Communication Support Policy

 

 

 

Policy Code: A3.1

 

Date: 09/06/2014

 

 

 

Purpose:

 

 

 

To ensure that all clients can access our services easily regardless of any communication barrier.

 

 

 

Responsible Staff:

 

 

 

Implementation: Quality Manager

 

 

 

Action: All Staff

 

 

 

Audit: Quality Manager

 

 

 

Audit:

 

 

 

Code	Cycle (months)	Criterion	Standard
A3.1.1	24	Clients on the communication register have been contacted within the last 24 months to inquire as to their needs and to ask if we can improve our systems.	50%
A3.1.2	24	All needs identified by discussion with the clients on the communication register have been considered at a practice meeting.	100%
A3.1.3	12	A practice meeting has discussed the communication register and the possibility of any further additions to the communication register withing the last 12 months	YES

 

 

 

 

 

Training Resources:

 

 

 

None

 

 

 

Linked Policies:

 

 

 

Maori Health Plan.

 

 

 

Policy:

 

 

 

Clients with communication difficulties are disadvantaged in accessing healthcare and need additional support to ensure equitable access.

 

 

 

The support offered should be appropriate for the condition as detailed below. Where a longer consultation is required, this should be offered at no extra charge.

 

 

 

Where a significant impairment exists, an alert should be considered and an entry in the screening register as 'COMMS' should be made, with appropriate detailing. This allows for audit.

 

 

 

Visual Impairment.

 

 

 

Clients with visual impairment may not be able to respond to written communication. This has implications both for us and for those to whom the clients may be referred.

 

Written communications are often read to blind people by relatives so great care needs to be taken in ensuring that clients are not given sensitive information by letter.

 

 

 

• Agree a suitable communication mode (such as verbal or large type) with the client

• Set an alert to ensure staff are made aware of this.

• Consider offering support to navigate within the practice.

• Consider longer appointments.

 

 

 

Hearing Impairment.

 

 

 

Deaf clients may be totally unable to communicate verbally, or may misunderstand communications. Not all deaf people are aware of their disability and not all are willing to make accommodation for it.

 

 

 

• Clients are welcome to bring a signer or other support person with them.

• Clients may, by arrangement, communicate by facsimile or, with specific consent, email (in exception to the Information Security Policy)

• Consider giving a copy of consultation notes to deaf clients – write the notes in plainer English for their benefit.

• Consider longer appointments.

 

 

 

Cognitive Impairment.

 

 

 

Clients with cognitive impairment are vulnerable to miscommunication in several ways:

 

 

 

• Misunderstanding – clients may not be able to understand or process complex concepts. The presence of a trusted advocate can be very useful in these circumstances though staff must always be alert to the possibility of abuse of this position of power.

• Confabulation – clients with cognitive impairment sometimes invent scenarios to cover their memory gaps. This may be conscious or unconscious. Confabulation can be very hard to detect and staff should be aware that confabulatory content is not reliable.

• Forgetting – clients may forget information they have been given. Written information and copies of the medical record may be helpful.

• Expressive Dysphasia – some clients may not be able to find the correct word for a situation. This can lead to frustration and slow communication. Longer appointments are appropriate.

• Receptive Dysphasia – Occasionally, clients are unable to recognise some words or to recognise some forms of communication. Longer consultations may be required.

• Dysphonia – Some clients have trouble forming words. This is a particular problem where the client is embarassed by the issue. Again longer consultations are appropriate.

 

 

 

Youth

 

 

 

Younger clients may be less skilled in communication than older clients and may find it difficult to cope with a standard consultation model. Youths who have difficulty communicating may prefer written information, web resources or even communication by txt.

 

 

 

Young people may prefer to have a parent present but it is also valuable to try to get them alone if this is acceptable, to ensure that the parent is not inhibiting free speech.

 

 

 

Great care is needed to identify the relationships where there are others present in consultation with young people. They are less likely to identify the people attending with them and less likely to object to others being present, even if they are not really happy about their presence.

 

 

 

Longer consultations are particularly important for youth mental health issues.

 

 

 

Mental Health

 

 

 

Mental health problems may lead to miscommunication in several ways:

 

 

 

• Distraction – potent medications and the effects of mental health issues may lead to clients being unable to follow complex concepts.

• Discord – clients may well behave inappropriately at times, leading to staff being uncomfortable with communication. Staff need to be understanding of clients' disabilities. Care needs to be used with alerts as it is important that client care is not prejudiced but staff safety must come first.

• Misunderstanding – clients may be prone to misunderstanding, especially where there is a degree of psychosis or paranoia.

 

 

 

In general, longer consultations or access to repeat consultations may be helpful.

 

 

 

Cultural Communication Problems.

 

 

 

Cultural communication problems are outside the scope of this policy – refer to policy for specific cultural groups as appropriate.

 

 

 

 

 

Change Record:

 

 

 

09/06/2014

 

 

 

Complete rewrite of original policy