Healthcare Communication Fundamentals
Master professional communication, therapeutic techniques, structured handoff methods, documentation principles, and interprofessional collaboration, foundational skills for safe, effective healthcare.
Therapeutic Communication
Purposeful communication that promotes healing
Therapeutic communication is goal-directed interaction that prioritizes the patient's needs. It requires active listening, empathy, and intentional use of verbal and nonverbal techniques.
Therapeutic Techniques
Non-Therapeutic Responses to Avoid
Giving false reassurance ('Everything will be fine'), being judgmental ('You shouldn't feel that way'), giving advice ('If I were you...'), changing the subject when the patient is expressing concerns, using medical jargon the patient doesn't understand, and asking 'why' questions ('Why didn't you take your medication?') which sound accusatory.
SBAR Communication
Structured handoff for patient safety
SBAR is a standardized communication framework designed to prevent critical information loss during handoffs, phone calls to providers, and escalation of concerns.
S: Situation
What is happening right now? State the patient's name, location, the immediate concern. Be concise and specific. Example: 'I'm calling about Mr. Smith in Room 412. His blood pressure has dropped to 82/50 and he is diaphoretic.'
B: Background
What is the relevant clinical context? Admitting diagnosis, pertinent medical history, current treatment, recent changes. Only include information relevant to the current situation. Example: 'He was admitted yesterday for pneumonia. He has a history of heart failure.'
A: Assessment
What do you think is going on? Share your clinical judgment. Example: 'I'm concerned he may be developing sepsis. His lactate was 3.2 an hour ago and he has a new fever of 38.8°C.'
R: Recommendation
What do you need? Be specific. Example: 'I'd like you to come evaluate him. Would you like me to start a fluid bolus and draw blood cultures in the meantime?'
Why SBAR Works
Without a structure, handoffs often bury the critical information in a sea of background data. SBAR forces the communicator to lead with the most important information (Situation), provide only relevant context (Background), share their clinical reasoning (Assessment), and state a clear ask (Recommendation). This saves time and prevents the receiver from having to extract the key message.
Documentation Principles
If it wasn't documented, it wasn't done
Healthcare documentation is a legal record that serves multiple critical functions: continuity of care, legal protection, communication between providers, quality improvement, and reimbursement.
Documentation Best Practices
Be objective: Document what you observe, not your opinions. 'Patient stated: I feel dizzy' not 'Patient seems dizzy.' Be timely: Document as close to the event as possible. Be accurate: Use exact measurements, times, and quotes. Be complete: Include assessment findings, interventions, and patient response.
Documentation Errors to Avoid
Never: Use correction fluid or erase entries. Backdate or add entries out of sequence. Document in advance ('pre-charting'). Include subjective judgments ('Patient is non-compliant'). Use unapproved abbreviations. Leave blank spaces in paper records. Document care that was not provided.
Error Prevention & Situational Awareness
Communication strategies that prevent harm
Most healthcare errors involve communication failures. A culture of safety requires specific communication strategies.
Read-Back / Repeat-Back
When receiving verbal orders or critical test results, repeat the information back to the sender for verification. 'I'm reading back: Give Metoprolol 25 mg by mouth now. Is that correct?' This catches mishearing or miscommunication before it reaches the patient.
CUS Framework: Escalating Concerns
C: 'I am Concerned' (first level). U: 'I am Uncomfortable' (second level). S: 'This is a Safety issue' (highest level: stops the action). This graduated framework gives team members language to escalate concerns assertively.
Two-Challenge Rule
If your concern is dismissed the first time, voice it again with different framing. If dismissed twice, escalate to the next level (charge nurse, supervisor, chain of command). Patient safety always takes priority over hierarchy.
Just Culture
A just culture distinguishes between human error (unintentional, support the person), at-risk behavior (taking shortcuts, coach the person), and reckless behavior (conscious disregard for safety, hold accountable). This distinction encourages reporting of errors and near-misses without fear of punishment, which is essential for learning and prevention.
Match the Communication Concept
Terms
Definitions
Communication Foundations Quiz
1/20Which response is an example of therapeutic communication?