Display as participants enter and explain that this training was developed and created based on industry and educator input in conjunction with the Health Workforce Initiative Statewide Advisory Committee, California Community Colleges Chancellor’s Office, Workforce and Economic Development. This is just one soft skills module of the comprehensive training package: “Hi-Touch Healthcare: The Critical 6 Soft Skills.” Hi-Touch Healthcare

Written Communication

WHAT TO EXPECT IN THIS PRESENTATION Background Key components to effective written communication Forms of written communication Misinterpretation in communication Tips for effective communication Quickly preview the session.

Background The Joint Commission on Accreditation of Healthcare Organizations (JCAHO) states that "70% of sentinel events are directly related to ineffective and poor communication between multi-disciplinary healthcare providers." (Willingham & Eden (2007). Oncology Nursing Forum, V34(2). Note that ineffective communication can come in the form of written communication and documentation.

Key Components to effective written communication Factual Objective Respectful Confidential Stress the importance of objectivity rather than subjectivity. Also, stress that ALL written documentation is admissible in court; Therefore, statements must be factual and use legally approved abbreviations.

Key Components to effective written communication Non-judgmental Non-emotional Correct grammar Correct spelling Use of legal abbreviations

Written communication IN HEALTHCARE Forms of written communication: Paper charting Interdepartmental memos E-mail Electronic Health Care Records (EHR’s) Text messages Patient education information Discharge instructions Important to note that even unofficial written notes placed on a chart, for example, for other providers to see can be misinterpreted as disrespectful or derogatory. Also, remember that notes and charts are admissible in court.

Misinterpretation in communication Words can mean different things to different people Healthcare workers use acronyms and medical terminology that lay people, including patients and families, may not understand Being aware of specialized vocabulary or phrases is important for written discharge instructions or copies of patient care records sent home with families. People who are not familiar with medical lingo may see words that they are not familiar with, words that may have different meanings for lay people.

Case example A new monitor technician in a local hospital ICU is being oriented to the unit. A new patient is admitted from surgery and she overhears the nurses talking about the “cabbage patient” (CABG – coronary artery bypass graft)

Case example The entire day she thinks she made the wrong choice in jobs because she thinks they are talking about the patient being a “vegetable” and are being disrespectful Luckily, one of the people who is orienting her explains to her that CABG is an acronym. But, how many times do people not get the meaning of what we say correct?

Activity Weasel Words Exercise Weasel words are words that can be misinterpreted Look at how easy it is to look at the two pictures of the weasels and instantly like the one on the right better… it’s all about impression and interpretation. The weasel on the left is definitely misinterpreted!! (See detailed procedures on page 5 of the Trainer Manual.) Procedures for Weasel Words Activity: Goal: To demonstrate that words used in healthcare (both written and verbal) can often be misinterpreted by patients and their families. It is important to remember to use language that can be understood.  Materials Needed:  A copy of the “Discharge Instructions” for each group of two participants. Colored pen or pencil Blank paper to re-write instructions to be more easily understood.  Procedures: 1. Hand out the “Discharge Instructions” (on page 6 of the Trainer Manual) to each group of two participants. 2. Each participant reads the discharge instructions to themselves. 3. Circle weasel words in the document with the colored pen/pencil. 4. Re-write the discharge instructions to make it more easily understood. 5. Discuss results as a group and any thoughts that this activity brought up.

Patient records 4 main areas of error in patient records: Making false entries Not maintaining adequate records Stating that certain care or observations were carried out when they weren’t Failure to implement an action plan when a problem is discovered (Fowler, 2014) Stress the importance of documenting actual care and not just “checking the boxes” When a problem is discovered, it is important to document what you did and then follow up on your interventions to see if you helped or resolved the problem.

E-mail guidelines Include a specific subject line Keep it focused Identify yourself Do not e-mail an angry message Proofread before sending Be courteous Do not assume your e-mail is private Avoid fancy fonts

Tips for effective communication Use precise language Don’t use specialized language your reader may not know Keep sentences short and to the point Seek feedback – your message may not be as clear as you think Precise language – avoid vague words such “stuff” or “thing” or pronouns such as “it” or “they.” Seeking feedback is always helpful—have someone else read important documents.

Activity – read your last… Read your last work e-mail Read your last personal e-mail Read your last text message Read your last Facebook posting, Tweet, Instagram, etc. (See detailed procedures on page 9 of the Trainer Manual). Goal: To examine communication styles using various types of media. Materials Needed: Each participant will need to access his/her text messages, email, and Facebook posts. Paper and pen/pencil for each participant. Procedures: Have participants look up their last posts on the following types of media: Personal e-mail Text message Facebook post, Tweet, Instagram etc. For each type of post answer the following questions: What are the conventions dictated by each type of media? Is there a particular “style” that develops from the media form? In what ways is content influenced by the type of media used? How are the posts different? Similar? In what ways do the styles “bleed” into each other? Divide participants in pairs or small groups to discuss observations. Pose questions such as: Audience—how does audience influence the choice of media? Have you ever, or can you imagine a situation where, a message was accidentally sent to the wrong person (for example, a personal message to a supervisor?). Next steps: have groups develop a set of recommended practices for health care professionals regarding the use of different types of media.

Conclusion Questions? Comments?