Wednesday, July 15, 2009

"Seven" things about communication

Yesterday, I posted a comment about the importance of linking high-end IT gadgets, things that often appear to be stand-alones, to the larger whole. I'm sensitive to this since my daughter has been hearing with a cochlear implant for the past 12 years.

I know from experience that it's easy to think you're being heard when you call a child to dinner and she shows up. She comes because she heard you say, "Time for dinner!" Or she heard something and decided to check it out since dinner is normally served at this time. Or she heard nothing but something smelled good. The outcome "showing up for dinner" is the same in each case. But you'll only replicate the results (and achieve them under tougher conditions) if the first statement is the accurate one.

In healthcare, regulators are focusing on closed-loop communication, techniques that are long-time norms in industries that deliver reliable results. Healthcare workers now have standards that prohibit transmission of high-stakes information--such as chemotherapy orders--by telephone. Clinicians receiving verbal orders have a duty to "read back," and clinicians who have given verbal orders must verify the information has been heard as intended. Other communication-sensitive initiatives include standard pathways and windows of time for notifying providers of critical lab values and radiology findings.

There's been more than a small amount of push-back from clinicians, especially from those who perceive they have never initiated, contributed to, or facilitated an error rooted in poor communication. (Every year, 1.5 million people in the US are harmed by medication errors, a statistic which substantively refutes the notion that entrenched communication patterns are sufficient.)

So I thought I'd share some communication "best practices" from my daughter, a reluctant but seasoned communication expert. She's a college student and, in the summer, the equine director at a residential camp who goes by the name "Seven." Here's what she shares with other camp staff and her campers, consider them seven from Seven:

Tips for Talking to Seven
The numbers below look different even though they're all the number “7.” Hearing with a cochlear implant is like that, too. I (“Seven”) don’t hear exactly like you do. My hearing “looks” different than yours (unless you hear with a cochlear implant, too!).

Even though I can use a cell phone and do many of the same things you do, when I miss words and exchanges that happen in “real time,” I may wind up lost, even though I was “with” you just a minute before. Here are things you can do to help me hear what you’re saying & stay current since I definitely don’t want to miss any of the fun!

I rarely overhear things, especially in noisy places (like the dining hall or a restaurant).

Be sure to talk to me directly when something important—like what we’re doing next or a change in the schedule—pops up.

I’m a really good lip-reader. Let me see your face when you’re talking whenever possible.

I’m “in my zone” when I’m around the horses. I usually know what’s going on or can guess what’s about to happen. So I may look like I’m a better hearer at the barn than I am in other places.

I don’t mind repeating things if you don’t understand me the first time I say them. I often have the same trouble with what you say. :)

I know sign language and will be happy to teach you how to make a “name sign” for yourself and help you learn some signs.

It’s okay to ask me questions about cochlear implants and how I hear.


Reality Rounds said...

Great post! I am the director of the universal newborn hearing screen program at my hospital, so this post really resonates with me. Your daughter sounds awesome.lime

Susan Carr said...

Great post! This insight from your "reluctant but seasoned communication expert" will help me in both of my roles: editor a journal on safety improvement in healthcare and daughter of a cochlear implant recipient. I agree with Reality Rounds that your daughter "sounds" awesome. Many thanks to both of you.

Jeff said...

Great advice. It is too easy to forget about the person you are communicating to and just focus on your own message, not how they need/want to hear it. Thanks.

Sean said...

I think this subject of 'listening' falls under the 'assumption - umbrella'.
We assume everyone listens and communicates the same way we do and we take for granted some of the most basic and very important characteristics of listening.
Communication is always changing and growing, it's our job to keep up.
Otherwise we compromise the message and the safety of those involved.
Great post!

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