflection.
• Communicate critical matters in a place where it is free from disturbance and the patient is comfortable with the place.
• Always maintain eye contact, speak with clarity, and listen before making responses;
• Always use simple language while giving instructions, information, and choices.
• Regularly check whether the other person has understood it by asking questions.
• Seek help from others if the user cannot be understood.

Task 1: Report and self-evaluation

3.1 Accessibility and usage of standard ICT software packages to support work in health and social care

As we are working on health and social care projects, we are familiar with Information and Communication Technologies (ICTs) and their uses. They are critical for managing the Common Assessment Framework (CAF) and other patient services. ICTs are a set of computer-based technologies used to store, retrieve, manipulate, and report data through electronic devices such as computers, mobiles, laptops, etc. In typical health care situations, the data and information regarding health care are collected analyzed, and reported using standard or customized software packages. The formal and informal are communicated through e-mails, SMS text messaging, Twitter, WhatsApp messages, video chats, Facebook posts, etc, also.   The dedicated software packages that collect, store, and analyze data are the property of the healthcare institutions and can be accessed only by the relevant healthcare workers who have permission. Relevant data can be accessed through the network of computers using the password and identity of the worker.

In the recent trends in health care, the ICTs have become more pervasive in care institutions and are inevitable for improvement of the quality of the services.  For example, the United Nations (UN News Center 2006) proposes that ICTs are an integral part of developmental work necessary for helping health service customers. Various software packages are available from organizations such as GE Healthcare, Merge Healthcare, Quality Ststems Inc., etc. for application in healthcare systems. The common issues and functions addressed by ICT include medical record storage, medical practice management, patient tracking systems, networking and content management solutions, hospital management, service integration systems, and medical research  (Seth 2015).

ICT allows healthcare workers, patients, and organizations to access relevant and permitted information and communicate effectively and efficiently with each other. The health care workers have sufficient accessibility and opportunity to contribute to the health services and innovation of their performance using the ICT development services for patients (National Midwifery Council u.d).

3.2 Analysis of the Benefits of ICT in Healthcare Settings

A large range of stakeholders within society as a whole and the active professionals in healthcare institutions use ICT for many of their tasks. Most of them, i.e. existent in various levels of health care services are beneficiaries of the ICT. For example, at the International level, institutions such as WHO, UNICEF, etc., use ICT to administer their health programs and on the other end, the staff at health clinics, hospitals, care homes, etc. use ICT extensively.

It is noteworthy that ICTs enable the integration of access to health care in urban to rural areas; it has helped the caregivers to connect with patients to provide, advice, counseling, and information.  People with healthcare needs can now access their healthcare information and data easily. For example, the diagnostic data and pictures are available to the patients in their Smartphones and can be easily presented to the caring doctors. The busy and remotely working health professionals can interact with their superiors and colleagues effectively while being part of the ICT network established by the respective institutions. Their advice, service, and support provided through the ICT have created remarkable value for the patients and service takers.

The Hospital authorities and healthcare policymakers are also using ICT to gather relevant information from the field and make decisions for improved services. Many healthcare institutional managers are basing their strategic decisions on the hard data available from the inputs by the field workers.   Not only gathering of data but managing the services is also carried through the appropriate ICT systems. The Government health departments use digitalized data to map the needs of the community for short, and long-term issues and administer their program through virtual systems.

Overall, ICT is not merely a technology; it has the potential to bring out many useful outcomes (Dzenowagis et al 2005). The significant benefits of the ICT are listed below.

• health workers make better service decisions
• Healthcare institutions provide a better quality of service and safer care
• people in need of healthcare services get relevant information about their health and the choices available to them
• health authorities and governments respond to health needs effectively with equitable and efficient health systems
• Policymakers and the public are aware of the contexts, situations, and risks prevalent in the community
• All stakeholders have access to information and knowledge regarding health issues

3.3 Legal Considerations in the Use of ICT in Health and Social Care

Though ICT provides health workers with tremendous power to improve services and perform better, they must heed the legal implications of accessing and using health care data. Legislation and codes of practice are established to protect the rights and prevent harm to individuals and institutions. Various legislation and code of conduct rules are brought out by the government and the institutions to prevent the illegal use of ICT and to avoid harm to the stakeholders. Some of the prominent legislations and their implications are described below.

The health care workers are bound by Health and Safety at Work etc. Act 1974, and must ensure reasonable safety to the patients as well as colleagues (Aldworth et al 2007), which means that the health carers must not at any cost, create health and safety risks, and take appropriate action to prevent health damages. Data Protection Act of 1998 stipulates that the personal information stored in the hospital system must be secured and cannot be shared with unauthorized individuals or agencies (Gov 2014). Another legislation i.e. the Computer Misuse Act of 1990, is introduced to prevent deliberate misuse of computer systems such as phishing, data pilferage, hacking, etc (UK Government u.d). There are penalties with fines and custodial sentences for illegal and unauthorized attempts to access or use data stored in healthcare database access. The health care employees must be aware of the data security and the probable misuse of the technology by the culprits. ICT is meant to collaborate with individuals and institutions and not to harm civil establishments.  Hence, all stakeholders, professional and non-professional participants in the healthcare industry have a responsibility to understand and apply effective communication to deliver quality care services.

Conclusion

Communication is critical to the health care professional and the caregiver must not only know about the communication process but also develop skills to manage a variety of communication situations presented in the work situations. The current challenges should be addressed by developing new communication paradigms and expanding the tools of communication in the healthcare systems.

References

Aldworth, C; Talman, H; Billingham, M; Stretch, B; Moonie, N; Whitehouse, M; Mason, L., 2007. BTEC National health and social care. Oxford: Heinemann.

Dzenowagis, J., Kernen, G. and World Health Organization, 2005. Connecting for health: global vision, local insight: report for the World Summit on the Information Society.

Ferraro, G. P., 1990. The cultural dimension of international business. New Jersey: Prentice-Hall.

Jandt, F., 2004. An introduction to intercultural communication. 4^th ed. London: Sage Publications.

Michie, V., 2004. Working in Care Settings. Nelson Thornes

National Midwifery Council (u.d) Confidentiality| Nursing and Midwifery Council. [Online} Available at: http://www.nmc-uk.org/nurses-and-midwives/advice-by-topic/a/advice/confidentiality/. Accessed 25^th March, 2017.

Rutter, J., 2002. Changing health behavior: intervention and research with social cognition models. McGraw-Hill Education (UK).

Seth, S 2015. Top Medical & Healthcare Software Companies, Available at http://www.investopedia.com/articles/investing/010715/top-medical-healthcare-software-companies.asp, Accessed on 25^th March 2017.

UK Government (u.d) Computer Misuse Act 1990 – computer misuse offense. Available at: http://www.legislation.gov.uk/ukpga/1990/18/contents, Accessed on 25^th March 2017.

UN News Center 2006. Information and communication technology vital to development – UN Assembly chief. [Online} Available at http://www.un.org/apps/news/story.asp?NewsID=20780&Cr=information&Cr1=technology Accessed on 25^th March 2017.