2. Partnering with Consumers

Communication that supports effective partnerships

Action 2.8

Consumers receive the information they need in a way that is appropriate for them.

Intent

Consumers receive the information they need in a way that is appropriate for them.

Reflective questions

How are the communication needs of consumers and the community identified?

What strategies are used to tailor communication to meet the needs of a diverse consumer and community population?

Key tasks

  • Develop a framework for meeting the communication needs of a diverse consumer and community population

  • Ensure that accredited interpreter services are available to consumers who require them

  • Use a variety of mechanisms to meet the communication needs of a diverse consumer and community population.

Strategies for improvement

Hospitals

Language and cultural factors can create barriers to accessing health care, leading to poorer health outcomes and a lower quality of care for some sections of diverse populations. Diversity comes in many forms – for example:

  • Language factors may affect consumers for whom English is not their first language, consumers with a cognitive impairment and consumers with a physical condition such as deafness or blindness
  • Cultural factors may affect consumers from culturally and linguistically diverse communities, whose view of health and wellbeing may differ from the Australian experience; the diversity of cultures accessing health care in a multicultural country such as Australia can pose challenges for a health service organisation and its workforce to engage in a culturally responsive way.

There is no ‘one size fits all’ solution to meeting the communication requirements of a diverse consumer population. However, health service organisations can work to develop a framework that integrates cultural competency into its communication mechanisms.1

Different consumers will engage with different communication mechanisms. Some consumers may prefer casual, verbal conversations, whereas others may prefer written information resources or audiovisual presentations. Communication mechanisms should not be viewed in isolation; instead, the mechanisms chosen should complement each other and aim to appeal to different consumer communication preferences.

Determine the diversity of consumers and the local community

Patient and community data are essential to understanding consumer communication needs, and developing or improving communication mechanisms to meet these needs.1 Review the diversity of the consumers who use the organisation’s services and make up the local community by2:

  • Undertaking a community profiling project, which involves gathering information about the diversity within the community; its history, social and economic characteristics; the groups and networks within the community; and the social and infrastructure services that exist
  • Administering surveys to help identify diversity among consumers
  • Using demographic data from the Australian Bureau of Statistics, or local, or state and territory government sources to understand the background of the organisation’s consumers
  • Networking with other organisations or individuals in the community – such as culturally and linguistically diverse community groups; community participation managers; Primary Health Networks; Local Hospital Networks; local, state and territory government organisations; and professional associations – to share knowledge about communication preferences and needs.

For guidance on undertaking consultations and surveys, see the Scottish Health Council’s Participation Toolkit.3

Review current communication mechanisms

Determine whether the organisation’s current communication mechanisms meet the needs of diverse patient populations by reviewing:

  • Consumer information developed by the organisation, such as patient brochures, posters and consent forms, to see whether they are
    • culturally appropriate or available in culturally appropriate formats
    • available in a variety of community languages
    • available in a variety of accessible formats, such as audio or braille
  • The availability of interpreting services, and methods of access to these services for patients and members of the workforce
  • The cultural competency and confidence of the workforce in communicating with diverse patient populations.

One Size Does Not Fit All: Meeting the health care needs of diverse populations1 can be used to help evaluate the current services provided for diverse patient populations.

If the organisation currently uses communication mechanisms that are tailored to the needs of its diverse consumer and local community populations, review them to determine whether any additions or improvements can be made.

If the organisation does not use communication mechanisms that are tailored to the needs of its consumers, use the strategies outlined below to develop or adapt a framework to help meet these needs.

Set up a supportive foundation for tailoring communication mechanisms

This may involve:

  • Engaging the support of the organisation’s management and governing body to help drive change and build workforce support
  • Implementing a policy that requires cultural and language considerations to be incorporated into all communication strategies
  • Implementing a plain-language policy that makes written information easier to understand4
  • Educating the workforce about the diversity of the consumers who use the organisation’s services; consider accessing cultural competency training if people from culturally and linguistically diverse communities, or Aboriginal and Torres Strait Islander communities regularly use the service5
  • Engaging consumers in developing and reviewing health communications
  • Facilitating easy access to interpreting services by
    • identifying and promoting appropriate interpreting services that are competent at working in a health setting (for example, discussing health and medical issues); the Australian Government’s Translating and Interpreting Service can supply phone and on-site services
    • developing policies and procedures, and educating the workforce on when and how to engage an interpreting service
    • educating the workforce on the appropriate use of interpreters – family or friends may not be appropriate interpreters because of health privacy issues.

Resources and tools include:

Implement communication mechanisms that meet the needs of specific populations

This may involve:

  • Adapting existing consumer information into culturally appropriate formats by changing the design and messaging used in a resource, or adapting the information for an alternative delivery channel, such as video or audio
  • Translating existing consumer information into community languages
  • Providing multiple opportunities for consumers to gain access to information in a variety of formats
  • Employing or engaging interpreters to be part of the patient care team
  • Using techniques to check a consumer’s understanding of information, such as a ‘teach back’ method9
  • Using symbols or cue cards for communicating with patients during care, such as instructions for the correct use of medicines
  • Using technology, mobile apps or social media to help communication, if appropriate.

A number of tools and resources can help guide effective and tailored communication with diverse patient populations, including:

Day Procedure Services

Language and cultural factors can create barriers to accessing health care, leading to poorer health outcomes and a lower quality of care for some sections of diverse populations. Diversity comes in many forms; for example:

  • Language factors may affect consumers for whom English is not their first language, consumers with a cognitive impairment and consumers with a physical condition such as deafness or blindness
  • Cultural factors may affect consumers from culturally and linguistically diverse communities, whose view of health and wellbeing may differ from the Australian experience; the diversity of cultures accessing health care in a multicultural country such as Australia can pose challenges for a health service organisation and its workforce to engage in a culturally responsive way.

There is no ‘one size fits all’ solution to meeting the communication requirements of a diverse consumer population. However, health service organisations can work to develop a framework that integrates cultural competency into its communication mechanisms.1

Different consumers will engage with different communication mechanisms. Some consumers may prefer casual, verbal conversations, whereas others may prefer written information resources or audiovisual presentations. Communication mechanisms should not be viewed in isolation; instead, the mechanisms chosen should complement each other and aim to appeal to different consumer communication preferences.

Day procedure services may provide care to people from different communities, not just from the local area. Services should identify the diversity of consumers who use their service to develop or improve current communication mechanisms.1 A first step in this process is to routinely collect patient data through pre-admission screening or by administering surveys to identify diversity among current consumers.

For guidance on undertaking consultations and surveys, see the Victorian Government’s Engagement Toolkit2 and the Scottish Health Council’s Participation Toolkit.3

Review current communication mechanisms

Determine whether the organisation’s current communication mechanisms meet the needs of diverse patient populations by reviewing:

  • Consumer information developed by the organisation, such as patient brochures, posters and consent forms, to see whether they are
    • culturally appropriate or available in culturally appropriate formats
    • available in a variety of community languages
    • available in a variety of accessible formats, such as audio or braille
  • The availability of interpreting services, and methods of access to these services for patients and members of the workforce
  • The cultural competency and confidence of the workforce in communicating with diverse patient populations.

One Size Does Not Fit All: Meeting the healthcare needs of diverse populations1 can be used to help evaluate the current services provided for diverse patient populations.

If the organisation does not use communication mechanisms that are tailored to the needs of its consumers, use the strategies outlined below to develop or adapt a framework to help meet these needs.

Set up a supportive foundation for tailoring communication mechanisms

This may involve:

  • Engaging the support of the organisation’s management and governing body to help drive change and build workforce support
  • Implementing a policy that requires cultural and language issues to be incorporated into all communication strategies
  • Implementing a plain-language policy that makes written information easier to understand4
  • Educating the workforce about the diversity of the consumers who use the organisation’s services; consider accessing cultural competency training if people from culturally and linguistically diverse communities, or Aboriginal and Torres Strait Islander communities regularly use the service
  • Facilitating easy access to interpreting services by
    • identifying and promoting appropriate interpreting services that are competent at working in a health setting (for example, discussing health and medical issues); the Australian Government’s Translating and Interpreting Service can supply phone and on-site services
    • developing policies and procedures, and educating the workforce on when and how to engage an interpreting service
    • educating the workforce on the appropriate use of interpreters – family or friends may not be appropriate interpreters because of health privacy issues.

Resources and tools include:

Implement communication mechanisms that consider the needs of specific populations

This may involve:

  • Adapting existing consumer information into culturally appropriate formats by changing the design and messaging used in a resource, or adapting the information for an alternative delivery channel, such as video or audio
  • Sourcing culturally appropriate and accessible consumer information from other organisations that have developed relevant materials
  • Translating existing consumer information into community languages
  • Providing multiple opportunities for consumers to gain access to information in a variety of formats
  • Employing or engaging interpreters as part of the patient care team
  • Using techniques to check a consumer’s understanding of information, such as a ‘teach back’ method.8

A number of tools and resources can help guide effective and tailored communication with diverse patient populations, including:

Examples of evidence

Select only examples currently in use:

  • Policy documents about communication, including the use of plain language, and addressing the cultural and linguistic diversity of the community that the health service organisation serves
  • Demographic profile or demographic survey for the health service organisation that identifies the diversity of the community it serves
  • Results of a needs assessment project that identifies local health needs
  • Demographic data from external sources that are used for strategic and communication planning to identify the cultural diversity and needs of patients and carers
  • Training documents about cultural awareness and diversity
  • Consumer and carer information packages or resources that are culturally appropriate, and are available in different languages and accessible formats
  • Feedback from consumers from culturally or linguistically diverse backgrounds during the development or review of information packages or resources
  • Committee and meeting records that show that the health service organisation is represented at local network meetings that reflect the local diversity of the patient population
  • Reports on interpreter use and access
  • Feedback from patients and carers about whether communication processes meet their needs
  • Observation that clinicians have access to communication resources that provide contact details for support services such as local consumer health advocates, interpreters, or cultural support and liaison services.
MPS & Small Hospitals

Patient and community data are essential to understanding consumer communication needs, and developing or improving communication mechanisms to meet these needs.1

MPSs or small hospitals that are part of a local health network or private hospital group should adopt or adapt and use the established framework for meeting the communication needs of a diverse consumer and community population.

Small hospitals that are not part of a local health network or private hospital group should develop mechanisms for determining the diversity of the consumers who use the services and the local community by2:

  • Administering surveys to help identify diversity among consumers
  • Using demographic data from the Australian Bureau of Statistics, or local, or state and territory government sources to understand the background of the organisation’s consumers
  • Networking with other organisations or individuals in the community – such as culturally and linguistically diverse community groups; community participation managers; Primary Health Networks; Local Hospital Networks; local, state and territory government organisations; and professional associations – to share knowledge about communication preferences and needs.

Determine whether the organisation’s current communication mechanisms meet the needs of diverse patient populations by reviewing:

  • Consumer information developed by the organisation, such as patient brochures, posters and consent forms
  • The availability of interpreting services, and methods of access to these services for patients and members of the workforce
  • The cultural competence and confidence of the workforce in communicating with diverse patient populations.

One Size Does Not Fit All: Meeting the healthcare needs of diverse populations1 can be used to help evaluate the current services provided for diverse patient populations.

If the organisation currently uses communication mechanisms that are tailored to the needs of its diverse consumer and local community populations, review them to determine whether any additions or improvements can be made.

Action 2.9

Where information for patients, carers, families and consumers about health and health services is developed internally, the organisation involves consumers in its development and review

Intent

Consumers are involved in the development of information about health and health services, so it easy to understand and act on.

Reflective question

How are consumers involved in the development and review of patient information that is developed internally?

Key tasks

  • Develop and implement a process for engaging consumers during the development of consumer information about health and health care.

  • Develop and implement a process for sourcing consumer feedback on internally developed consumer information and incorporating this feedback to inform future improvements.

Strategies for improvement

Hospitals

Consumers can play an important role in supporting health service organisations to develop information that is clear, easy to understand, and relevant to the needs of consumers and the local community.11, 12

Review existing processes for involving consumers in the development of consumer information

This could include identifying the publications that the organisation has produced, looking at how they were developed and determining whether consumers were involved in their development.

If consumers were not involved in developing the publications, develop and implement a process to involve consumers for all relevant new consumer information. Strategies may include:

  • Establishing a consumer-based patient information working group to lead and advise on developing consumer information11
  • Attending community meetings to discuss the information needs of consumers, and the barriers and facilitators to understanding health information in the community
  • Holding waiting-room discussions, focus groups or workshops to plan and develop consumer information
  • Engaging consumers to co-author information in conjunction with the organisation
  • Collaborating with local health consumer organisations to develop information
  • Conducting interviews or one-on-one consultations with consumers to inform the development of information.

Engage consumers to review and provide feedback on existing patient information

Strategies may include:

  • Conducting email, mail or phone surveys of consumers who have used the organisation’s publications
  • Making follow-up phone calls to consumers who have been provided with patient information publications, to identify any problems they had with understanding the information
  • Holding waiting-room discussions, focus groups or workshops for consumers to review and provide feedback on consumer information.11, 12

Further information on involving patients in testing information publications can be found in:

Incorporate feedback and report on how this was done

Feedback from consumers could be16:

  • Directly incorporated into the development of patient information publications (for example, feedback might indicate that language needs to be modified so that the information is understandable for consumers with low levels of literacy)
  • Used as a basis for the development of new publications (for example, if feedback indicates that there are gaps in the information, a new publication could be developed to avoid misunderstanding)
  • Analysed by committees or groups tasked with the development of patient information publications to identify key themes for action (for example, many consumers may be experiencing a similar misunderstanding, which might require changes in programs and policies)
  • Used as a basis for a broader organisation-wide communication strategy or policy to reduce health literacy barriers.

When a publication has been refined after consumer feedback, show the revised document to consumers to check that the interpretation and changes are appropriate. This could be through one-on-one conversations, committee meetings, discussions in waiting rooms or workshops.

Provide feedback to the community about the kinds of changes made to the publications in response to consumer feedback. This could be through information and updates in newsletters, meetings or reports for the people who were involved in identifying, developing and implementing the changes.

If the organisation does not develop its own information publications, source and use publications that have been developed in partnership with consumers, such as those developed by state and territory health or other government departments, professional associations or external providers. Publications from other organisations may need to be tested with the local community and adapted.

Day Procedure Services

Consumers can play an important role in supporting health service organisations to develop information that is clear, easy to understand, and relevant to the needs of consumers and the local community.11, 12

Day procedure services may not have the resources to develop their own consumer information. If this is the case, source and use publications that have been developed in partnership with consumers, such as those developed by state and territory health departments, professional associations or external providers. Publications from other organisations may need to be tested to ensure that they suit the patients who use the day procedure service, and adapted if necessary.

Review existing processes for involving consumers in the development of consumer information

This could include identifying the publications that the organisation has produced, looking at how they were developed and determining whether consumers were involved in their development.

If consumers were not involved in developing the publications, develop and implement a process to involve consumers for all new consumer information. Strategies may include:

  • Holding waiting-room discussions, focus groups or workshops to plan and develop consumer information
  • Engaging consumers to co-author information in conjunction with the organisation
  • Collaborating with local health consumer organisations to develop information
  • Conducting interviews or one-on-one consultations with consumers to inform the development of information.

Engage consumers to review and provide feedback on existing patient information

Strategies may include:

  • Conducting electronic, mail or phone surveys of consumers who have used the organisation’s publications
  • Making follow-up phone calls to consumers who have been provided with patient information publications, to identify any problems they had with understanding the information
  • Holding waiting-room discussions, focus groups or workshops for consumers to review and provide feedback on consumer information.11, 12

Further information on involving patients in testing information publications can be found in:

Incorporate feedback and report on how this was done

Show the revised document to consumers to check that the interpretation and changes are appropriate. This could be done on a one-on-one basis, or through discussions in waiting rooms or workshops.

Provide feedback to the community about the kinds of changes made to the publications in response to consumer feedback. This could be through information and updates in newsletters, meetings or reports for the people who were involved in identifying, developing and implementing the changes.

Examples of evidence

Select only examples currently in use:

  • Committee and meeting records that show consumer involvement in the development and review of patient information resources
  • Feedback from consumers who have used the health service organisation’s information publications
  • Evaluation reports on existing patient information publications that identify how consumers were involved in development and review
  • Examples of publications that have changed in response to consumer feedback
  • Communication with consumers who provided input into the development or review of resources about the types of changes made in response to their feedback.
MPS & Small Hospitals

Consumers can play an important role in supporting health service organisations to develop information that is clear, easy to understand, and relevant to the needs of consumers and the local community.11, 12

Some MPSs and small hospitals may not develop their own publications. If this is the case, use publications that have been developed in partnership with consumers, such as those developed by state and territory health departments, professional associations or external providers. Publications from other organisations may need to be tested with the local community and adapted.

If the MPS or small hospital develops its own consumer information, review existing processes for involving consumers in the development process. This could include identifying the publications that the organisation has produced, looking at how they were developed, determining whether consumers were involved in their development, and engaging consumers to review and provide feedback on existing patient information.

Action 2.10

The health service organisation supports clinicians to communicate with patients, carers, families and consumers about health and health care so that:

a. Information is provided in a way that meets the needs of patients, carers, families and consumers

b. Information provided is easy to understand and use

c. The clinical needs of patients are addressed while they are in the health service organisation

d. Information needs for ongoing care are provided on discharge

Intent

Consumers receive the information they need to get the best health outcomes, and this information is easy to understand and act on.

Reflective questions

What processes are used to ensure that the information available for clinicians to give to patients meets the patients’ needs?

How are clinicians supported to meet the information needs of patients for ongoing care on discharge?

Key task

  • Set up processes to support clinicians to communicate effectively with consumers about their health and healthcare needs.

Strategies for improvement

Hospitals

Clear and open communication between consumers and clinicians is vital for the delivery of effective, efficient and ethical health care. It also facilitates good clinical decision-making, protects the legal rights of consumers to be informed and involved in decision-making, and assists when supported decision-making is required.

Processes to support clinicians to communicate effectively with patients and their carers about all aspects of their care involve obtaining informed consent, and determining a patient’s treatment preferences and goals of care. Use the strategies below to adapt current processes or adopt new processes for supporting communication between clinicians and consumers.

Set up an environment that supports open, clear and effective communication between clinicians and consumers

This may involve15, 5:

  • Engaging leadership and governing bodies to integrate the importance of health literacy and clear communication into the organisation’s operations, and align it with other organisational priorities, such as reducing health disparities
  • Assigning responsibility to an individual or group for actions to improve the health literacy environment
  • Auditing the health literacy environment (either in the annual audit program of the organisation or as a standalone audit)
  • Providing clinicians with training that highlights the importance of health literacy
  • Implementing a plain-language policy that makes written information easier to understand.

Provide access to appropriate consumer information resources and tools to support communications

Consumer information should be at a level that can be understood and used by diverse consumers. It may be appropriate to identify or develop both simpler and more complex information resources, so that clinicians have access to the most appropriate information for an individual patient.

Information resources and tools that clinicians can use to support their communications may include:

  • Written information (for example, brochures, fact sheets, posters, online material); if developed locally, consumers should be involved in developing these resources (Action 2.9)
  • Visual diagrams and decision aids (for example, the Commission’s patient decision aids)
  • Cue cards or symbols to support communication with people who do not understand English (for example, Eastern Health’s Cue Cards in community languages9).

Health service organisations are responsible for ensuring that the information provided to patients is current.

Educate consumers about their important role in supporting effective communication

Develop information resources about communication processes and provide these to patients receiving or preparing to receive care. Resources may include brochures, fact sheets, newsletters, posters, online resources and information broadcast on internal media communication channels in the service.

Include information about:

  • The important role that patients and carers play in providing information to the healthcare team
  • When agreed communication processes occur (times, locations)
  • Which clinicians take part in these processes
  • Alternative methods for communicating concerns to the healthcare team
  • Ways of providing feedback on these communication processes.

Involve patients and carers in developing information and resources about communication processes (Action 2.9).

Monitor and assess communication

Strategies may include:

  • Auditing healthcare records to assess the information provided to patients and carers
  • Providing a mechanism for patients to give feedback about the communication and information they receive during an episode of care
  • Seeking feedback on communication and information resources from consumers who use the services (for example, including questions about medicines information in patient experience surveys).
Day Procedure Services

Clear and open communication between consumers and clinicians is vital for the delivery of effective, efficient and ethical health care. It also facilitates good clinical decision-making, protects the legal rights of consumers to be informed and involved in decision-making, and assists when supported decision-making is required.

Processes to support clinicians to communicate effectively with patients and their carers about all aspects of their care involve obtaining informed consent, and determining a patient’s treatment preferences and goals of care. Use the strategies below to adapt current systems or adopt new systems for supporting communication between clinicians and consumers.

Set up an environment that supports open, clear and effective communication between clinicians and consumers

This may involve15, 5:

  • Auditing the health literacy environment (either in the annual audit program of the organisation or as a standalone audit)
  • Providing clinicians with training that highlights the importance of health literacy
  • Implementing a plain-language policy that makes written information easier to understand.

Provide access to appropriate consumer information resources and tools to support communications

Consumer information should be at a level that can be understood and used by diverse consumers. It may be appropriate to identify or develop both simpler and more complex information resources, so that clinicians have access to the most appropriate information for an individual patient.

Information resources and tools that clinicians can use to support their communications may include:

  • Written information (for example, brochures, fact sheets, posters, online material); if developed locally, consumers should be involved in developing these resources (Action 2.9)
  • Visual diagrams and decision aids (for example, the Commission’s patient decision aids)
  • Cue cards or symbols to support communication with people who do not understand English (for example, Eastern Health’s Cue cards in community languages9).

Health service organisations are responsible for ensuring that the information provided to patients is current.

Monitor and assess communication

Strategies may include:

  • Providing a mechanism for patients to give feedback about the communication and information they receive during an episode of care
  • Seeking feedback on communication and information resources from consumers who use the services (for example, including questions about medicines information in patient experience surveys).

Examples of evidence

Select only examples currently in use:

  • Observation that the workforce, patients and carers have access to information about the health service organisation and the services it provides
  • Audit results of healthcare records that reflect an assessment of need, and the information and support provided before, during and after an episode of care
  • A register of interpreter and other advocacy and support services available to the workforce, patients and carers
  • Examples of information materials provided to patients and carers that are in plain language, and available in different languages and formats
  • Results of patient and carer experience surveys regarding the information provided
  • Audit of the proportion of patients receiving a discharge summary
  • Feedback from patients and carers about the information communicated to them in the health service organisation and on discharge.
MPS & Small Hospitals

Providing clinicians with access to training that highlights the importance of health literacy can improve communication with consumers.

The effectiveness of clinicians’ communication can be monitored and assessed by:

  • Providing a mechanism for patients to give feedback about the communication and information they receive during an episode of care
  • Seeking feedback on communication and information resources from consumers who use the services (for example, including questions about medicines information in patient experience surveys).
Last updated 21st June, 2018 at 11:22pm
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