Book Review: Communicating in Hospital Emergency Departments

This book outlines the research findings of a three-year project. It effectively draws the reader into wanting to know more, causes the readers to reflect on their own practice, and clearly identifies which actions need to be taken by the readers to improve their practice. This book is written in such a way to achieve all of this.

 

The nine authors outline how seven experienced researchers undertook a research initiative conducted in five emergency departments over a three-year period.

 

The researchers were motivated to conduct the research project by concerns that failures in communication have been identified as “a major cause of adverse events, leading to avoidable patient harm”. The researchers collectively spent 1093.5 hours in the emergency departments and applied qualitative ethnographic methodology. This analysis, together with sociolinguistic and discourse analysis of the spoken interactions between clinicians and patients, enables the researchers to identify key features of successful and unsuccessful interactions between clinicians and patients and also between clinical staff. As a result, the authors identified systemic improvements that could lead to safer practices and improve the quality of patient care.

 

The research clearly examines all aspects of communication between the clinical team working with the patient (including spoken, gestured, written and electronic communication) and is therefore very relevant to readers interested in interprofessional care of patients in emergency departments.

 

The book is presented in seven sections which effectively: outlines the need for good communication, reviews the emergency department environment, examines the patient’s journey through the department, details the communication patterns, looks specifically at the communication of medical information between the patient and the clinical staff, explores strategies for bridging the communication gap, and suggests strategies to promote change in ways of working and communicating.

 

The authors provide detailed descriptions of all aspects of working in emergency departments, and present a series of vignettes and case studies which demonstrate the complexities of communication. The authors then identify key moments where effective communication is at risk. The use of tables, graphs and diagrammatic representations very effectively complements the text, and each chapter includes a comprehensive list of references.

 

This book is an essential text for anyone working in an emergency department, as well as being of interest to interprofessional researchers, educators, practitioners and students internationally. I am pleased to recommend this book to readers who want to improve their working relationships as a health care team or increase their knowledge of communication among interprofessional teams.

 

Reviewed by 

Dawn Forman, Visiting Professor, University of Derby and Chichester University and Adjunct Professor Curtin University and Auckland University of Technology

Communicating in Hospital Emergency Departments by Diana Slade, Marie Manidis, Jeannette McGregor, Hermine Scheeres, Eloise Chandler, Jane Stein-Parbury, Roger Dunston, Maria Herke, Christian M.I.M. Matthiessen

Springer, Heidelberg, New York, Dordrecht, London, 2015, 158 pages Price €99.99 (hard copy) or €83.29 (eBook). ISBN 978-3-662-46020-7

Book Review: Communication Skills in Health and Social Care

Benard Moss is an Emeritus Professor from the Social Work Education and Spirituality department at Staffordshire University. The goal of the textbook is to enhance essential communication skills for students and team members to promote best practice. The textbook is aimed at social workers but reference to probation officers, doctors, nurses, paramedics, teachers, police officers, youth workers, advice workers, and faith community leaders is also included. Moss engages his readers with a witty, easy-to-read style that entices readers to think about each topicthrough practical scenarios. Throughout each chapter activities are incorporated creating an interactive book that allows readers to apply the concepts to practical situations they have or have not yet encountered.

 

Moss highlights important aspects of communication froma variety of situations such as “Breaking Bad News,” “Chairing Meetings,” or “Court Room.” The textbook reviews current research regarding these different topics on professional communication skills in health care settings. Adequate references are used for each section and suggested readings are identified for readers who are interested in learning more about a topic. The textbook refers to situations that occur in England but remains applicable for international interpretation, especially for English speaking regions such as Canada, United States,and Australia.

 

This textbook is designed for individuals who are beginning their journey in people-work to adopt necessary communication skills. Moss refers to people-workers as individuals who provide confidential assistance to individuals. Moss identifies that the textbook is as an overview of adequate communication in the health and social care profession. For individuals who require further understanding in an area of communication, Moss suggests other readings to assist the reader.

 

Each chapter follows a similar organization of topics.Chapters start with a paragraph overview of the general research on a topic, incorporates activities, provides examples of practical situations, and ends with a “Final Thoughts” section to review each of the main concepts. This format allows readers to digest the information.  The activities summarize the previous content and touch on proceeding paragraphs, allowing readers to build on the ideas presented. The examples provide suggested phrases to use in challenging situations to help the reader develop their own repertoire of professional wording. The “Final Thoughts” section brings all the concepts together in a short paragraph reminding readers of the key concepts. Each section ends with a list of other topics covered in the textbook that are directly related to the one discussed linking topics together appropriately.

 

Overall, Moss provides a useful guide for enhanced communication for individuals in the social and health care professions to apply the skills learned in this book to day-to-day interactions. The book is a concise overview that allows professionals to enhance their practice without spending extended time reviewing multiple textbooks. I readily recommend this to students, people-workers, and educators as a useful resource for enhancing collaborative communication.

 

Review by

Lorelle Kerik, Registered Kinesiologist, Lifemark Health Centre

Communication Skills in Health and Social Care (3rd Edition)

Bernard Moss. Thousand Oaks, CA: Sage, 2015

222 pages, $52.95 (paperback) $138.95 (hardcover) – Canadian Dollars

ISBN: 978-1-4739-1276-2

Book Review: Leadership and Collaboration: Further Developments for InterprofessionalEducation

This book aims to provide students, educators and clinicians alike the latest advances in international leadership in interprofessional education, practice and collaboration. Fifteen chapters, written by a variety of authors from different healthcare professions and nine countries combine to produce a very practical guide for readers of all types.

 

Leadership theories are defined and connections are made to collaborative practice. The book highlights the importance of appropriate leadership styles for successful interprofessional collaboration, which results in higher quality patient care and efficiencies. The authors address the increasing need to recognize that health care demands cannot be met without changing how healthcare workers are educated and practice.  

 

Students and educators will discover a well-organized text with useful tables to help navigate the book by country, leadership model or topic.  A directory of additional readings is provided along with numerous references, a list of helpful definitions and a detailed index to assist in furthering one’s learning. Clinicians will find practical examples of implementation of interprofessional collaborative projects in both academic and health care settings, along with the challenges and lessons learned which help guide one's own project development.  

 

The book is divided into three distinct parts allowing readers to access topics as desired.  Part one delineates theoretical frameworks on the development of interprofessional leadership and interprofessional practice internationally, part two is clinical in nature outlining stories of collaborative developments taking place in a variety of countries, and part three provides additional stories of recent innovations both in leadership and interprofessional collaboration.

 

The editors have produced an extremely well organized and structured text. The chapters are authored by different writers offering a variety of writing styles, perspectives, and levels of detail. Overall this book provides an excellent mix of theoretical and practical information linking leadership theories, interprofessional collaboration and healthcare delivery from an international perspective. Contents assist healthcare students, educators and practitioners to address emerging healthcare needs for greater interprofessional collaborative education and practice with the ultimate goal of improving healthcare delivery worldwide.

 

Reviewed by

Shelly Bercovitch, BSc(PT), MHM (candidate), McMaster University, Acting Chief Physiotherapy, The Ottawa Hospital, Ottawa, Canada 

 

Leadership and Collaboration: Further Developments forInterprofessional Education

Dawn Forman, Marion Jones & Jill Thistlethwaite, editors

New York, NY: Palgrave MacMillan, 2015

257 pages, $115.00

ISBN: 978-1-137-43207-0

 

 

 

 

Conference Report: Developing Multiprofessional Health Educators of the Future

“Developing Multiprofessional Health Educators of the Future” was a radical new conference that brought together healthcare workers from across the range of professional backgrounds, levels of experience and educational modalities. It considered multiple good practice initiatives for healthcare educators, trainees and students.  

The conference was planned jointly between the London and the South East Local Education and TrainingBoards (LETB) and was held on 7 July 2015 at the Kia Oval conference centre in London. The organising committee included a healthcare scientist, medical education fellows, nurse educators, Shared Service staff and a HEKSS programme manager. All 300 places were fully booked within weeks of registration opening.

Professor Ian Cumming, Chief Executive of Health Education England, opened the conference. He strongly reiterated the commitment to more multiprofessional training in the future.  This was followed by an inspiring talk by Laura Sherlock, a patient educator from King’s College London, who highlighted the vital role that patients play in clinical education and the need for more meaningful engagement to maximise this resource.  Professor Scott Reeves rounded off the day with a forward-looking summary of the state of interprofessional education and promising avenues for further exploration.

Alongside these exciting keynotes were over ten parallel workshops, face-paced ‘laser-coaching’ and a poster display of a range of successful education projects conducted by delegates.  The very best abstract submissions were selected to present to the whole conference audience, who then voted for their favourite to receive a prize.

The day was a great success and demonstrated the level of enthusiasm for such events that bring together a wide range of professionals to share their passion for clinical education in all its multifarious forms. It is hoped that this will become a regular feature of the clinical education calendar.

 

Book Review: Evidence-Based Practice for Health Professionals: An Interprofessional Approach

While evidence-based practice (EBP) has become an essential component of training in a wide range of healthcare professions, a textbook for beginning practitioners was largely missing. Howlett, Rogo, and Shelton authored Evidence-Based Practice for Health Professionals: An Interprofessional Approach to engage student audiences from rehabilitation, medicine, dentistry, nursing, pharmacy, and public health programs. The text was designed to help readers achieve two objectives: (1) to locate, interpret, evaluate, and apply research to the care of individual patients/consumers; and (2) to effectively communicate research results to consumers, colleagues, and other professionals. The authors’ emphasis is on the knowledge and skills needed to facilitate informed, evidence-based, and patient-centered healthcare decisions.

The text has two parts and 11 chapters. Part I, “Foundations of Evidence-Based Practice,” consists of six chapters. Chapter 1 defines and explains EBP; Chapter 2 provides an overview of research methods; Chapter 3 examines health communication; Chapter 4 illustrates the process of locating relevant evidence; and to conclude, Chapters 5 and 6 review basic descriptive and inferential statistics, respectively. Part II, “Applications of Evidence-Based Practice,” explores how EBP is implemented in different contexts. Chapter 7 introduces readers to epidemiology as it relates to EBP; subsequent chapters depict EBP in assessment and diagnosis (Chapter 8), treatment, examination of harm, and prevention (Chapter 9), and working with the pharmaceutical industry (Chapter 10). Finally, Chapter 11 synthesizes the process of implementation of EBP including detailed simulation of critical appraisal of examples from research studies.

In this text, the process of EBP is broken down into concrete steps, and a variety of tools to work through these steps are presented. For example, evaluation of research evidence to clinical questions is daunting for beginners. To guide this process, the authors present a systematic method in a chart to compare components of the clinical question with components as addressed in the study. Similarly, critical appraisal of trustworthiness of research may appear to be a formidable process to novices. The authors provide worksheets to use for appraising quantitative and qualitative studies composed of questions on various dimensions of research reports that contribute to their overall credibility. These focused steps can guide beginners in EBP in simulating the process of critical analysis of an experienced practitioner. Tools like these can play a vital role in the development of skills and judgment needed for evidence-based clinical decision making.

Due to the rapid pace of scientific and technological advancement, healthcare professionals are increasingly required to locate, appraise, and synthesize most up-to-date information in their daily practice, rather than solely rely on the previously acquired knowledge base. In addition to deciphering the procedure of EBP, this text introduces beginning clinicians to processes of healthcare provision that is based on critical thinking. The versatile tools, in combination with ample case studies dealing with an array of clinical conditions, render this text particularly suitable for experiential approach to training interprofessional teams composed of early career professionals. In conclusion, the text is a unique contribution to the clinical training in healthcare disciplines on multiple dimensions, including EBP and interprofessional care.


Review by: Naoko Yura Yasui, PhD, CRC; Assistant Professor, Department of Rehabilitation Studies, Alabama State University

Evidence-Based Practice for Health Professionals: An Interprofessional Approach
Howlett, B., Rogo, E. J., and Shelton, T. G.
Burlington, MA: Jones & Bartlett; 2014
394 pages; US$86.95
ISBN 9781449652777

Book Review: The Spirit Catches You and You Fall Down: A Hmong Child, Her American Doctors, and the Collision of Two Cultures

Anne Fadiman, the author and narrator of The Spirit Catches You and You Fall Down: A Hmong Child, Her American Doctors, and the Collision of Two Culture, shares the story of Lia Lee, a young Hmong girl with severe epilepsy, to demonstrate the detrimental impact of cultural misunderstanding between families and their doctors. This book alternates with one chapter focusing on Lia’s story and the next educating the reader on Hmong traditions and culture. Fadiman supports her argument by countlessly comparing traditional Hmong healing practices with American medicine, emphasizing the gap between the two and the need for improvement.

Fadiman’s story is targeted at culturally uninformed interdisciplinary members. She foils Lia’s doctors Neil Ernst and Peggy Philp with Jeanine Hilt, Lia’s social worker who is an “incredible patient advocate” (p. 114) for the Lee’s. When the Lee’s first bring Lia to the emergency room for her seizures, the hospital staff is unable to communicate with Foua and Nao Kao about their daughter’s illness. This miscommunication continues with each hospital visit. The lack of translators and individuals educated on Hmong traditions force the American doctors, hospital staff, and social services to view the Lee’s as uncooperative and noncompliant. With the growing Hmong community in Merced, California, the American doctors and hospital staff would have benefitted from learning about the Hmong culture, as this would allow them to understand how and why the Lee’s made some of their questionable decisions regarding Lia’s treatment. The tone expressed by Fadiman is objective and solemn; this allows both the Lee’s and the health professionals involved in Lia’s treatment to rationalize their annoyance, irritation, and frustration with each other to the reader. When Lia experiences her most severe seizure, she suffers brain damage. This tragedy ultimately brings the two parties closer, although it is too late. The closing of the book, aspiringly, fills the reader with hope.

Lia’s brain damage could have been preventable by removing cultural barriers and improving collaboration between families and interdisciplinary teams. Fadiman clearly argues that a mix of traditional healing with western medicine is ideal. She mentions a program called “Bridging the Gap,” which is a cross-cultural education program to train hospital staff to be culturally mindful of patients. The television segment on the Hmong cable channel regarding American hospitals and treatment was another attempt to reduce the cultural miscommunication in Merced. The Nationalities Service of Central California received a grant to integrate western mental health with traditional Hmong practices, and this was an outstanding success. The interaction between doctors and spiritual healers indicated that the interaction between these fields boosted patient morale.

Doctors alone are not enough to cure a patient, especially when culture is the barrier. Fadiman countlessly brings up the sad fact that Lia’s brain damage could have been prevented by communication and strengthened interactions between the doctors and hospital workers, social workers, translators, spiritual healers, and patients. This emotionally captivating book will motivate the reader from any background for advocating cultural awareness among interdisciplinary teams.


Review by: Shannon Sim, Concordia University of Edmonton

The Spirit Catches You and You Fall Down: A Hmong Child, Her American Doctors, and the Collision of Two Cultures
Anne Fadiman
New York: Noonday Press, 1998
341 pages, CA$12.29
ISBN 0374525641 9780374525644

Summary: Adherence to clinical guidelines in heart failure (HF)outpatients: Impact of an interprofessional HF team on evidence-basedmedication use

Clinical systolic heart failure (HF) guidelines specify recommendations for ACE inhibitors (ACEI), angiotensin receptor blockers (ARB) and beta blockers according to doses used in clinical trials. However, many HF patients remain suboptimally treated.

Crissinger and colleagues sought to determine which provider type, between an interprofessional HF team, non-HF cardiologists and primary care physicians (PCP), most optimally manages HF medications and doses. A retrospective chart review was performed on adult patients at an academic county hospital with an ejection fraction ≤40% and a diagnosis of HF, seen by a single provider type (HF team, cardiologist or PCP) at least twice within a 12-month period. 

Utilization rates of any ACEI/ARB and any beta blocker were robust across provider types, though evidence-based ACEI/ARB and beta blocker were greatest from the HF team. Doses of evidence-based therapies dropped markedly in the non-HF team groups. The percent of patients prescribed optimal doses of an evidence-based ACEI/ARB AND beta blocker was 69%, 33% and 25% for the HF team, cardiologists and PCPs, respectively (p < 0.0167). Patients followed by the HF team were more frequently prescribed evidence-based medications at optimal doses. 

The findings of this study support the use of specialized interprofessional HF teams to attain greater adherence to evidence-based recommendations in treating systolic HF.

For more: http://informahealthcare.com/doi/abs/10.3109/13561820.2015.1027334