The issue
Effective communication is essential to a positive healthcare experience and is linked to a range of care outcomes.
The National Health Service (NHS) in Great Britain emphasises that skilled communication is key to ensuring that patients and their families can participate in health decisions about their own care.
We know at a general level that communication matters but the precise details of what counts as ‘effective’ or ‘skilled’ methods of communication are largely missing from NHS policies that endorse good communicative healthcare practices.
The research
The study of language and communication has been the focus of our research for over four decades. We have an international reputation for work in basic and applied conversation analysis, a distinguishing feature of which is conversation analytic studies of real-time interactions in healthcare settings.
Distinctively, we focus on delivering patient choice. Research externally funded by the NIHR on this theme includes the recently completed publications:
- Delivering patient choice in clinical practice: a conversation analytic study of communication practices used in neurology clinics to involve patients in decision-making
- Evaluating nuanced practices for initiating decision making in neurology clinics
- Interactional practices of decision making during childbirth in maternity units.
These studies have analysed conversations and communications between healthcare practitioners, patients and their families to challenge methods of communication that currently inhibit patient choice. The findings have influenced new methods of communication that ensure patients feel involved with and in charge of their own care.
The outcome
Our research into neurology clinics has shown that option-listing - providing a menu of options from which a patient might make a selection - is usually perceived by patients as an invitation to make a choice.
Our study discovered that option-listing is a relatively rare practice and that even when it is used, the way options are described can impact patients’ responses.
Our research on decision making during labour and birth in NHS midwifery units is building on this finding. We aim to identify the types of communication that contribute most effectively to shared decision-making between midwives, pregnant people and their birth partners during labour and birth.
We intend to continue to contribute to evidence-based guidance for health practitioners and patients. We are also working with the Royal College of Midwives’ Progress Theatre Group to disseminate our findings to key stakeholders within the NHS and beyond.
