Patient centred communication on hospital wards

This is an enter and view report published by Healthwatch Coventry, October 2017.

The Healthwatch was planning to do work on communication and the University Hospital Coventry and Warwickshire (UHCW) was also looking into the issue. There was a special focus on those with specific communication needs, this might include those with learning disabilities or English as a second language.

A total of 107 people were spoken to, this included 72 patients, 24 members of staff and 11 relatives.

Majority of comments were positive. A detailed summary of findings is given in the report, which involved visits to a number of different wards within the hospital.

A set of recommendations were published and a response is given from the provider.

Summary of recommendations:

- Address variation in availability and awareness of resources to support communication with patients. A small number of accessible and useful resources are more likely to be identifiable and used by ward staff than many different resources. Utilise good practice examples from individual wards making these more widely available on different wards.

- Review policy and guidance on patient interpretation and translation within the Trust. Look at the appropriateness of current practice on who is doing translation and in what circumstances. We found staff of many roles and relatives doing translation. It was unclear the extent to which this was for day-to-day communication or for clinically related communication. The aim should be a patient focused approach, which is consistent, safe, and workable.

- Develop the support for patients who are hearing impaired, this is a significant number of patients (from our findings the majority are older people with hearing loss) and the Trust needs to consider and resource how to address these needs consistently and effectively on a day to day basis. Review the Sign Language Charter, what it should be achieving and if this is useful for direct patient care and to ensure that ward staff are aware of it. Evidence this.

- Build on existing training to develop and provide training for different grades of staff around learning disability awareness.

- Work with CWPT to review the role of the Learning Disability Acute Liaison nurses by gathering input of ward staff and the Acute Liaison nurse team to assess how this is working; if this support is meeting the needs of wards and if this service has sufficient resource to meet needs.

- Work with ward staff to establish the best resources to provide simple translated information in other languages and make this available on every ward. This may be the British Red Cross book if awareness of this resource amongst staff is raised/promoted.

- Promote greater access to the Language Line interpretation service for patients on wards when it is difficult to organise a face-to-face interpreter in a timely way. To build on the work already carried out on how better access to phones can be provided on wards including travelling phones so that patients are not restricted to accessing a phone at a desk or fixed point.

- Improve the quality of communication with patients and relatives regarding planning for discharge, working for this to begin earlier and be clearer to patients and relatives. The key is the culture and leadership around this. As new approaches around discharge are adopted, gather evidence to see if improved communication is resulting.