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President & CEO, Accreditation Commission for Health Care

In today's dynamic health care landscape, effective communication is pivotal to ensuring patient satisfaction and fostering positive care outcomes. From my perspective and experience leading an accreditation organization with programs for a wide range of health care settings, I see firsthand the impact of successful communication within and across care teams and between providers and patients. Proactive recognition and prioritization of good communication skills improve patient satisfaction in tandem with more consistent achievement of desired health outcomes.

For decades, research has consistently shown that effective communication between health care providers and patients is a vital aspect of patient care. For example, a 2017 report published in Studies in Health Technology and Informatics revealed that patients who perceive the communication with their providers to be of high quality are more likely to maintain treatment plans, achieve better health outcomes and report higher levels of satisfaction.¹ This aligns with long-held nursing values that prioritize patient-centered communication, which recognizes the importance of tailoring care to individual needs and responding to patient health concerns.²

Across health care settings, communication that is clear, honest, delivered with empathy and in a manner easily understood by the patient — and, often, their family members — helps to manage expectations, ensure follow-up and treatment adherence postdischarge, and improve perception of the entire health care experience. This connects directly to the reported level of satisfaction.

The significance of patient satisfaction extends beyond subjective experiences. A research report in the Annals of Surgery showed that hospitals with higher patient satisfaction scores tend to have lower readmission rates and fewer incidents of patient harm.³ This demonstrates how satisfaction, driven by communication, yields better outcomes.

Moreover, the Agency for Healthcare Research and Quality emphasizes that poor communication is one of the leading causes of medical errors, which can result in adverse events and patient harm.⁴ Thus, the quality of communication among all participants in the health care experience plays a critical role in preventing avoidable outcomes and promoting patient safety.

Collectively, the research makes a powerful argument for the immense impact of effective communication on patient satisfaction, treatment adherence, health outcomes and patient safety. Health care leaders must recognize the significance of clear and empathetic communication in fostering positive patient experiences that directly impact their business operations.

DIFFERENT COMMUNICATION DYNAMICS FOR DIVERSE SETTINGS
Having established that the quality of communication — especially between providers and patients — informs patient satisfaction, different settings demand specific strategies and technologies tailored to optimize these interactions. In hospitals, clinics, hospices, home health environments and ambulatory surgery centers, language and cultural considerations should be addressed to ensure communication accessibility and inclusivity across the spectrum. Clear and empathetic communication establishes trust, enables understanding of patients' concerns and provides insight on how to address their needs. It also empowers patients by providing the information necessary for informed decision-making about their health and treatment options. In specific settings, communication techniques and priorities may vary to effectively meet the needs of the patient population:

• Inpatient settings: Clear and concise communication is crucial due to time constraints, unfamiliar terminology and the emotional state of patients. For instance, in an acute care hospital setting, communication is critical for coordinating multidisciplinary teams, managing critical situations and ensuring patient safety. Standardized communication protocols must also adopt patient-centered approaches to contribute to positive patient experiences.
• Hospice settings: Effective communication establishes relationships of trust and support. Transparent and honest information enables well-informed decisions, while active listening and guidance enhance patient satisfaction by fostering emotional well-being and comfort.
• In-Home settings: Communication should be personalized and emphasize rapport-building, patient autonomy and comprehensive instructions.
• Durable medical equipment, prosthetics, orthotics and supply programs: Skill in providing detailed instructions and technical support is necessary to ensure patients understand the proper use and maintenance of equipment.
• Telehealth services: With suppression of physical cues, remote communication must be engaging and clear. Patients and colleagues will need clear instructions that may include offering technological support and facilitating digital engagement.
• Ambulatory surgery centers: Time-limited encounters make quality communication vital for managing patient expectations, providing preoperative information and updates, and offering clear postoperative instructions.

In each of these settings, targeted communication approaches enable health care providers to focus on specific challenges and ensure effective engagement with patients.

Changes in technology further revolutionize patient-provider interactions and give health care executives new challenges and opportunities to enhance the patient experience. These advancements — including electronic health records, telemedicine, patient portals and remote monitoring — have changed how health care is delivered and experienced.

Empowering patients with knowledge and skills to manage their care gives patients more opportunities for engagement and direction of their own health care trajectory. It is critical to focus on the beneficial uses of tools (especially electronic portals and health records), which includes access and on-demand convenience for patients, and error reduction and improved care coordination for providers.

However, the possibility exists for these channels to depersonalize the patient's experience, especially if the offerings are not highly intuitive for those with minimal digital literacy. Therefore, including education when introducing these resources is important, as is striking a balance between human interactions and the use of digital tools.

STRATEGIES FOR GREATER UNDERSTANDING AND ENGAGEMENT
In every setting, active listening forms the foundation of effective communication. Health care professionals who actively listen demonstrate genuine interest and empathy toward their patients, allowing them to understand patients' concerns, fears and expectations. This approach fosters a trusting and supportive environment, promotes stronger patient-provider relationships and enhances overall satisfaction.

To ensure effective communication, health care professionals should employ clear and patient-centered strategies that prioritize patient understanding and engagement. Many of the following techniques are embedded within accreditation standards:

1. Use plain language and avoid medical jargon: By simplifying terms and avoiding jargon, providers can help ensure that patients successfully absorb a wide range of information. Simple language facilitates better communication, improves patient comprehension and empowers informed decisions.
2. Visual aids and written materials: Supplementing verbal instructions with visual aids — such as diagrams, charts, infographics and written materials — enhances patient understanding and retention. Visual aids can effectively convey complex information, making it more accessible and engaging for patients. Printed materials — such as pamphlets or brochures — can serve as valuable references for patients to reinforce and revisit vital information. Because health-related information can be complex, these should be written at a mid-elementary school comprehension level so that they are easily understandable.
3. Engaging patients in shared decision-making: Patients should be actively involved in their care, and establishing a shared decision-making process is crucial. Care professionals should explain the risks and benefits of treatment options to patients and empower them to actively participate in their plan of care. This is an area in which patient representatives can play an important role. Minors, individuals with cognitive deficits and those with language barriers are examples of patients who need another agent involved for decision-making, whether a guardian or an interpreter. However, the emotional element in managing a health concern can make it difficult for anyone to hear and process complex information in real time. While a competent adult patient should always retain the right to identify who may or may not participate, a trusted support person who listens — perhaps taking notes, asking questions and providing information and insight — can act as an advocate for the patient's values, preferences and goals. This allows provider teams to collaboratively identify the best course of action and yields increased patient satisfaction and treatment adherence.
4. Ongoing education and support: Patient education should be an ongoing process that equips individuals with the knowledge and resources needed to effectively manage health concerns. Health care organizations should provide education through such channels as group sessions, one-on-one consultations, online resources and informational materials. By offering ongoing help and education, providers are supporting not only the needs of individual patients, but those of their entire community. Effective communication also involves assessment to make sure patients understand information being shared with them.
5. Incorporate cultural sensitivity: Patient-centered care demands awareness of diverse expectations, communication styles and behavioral norms. While organizations cannot be expected to alter standardized protocols for care, they can — and should — incorporate guidelines to ensure that patients feel not just heard but understood.

Accreditation and Medicare standards for patient rights and emergency management urge cultural competency training for staff. In addition to shining a light on the importance of recognizing the diversity of patients, this best practice promotes sensitivity to their needs as individuals and appropriate actions to meet those needs.

Similarly, awareness of faith-based customs and preferences is important to a whole-person approach to care. Not every patient will feel empowered to speak out on behalf of their spiritual needs, but every patient should be offered the opportunity to do so, thereby enhancing trust in the relationship with the provider.

While health care organizations may not typically use the term "customer service," it correlates with patient experience. It serves as a critical metric for evaluating overall organizational performance and can impact financial outcomes.

From my perspective, "customer service" refers to the support provided to individuals using health care services, while "patient experience" encompasses the path to — and the quality of — treatment for illness or injury and the associated interactions with the health care organization. These two concepts are interconnected, as customer service represents the actual support offered, while patient experience reflects its perceived quality. Together, customer service and patient experience significantly influence the organization's success.

Health care operates as the ultimate team-based activity, involving multiple disciplines that rely on interdependence and collaboration. Adopting an intentional customer service approach empowers the entire care team to use thoughtful communication skills with every interaction. This approach creates a safety net for the patient experience by fostering an internal customer service culture.

In this culture, every member of the health care team contributes to problem-solving and improves the patient experience. By encouraging open communication, collaboration and creativity, organizations can optimize customer service and enhance patient outcomes. Recognizing the inherent value of effective customer service and its impact on patient experience is essential for achieving success in the health care setting.

CONTINUING THE PATH TO SOUND COMMUNICATION
Effective communication forms the bedrock of patient satisfaction and fosters trust, collaboration and better health outcomes. Health care executives and providers must recognize the significance of communication quality and continuously improve their practices.

By employing active listening, adopting clear and patient-centered communication strategies, and providing continuous education and support, health professionals can create an environment that promotes patient understanding, engagement and empowerment. These strategies not only improve patient satisfaction but also lead to better treatment adherence, improved health outcomes and stronger patient-provider relationships. By prioritizing effective communication, health care providers can deliver patient-centered care and enhance the overall patient experience.

JOSÉ DOMINGOS is president and CEO of the Accreditation Commission for Health Care (ACHC), a nonprofit health care accrediting organization with more than 35 years of experience promoting safe and quality patient care.

NOTES

1. Alex H. Krist et al., "Engaging Patients in Decision-Making and Behavior Change to Promote Prevention," Studies in Health Technology and Informatics 240 (2017): 284-302, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6996004/.
2. Susan Henly, "Health Communication Research for Nursing Science and Practice," Nursing Research 65, no. 4 (July/August 2016): 257-258, https://doi.org/10.1097/NNR.0000000000000171.
3. Dr. Thomas C. Tsai, E. John Orav, and Dr. Ashish K. Jha, "Patient Satisfaction and Quality of Surgical Care in U.S. Hospitals," Annals of Surgery 261, no. 1 (January 2015): 2-8, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4248016.
4. Catherine Dingley et al., "Improving Patient Safety Through Provider Communication Strategy Enhancements," Advances in Patient Safety: New Directions and Alternative Approaches 3 (August 2008): https://www.ncbi.nlm.nih.gov/books/NBK43663/.