“Every information exchange is a communication act, whether it is the exchange that occurs between two people or two machines. Communication can be studied at the level of the interaction between individual agents, or as a set of processes that coordinate different health services” (Elsevier Ireland, 2005, para. 1). These concepts of communication are applicable in every unit of the society, particularly to organizations. The health care systems and organizations are among those where communication plays a very vital and critical role.
“Communication systems are a crucial component of the information infrastructure of any health care organization, not just as pipes through which information flows, but as the systems where humans share, discuss and eventually decide upon clinical actions. Communication research in health care thus deserves a seat at the high table of health informatics, not just because we want to improve communication, but because by understanding communication, we better understand the role of the information systems we are so keen on building” ((Elsevier Ireland, 2005, 3).
The health care organizations however, have evolved in as much as the changes in the societies. As the societies have gradually become multicultural and multi-ethnic, so have the health care organizations. These changes have emerged due to the global migrations between nations. “The health professional/client relationship is changing. The once passive receiver of care is transforming into an active and informed participant in health care. This client wants to be informed about and involved in the medical decision-making process.
Consequently interactions with consumers are no longer limited to the face-to-face consultation, but now use every communication medium possible, and increasingly use e-mail” (Elsevier Ireland, 2005, 1). On top of these migratory and multicultural evolutions is the fact that a healthcare organization is composed of various players or actors. Hence, communication occurs among different characters which may be coming from different cultures, and probably with different languages.
In a typical healthcare organization, we have doctors, patients, managers, supervisors, nurses, attendants, surgeons, pharmacists, clerks and many others. For every patient or medical case, every one of these positions communicates and transacts with the patient and/or his escort in the hospital. The more players and roles, the more complex the communication process becomes. The more diverse the cultures and languages, the more difficult the communication process would be.
“Underlying this effort is the belief that understanding and being understood is a critical component in ensuring equal access to, and quality of, health care for all patients. Developing effective communication between physician and patient who speak different languages and who come from different cultural backgrounds is, therefore, an integral part of the effort to reduce or eliminate health disparities” (National Center for Health Statistics, Healthy People 2000, 2010 cited in Lee, S. 2003, 4).
Gender and Cultural Barriers in Communication in a Health Care Organization The two vital factors which can affect the effectiveness a communication process in a healthcare organization are cultural barriers and gender differences. “The effects of cultural differences on health care use are similar to those of language: cultural differences often translate into cultural barriers that lower access to health care. However, the research on cultural barriers on access or use of health care is not as extensive as research on language barriers.
The role of culture is mostly explored in terms of quality of care” (Lee, S. 2003, 7). “The growth of the culturally and linguistically diverse population has led to many efforts to encourage or ensure that health care systems respond to the distinct needs of culturally and linguistically different patients by becoming “culturally competent” (Fortier et al. 1998; U. S. Department of Health and Human Services, Office for Civil Rights 2001; U. S. Department of Health and Human Services, Office of Minority Health, Closing the Gap 2001 cited in Lee, S. 2003, 4).
“Overcoming the language barrier is a major step in effective communication with her Vietnamese-speaking patients, but cultural differences can still affect the patient-doctor relationship” (Lee, S. 2003, 7). “If there is cultural discordance between doctor and patient, effectiveness of communication is expected to be lower. Communication is additionally influenced by how familiar each is with the other’s cultural background. The higher the degree of cultural knowledge and familiarity each has of the other’s culture, the more effective the communication.
If there is language discordance, then effectiveness of communication is reduced, and is further influenced by how proficient each is in the language of the other. The more proficient each is in the other’s language, the more effective the communication. ” (Lee, S. , 2003, 16). As observed in many healthcare organizations, there seems to be insignificant difference in the effectiveness of communication in relation to gender. This is in contrast to the “Muted Group” communication theory.
Moreover, Lee says, “There is little evidence on the effects of gender concordance on communication and health care, although the research is thin on this issue” (Lee 2003, 15). What Can Be Done to Improve the Situation? The effectiveness and accuracy of communication systems in health care organization is illustrated by Coiera in the following excerpt, “The sheer scale and complexity of these interactions within the healthcare system puts a heavy burden on the process of communication, and miscommunication can have terrible consequences.
Not only is the communication space huge in terms of the total information transactions and clinician time, it is also a source of significant morbidity and mortality. Communication failures are a large contributor to adverse clinical events and outcomes. In a retrospective review of 14,000 in-hospital deaths, communication errors were found to be the lead cause, twice as frequent as errors due to inadequate clinical skill. Further, about 50% of all adverse events detected in a study of primary care physicians were associated with communication difficulties” (Coiera, 2006, p.
90) Hence, we need to adopt effective strategies to overcome cultural, language and slight gender barriers and issues. ” Effective communication between patients and physicians who are culturally and linguistically different implies the employment of strategies to provide culturally competent health care, such as those described by Brach and Fraser, 2000 as cited in Lee, S. 2003, 4. “At the administrative level, the poor communication of information can have substantial economic consequences.
It is now clear, for example, that the healthcare system suffers enormous inefficiencies because of the poor quality of communication systems that are often in place” (Coiera, 2006, p. 91). The Communication Accommodation Theory can be applied in the communication systems in a healthcare organization. “This theoretical perspective examines the underlying motivations and consequences of what happens when two speakers shift their communication styles. Communication Accommodation theorists argue that during communication, people will try to accommodate or adjust their style of speaking to others.
This is done in two ways: divergence and convergence. Groups with strong ethnic or racial pride often use divergence to highlight group identity. Convergence occurs when there is a strong need for social approval, frequently from powerless individuals” (McGraw Hill Companies, Defining Communication Theories). Some basic strategies that can be applied include the conduct of multicultural orientations on language, gender, traditions and beliefs. These orientations can help the hospital staff in dealing with issues on these areas.
Another strategy would be to hire personnel and health care workers coming from various cultures and who can understand and speak other languages. References Toussaint, P. J. and Coiera, E. (Eds. ). Supporting communication in health care. International Journal of Medical Informatics. (10 Jan 2005). Elsevier Ireland Ltd. Retrieved from http://www. intl. elsevierhealth. com/journals/ijmi. The McGraw-Hill Companies. Defining communication theories. 2001 Lee, S. M. , Ph. D. June 2003 (Rev.
) A review of language and other communication barriers in health care. Assessing the impact of physician-patient communication barriers on health care costs and quality. Office of Minority Health (OMH), Office of Public Health and Science OPHS, US Department of Health and Human Services. Department of Sociology, Portland State University. Coiera, Enrico. (May 2006). Communication systems in health care. Clin Biochem. (27:89-98). Centre for Health Informatics, University of New South Wales.
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