Effective Communications. Pharmacy Technician Training Systems Passassured, LLC

Transcription

1 Effective Communications Pharmacy Technician Training Systems Passassured, LLC

2 Effective Communications Effective Communications EFFECTIVE COMMUNICATION FOR PHARMACY TECHNICIANS Verbal Communication When you speak 1. Tone should be pleasant and respectful, 2. Speech clear and not garbled 3. Volume should be at an appropriate level. High Performance Communication High Performance Communication skills enable you to perform at your best when it really counts: under pressure. High performance communication includes the use of 1. Open-ended questions, 2. Empathetic responses, 3. Verification of the patient's understanding 4. The absence of distractions. The level of a pharmacy Technician communication performance is the most important cue used by patients in their ratings of service satisfaction; perceptions of overall service quality, and trust in the Pharmacy. Open-ended Questions 1. Allow for more than a yes or no response 2. Opens up a dialogue between both parties 3. It is more of a relationship than just a one-way giving of information. 4. It helps build relationships with patients and shows interest in their perspective. 5. Open-ended questions can also help prevent errors. People tend to pay more attention when answering an open-ended question. Closed-ended Questions 1. Only requires a yes or no response. 2. If the patient didn't hear you well or you didn't read the screen correctly you may not get a correct response. 3. The patient may be anticipating that you'll give the correct data and may not hear you say something differently. Close-ended Examples: Technician: Mr. Smith is your date of birth May 1, 1958? Mr. Smith: Yes Technician: Mr. Smith have you every had a prescription filled at our Pharmacy? Mr. Smith: Yes

3 Open-ended Examples: Technician: Mr. Smith what is your date of birth? Mr. Smith: May 1, Technician: Mr. Smith when was the last time you had a prescription filled at our store? Mr. Smith: Two months ago I had my Lipitor filled. In this situation the patient will give something back to you and you will pay attention to their response by writing it down. A significant error could occur if neither party is communicating clearly with the other. Close-ended questions are useful when you are following up on information you already have. Times when a close-ended question is appropriate: 1. When probing for additional information 2. When needing to confirm information Technician: Mr. Smith, Is the address on your prescription correct? Starting with How provides the customer with the opportunity to talk about any previous experience and will help you understand where they are coming from. Technician: How were you getting your prescriptions before this? Starting an open-end question with Why should be avoided. Technician: Why didn t you call our pharmacy for a refill before you run out of medication? This puts the customer: 1. On the defensive. 2. Feel you are accusing her/him or suggesting that she/he is in some way at fault. Avoid leading questions that may prompt a patient to answer a certain way. Incorrect Mr. Smith You do not have any questions for the pharmacist, do you? Correct Mr. Smith would you like to ask the pharmacist any questions? Mr. Smith is likely to perceive that he does have the option of speaking with the pharmacist. Technicians should avoid leading questions when discussing sensitive subjects such as noncompliance. Incorrect Mr. Smith: I am late again on my refill. This medication is just too expensive. Technician: Mr. Smith it s not like you can t afford this medication is it? Mr. Smith: No of course not. The technician should phrase the question differently. Correct Mr. Smith: I am late again on my refill. This medication is just too expensive. Technician: Mr. Smith is it sometimes difficult to pay for the medication all at once? This would have allowed the pharmacy to solve the problem by working out a payment schedule or by having the pharmacist contact the physician for a less expensive therapeutic option.

4 Responsibilities PassAssured's Pharmacy Technician Training Systems You are responsible: 1. for ensuring that the message is transmitted in the clearest form 2. terminology is understood by the customer 3. your environment is favorable for clear transmission. Always use terms and concepts that are familiar to the patient. Medical Terminology can be easily misunderstood. Incorrect Technician: Mr. Smith, the pharmacist needs to call the dermatologist to clarify the urticaria medication. The Sig: wasn't specified. After that, he s going to need to get a PA on the ACE inhibitor your cardiologist prescribed for your hypertension. He's on the phone now so it may take a while. Please have a seat and I will call you when your scripts are completed. Now look at the same conversation in plain language and determine how much more meaningful this conversation is to Mr. Smith. Correct Technician: Mr. Smith, the pharmacist needs to call your skin doctor. He needs to get the directions for your rash medicine. After that, he needs to call your insurance company. The insurance company needs to approve the blood pressure medicine your heart doctor wrote. It may take a little while because he is on the phone with a Doctor for a patient that was here before you. Please have a seat. I'll let you know when your medicine is ready. When a patient understands why he is waiting, he is more likely to be patient. Always check whether the message was received clearly by asking for feedback. Technician: Mrs. Smith the directions for the medication are on the bottle Mrs. Smith: Yes I know. I am to take one teaspoonful twice daily. You have the responsibility of listening to what is being transmitted by the patient. Providing feedback to the patient ensures accurate communication. Do not rely on assumptions. To become more effective, efficient, and accurate in our communication, we must strive to include feedback in our interactions with others. Non-verbal Communication Your body language tells others a lot about how well you are listening to them. Your body language should show that you are open to them and are willing to make them the center of your focus. Exhibiting positive body language will make your communication more effective. If you can remember "SOLER" it will help you keep your body language open.

5 S: Squarely face the patient O: Open posture (Crossed legs and arms can be interpreted as lack of interest) L: Lean toward the patient to demonstrate interest (as appropriate) E: Eye contact maintained R: Relax (fidgeting may indicate you're impatient) Non-verbal communication to be aware of: 1. facial expression ex: scowling 2. eye movement ex: rolling your eyes 3. breathing ex: heavy sighs It may cause the patient to feel inferior. If your facial expression is pleasant and you are smiling, the patient will likely respond more positively than if you were scowling. Be aware of these cues as you communicate. Barriers in Communication There are a large number of potential barriers that exist in the practice of pharmacy. These barriers may disrupt or may even eliminate communication. The key is to identify when barriers exist and then develop strategies that minimize them. List of barriers: 1. environmental 2. personal 3. cultural 4. language Many things seem to get in the way when you try to communicate with someone else. Some issues are rather obvious, while others are not. Minimizing communication barriers typically require a two-stage process: 1. You must be aware that they exist. 2. You need to take appropriate action to overcome them. Environmental Barriers The environment in which communication takes place is critical in pharmacy practice, and distractions within the environment often interfere with this process. Crowded, noisy prescription areas inhibit one-to-one communication. This can interfere with your ability to communicate with patients. Others can overhear your conversation, which limits the level of perceived privacy for the interaction. Personal Barriers Discomfort and perceptions can make a negative impact on effective communication. If people are not in the same level in terms of their perceptions, knowledge and attitudes; the

6 communications between them are not often successful. Many people feel that an effective communication style is something you are born with. Communication skills can be learned and developed. They require practice and reinforcement. Positive reinforcement is critical. You must strive to improve your communication skills by constant practice and reflection on your strengths and weaknesses. Cultural Barriers Many communication issues come through cultural differences. List of cultural barriers: 1. Age differences 2. gender differences 3. economic positions 4. political beliefs 5. cultural backgrounds Effective communication between people of different cultures is really difficult. The same word can have a different meaning to people who have cultural differences. For example, in some cultures it is not proper to engage in eye contact during communication. Such behavior would be labeled as disrespectful; while in other cultures, direct eye contact is appropriate and is almost required. Other barriers related to culture include: 1. definitions of illness (some patients may not perceive themselves to be ill) 2. perceptions of what to do when ill (some cultures stress self-reliance rather than seeking help) 3. health-related habits or customs (eating habits) 4. health-seeking behavior (some cultures place more reliance on folk medicine) 5. perceptions of health care providers (based on possible distrust of the health care system or past negative experiences) Language Barriers Language Barriers is one of the most common barriers that can be found. Many communication issues occur because of the language and vocabulary differences. If the sender and the receiver cannot understand the languages of each other s, the communication will not give the intended effect. Use of unclear and inappropriate words can also cause confusion. Importance of Listening When we think about skills of effective communication, we almost always think of the skills involved in speaking clearly and forcefully. An equally critical part of the communication process, and perhaps the most difficult to learn, is the ability to be a good listener. Listening plays a vital role in communication. Many barriers can be avoided through effective listening. Use these tips to improve your listening capabilities. 1. First step to listening is to stop talking 2. Use face-to-face communication and eye contacts 3. Listen to ideas not just words 4. Do not interrupt when someone speaks 5. Ask questions to clarify unclear points of the conversation 6. Always give feedbacks Eliminating barriers completely is not possible. But by knowing the barriers you have for effective communication, you can take necessary actions to avoid them or lower them.

7 Empathic Communications Empathy is communicating back to the sender that you understand their feelings, and then a caring, trusting relationship can be established. Empathy conveys understanding in a caring, accepting, nonjudgmental way. Empathic Communication is the ability to utilize empathy as you communicate with others. When we talk about empathic communication we must not become confused between empathic response and a paraphrase. The main difference between an empathic response and a paraphrase is that empathy serves primarily as a reflection of the patient s feelings rather than focusing on the content of the communication. Mr. Smith: I do not know about Doctor Brown. Last week when I saw him he was so nice. Today he was so rude. I may not go back. Paraphrase Response: Technician: Doctor Brown seems to be inconsistent. Empathic Response: Technician: Mr. Smith you must be uncomfortable seeing Dr. Brown if you never know what to expect. Mr. Smith: I am glad that I moved to the Lake Mallard. Every day I can fish, play golf are just walk the trails. Paraphrase Response: Technician: You have lots of activities to choose from. Empathic Response: Technician: Mr. Smith that is great. You seem to love living there. There are 10 obstacles which tend to get in the way of effective empathic communication, even beyond things like perceptions tinted by prejudice, judgment, and preconceptions. These common forms of communication block empathy and take the focus away from the speaker. 1. Giving Advice or Fixing Technician: Mr. Smith, I think you should stop seeing Dr. Brown and see Dr. Jones. This is telling the patient what you think they should do. 2. Analyzing: Technician: Mr. Smith I think you are taking this out on Dr. Brown when you are actually frustrated with not getting better. Interpreting or evaluating a patient s behavior 3. Storytelling: Technician: Mr. Smith I know just how you feel. This reminds me of a time that Dr. Jones was so rude. You know what he said.

8 Moving the focus away from the patient and back to your own experience. 4. Sympathy: Technician: Mr. Smith, you poor thing I feel so sad for you. Either feeling sorry for patient or sharing your own feelings about what they said. 5. Reassuring or Consoling: Technician: Mr. Smith you might be upset now, but I m sure you will feel better soon. Trying to make the patient feel better by telling them things will improve 6. Shutting Down: Technician: Mr. Smith, you need to quit feeling sorry for yourself Technician: Mr. Smith, there is no reason to feel that way! Discounting a patient s feelings and trying to shift them in another direction. 7. Correcting: Technician: Wait a minute Mr. Smith, I never said that! Technician: Mr. Smith you don t remember this accurately. This is giving the patient your opinion or belief about a situation. 8. Interrogating: Technician: Mr. Smith when did this begin? Technician: Mr. Smith why did you decide to do that? Technician: Mr. Smith what got into you? This is using questions to figure out or change the patient s behavior. 9. Commiserating Technician: I know what you mean, Mr. Smith, Dr. Jones can be a big jerk. Agreeing with the patient s judgments of others

9 10. One-upping: Technician: Mr. Smith that s not too bad! Let me tell you what happened to me when I had the flu! Convincing the patient that whatever they went through, you had it worse. The Benefits of Empathic Listening 5 benefits to empathic listening 1. builds trust and respect 2. enables the one in need to release their emotions 3. reduces tensions 4. encourages the surfacing of information 5. creates a safe environment for sharing and problem solving Mr. Smith: I have been sick too long and sometimes wonder if I will ever get well. I have lost my spirit to keep going. Technician: This must be heartbreaking to be ill for 3 months. Mr. Smith: Oh it is. I feel that it is hopeless. Technician: Mr. Smith you seem so discouraged. Mr. Smith: (Nod head) Yes, just hopeless. Technician: Mr. Smith, is there anything we can do to help you? Mr. Smith: Sometimes it helps just to have someone like you to talk to. Technician: It is important for me to understand how painful this for you, instead of just trying to cheer you up. Mr. Smith: I don t blame anyone for my sickness. I just get frustrated by how long it is taking to get me well. The Process of Empathic Listening 1. You as a healthcare professional must give the person you are connecting with your full attention. Remember that the patient in front of you is your sole focus at this singular moment in time. 2. We all know that multitasking, is a great thing, but not appropriate when working empathically with patients, particularly when practicing empathic listening. Their problem is in your hands, so your understanding and your time are in their hands. 3. It is very important not to speak when the other person is in the middle of communicating their issue. Empathic listening means that it is your job to actually hear what is being said, and reach to the heart of the topic to achieve full understanding of the situation. 4. Offer a summary of what you have heard to the speaker, when they are done talking. This affirms to the patient that you were listening, and reaffirms to yourself what you heard.

10 Empathy Can Be Learned Many believe that empathic communication skills are not something that you can learn. This belief is based on the notion that you are born an empathic person. As with any new behavior, learning to alter existing habits of responding is very difficult. Pharmacy technicians who are not accustomed to conveying their understanding of the meaning of illness and treatment for their patients will sometimes feel awkward using empathic responses. This skill must be practiced before it becomes a natural part of how we relate to others. Empathic communication skills can be learned with a value system that places importance on establishing therapeutic relationships with patients. As part of the healthcare team, we must develop communication skills that allow us to effectively convey our understanding and caring to patients. Patient and caregiver communication As a pharmacy technician we often wonder if our patient understands our instructions on taking medications. Five basic tips to follow for better communication 1. Slow down. Take the time to explain and access understanding. Technician: Mr. Smith the directions on the bottle are to take one tablet at bedtime. 2. Use plain language, nonmedical language. Using plain language will insure understanding by your patient or caregiver. Incorrect Technician: Mr. Smith, your hypertension medication is ready. Your cardiologist Dr. Jones called it in. Correct Technician: Mr. Smith your blood pressure medication is ready. Your heart doctor, Dr. Jones called it in. Incorrect Technician: Mr. Smith, your Periodontist called you in an analgesic prescription. Correct Technician: Mr. Smith, your dentist called you in a pain killer prescription. 3. Encourage questions. Part of your job as a pharmacy technician is to prompt patients and caregivers to ask questions. Patients and caregivers may be shy or apprehensive. They might not know what to ask. Make patients feel comfortable by asking open-ended questions. Technician: Mr. Smith, tell me about your blood pressure. Technician: Mr. Smith, tell me how and when you take your water pill. 4. Use the teach-back technique. Teach-back is a way to check whether your patients understand the health information and

11 instructions you explain to them. It is a simple three-step process: 1. Explain 2. Check 3. Re-explain if needed PassAssured's Pharmacy Technician Training Systems Teach-back is a combination of common sense and being sensitive to a patient s needs and feelings. Technician: Mr. Smith, I want to be sure I explained how to take this medicine clearly. Can you please explain it back to me so I can be sure I did? Mr. Smith: I am to take one tablet twice daily one in the morning after breakfast and one at bedtime with a snack. Technician: That is correct. One tablet twice daily one in morning after breakfast and one at bedtime with a snack. 5. Give small chunks of information and repeat it. Information is best remembered when it is given in small pieces that are pertinent to the tasks at hand. Repetition further enhances recall. Technician: Mr. Smith, This medication is for your blood pressure. You are to take one tablet daily at bedtime. Do you have any questions for the Pharmacist? Conclusion: In closing we should note that communication is a common and complex practice that is essential for the pharmacy technician. In our professional lives we need to interact with people. Some of these interactions are successful, some are not. In a busy pharmacy, technicians typically do not have the opportunity to stop and analyze the situation. As a technician it is important to improve our communication skills. We need the ability to assess a particular situation quickly. Pass Assured, LLC, Pharmacy Technician Training Systems Copyright Pass Assured, LLC, Web Site - -o-