When it comes to health equity, everybody knows where they need to be, and wants to take action. But how? Here’s 5 reasons why communication should be part of any health equity strategy.
Hello Partners, welcome! If you’re a manager or an administrator who’s tasked with moving the needle on health equity, or if you’re someone who knows a thing or two about racial or social disparities in communication, I have some hopeful things to say that you might appreciate.
Hi everybody, I’m Dr. Anne Marie Liebel. This is “10 Minutes to Better Patient Communication” from Health Communication Partners. I’m a consultant, educator and researcher–and yes, your organization can work with me. Courses + Action is a flipped classroom model where you and your colleagues learn what you need to know, on your own time. Then we get to work putting it into practice. Start with our Foundations of Equitable Communication course. Don’t just take courses, take Courses + Action. Go to h-cpartners.com And we have a newsletter! Twice monthly. If you don’t get the newsletter, I’ll put that link in the show notes too.
You know by now that healthcare organizations have aimed to reduce inequities in access and in quality of care for decades. I feel like when it comes to health equity, everybody knows where there’re at, and knows where they need to be, and wants to take action. But how?
Well, it will not surprise you, I want to talk about communication. Communication as a way in. Specifically, communication as a lever for how organizations can integrate health equity in their cultures, their missions, their strategic plans.
So that’s why I want to give you 5 reasons. 5 reasons why communication should be part of any health equity strategy.
1. First of all, communication is directly tied to unequal treatment and disparities in outcomes. Right, 20 years ago, the Institute of Medicine told us in Unequal Treatment that “disadvantaged patients may be sicker partly because of the way in which they and their doctors communicate.”
10 years ago, the survey Listening to Mothers III survey found that 40% of participants experienced communication issues. Nearly one quarter perceived discrimination during birth hospitalization. Black or Hispanic race or ethnicity was associated with nearly three times higher odds of discrimination.
Around that same time, The National Institute on Minority Health and Health Disparities identified patient-clinician communication as a priority topic.
A 2018 study reminds us that system factors, such as communication failures are part of preventable morbidity and mortality events.
That’s reason #1 but it takes me right into reason #2:
2. The high costs of inequitable communication. A study from the Joint Commissions states: “Communication failures in United States hospitals and medical practices were responsible at least in part for 30% of all malpractice claims, resulting in 1,744 deaths and $1.7 billion in malpractice costs” over the five years of the study. I’ll put the link to that study in the notes.
And to this study, wonderfully titled “The cost of not addressing the communication barriers faced by hospitalized patients” that’s the title of this study, that estimates the annual costs that are associated with the adverse events that can result from poor patient–provider communication. Are you ready for this? $29 billion a year. A year!
It’s important to put numbers on this. Yes we know this is about people’s lives. But numbers talk. It’s important to put numbers on communication. It’s not all bad news. There is good news. So that brings me to reasons 3, 4, and 5.
3. Reason #3 why communication should be part of any health equity strategy: because there is a positive relationship between patient-provider communication and health outcomes. It’s established. There’s a wealth of research data that supports the benefits of effective communication. I’ve got one study that indicates “Reducing communication barriers could lead to an estimated reduction of 671,440 preventable adverse events cases and a cost savings of $6.8 billion annually.” So we’re saving a lot when we pay attention to communication, because there is an established link between effective communication and better outcomes. More equitable outcomes.
4. Now maybe #1 you’d heard of before, #2, 3, none of this is new to you. But I wonder if maybe reasons 4 and 5 of why communication should be a part of your health equity strategy, they might be things you might not have had a chance to think about. Communication is modifiable, and it’s everywhere. Why are these qualities of communication important to health equity strategy? Well yeah, there’s lots of health equity strategies out there, guided by many available frameworks. Yet a Scoping Review of these frameworks found that “healthcare organizations often struggle with implementing” these frameworks and the strategies that go with them.
So the fact that communication is something we all do and participate in, and it’s structural, can be very helpful in a strategy way. Communication is crosscutting. This same scoping review concluded that one of the weaknesses of existing frameworks and models was a lack of concrete guidance for implementation. What do we do?
You could focus on communication! Because no matter what framework you’re using, communication is involved at every step. Communication is, like I said, crosscutting. It’s something we all do so it’s individual. And it’s also structural, and organizational. Whether it’s internal communication you’re talking about, or maybe your jam is interpersonal communication. Or maybe you’re in the digital health world, or you’re thinking about telehealth. Maybe you’re a researcher on communication. Maybe you’re concerned with legal language, policy language. Marketing is communication. All of this is communication. So choosing to look at communication as a lever for action on equity makes sense–no matter where you are in an organization.
5. And #5, a focus on communication isn’t really a big change from what you’re doing. Organizational change in general is difficult. I’ve been through a lot of them, and I’ve helped folks with them. When it comes to helping out, I tell my clients, I’m a big fan of starting with what you’re already doing, for a lot of reasons. Communication fits that bill.
Think about it: you’re already gathering data on communication. All those forms of communication I just mentioned. Think about quality improvement: you’re already paying attention to communication as part of patient safety and quality. You’re paying attention to health literacy. You’re paying attention to communication as part of the patient experience. Maybe communication as part of employee engagement, communication as part of corporate social responsibility. There has been an increasing number of studies using health communication research to address inequalities. But if you’re in a sizeable organization, you don’t just have the data, chances are you have the people, too. Communication specialists! Health literacy specialists!
So if I were someone in charge of moving the needle on health equity in my department, I would start by tapping the knowledge and expertise already existing in my organization. So, if this is you, if you’re that leader, I’m going to ask you to reach out to your colleagues who are talking to communities, who are collecting stories and data, who are working on health literacy, who are doing research on patient-physician communication.
And ask them: what concrete guidance do you have for improving health equity? Ask them: How can your knowledge of communication help us promote equity? And they will tell you!
Now, if you are one of these professionals, I’m your biggest fan. I want to talk to you for a moment. I know you’ve been beating this drum for years. So here is what I am, in all honesty, suggesting you do: call a friend. Get with one of your Communication buddies. Meet together. Talk about your work, talk about your research. Remind each other of what you know. Remind each other how you have the power to effect change through a focus on communication. And then call up one of those leaders in your organization. Maybe one outside your usual hallway. Get on someone’s calendar for half an hour. Share with them your research, share with them this episode. And when you’re ready to go further, contact me. I can help with tools and structure, starting with Foundations of Equitable Communication Course + Action.
This has been “10 Minutes to Better Patient Communication” from Health Communication Partners. Audio engineering and music by Joe Liebel. Music by Joe Liebel and Alexis R.