Why clear, concise and accurate patient information is vital for good health outcomes
Many years ago, while working on a newspaper, I received a call from a distraught man who had just been diagnosed with cancer. He was a single dad of two young children and wanted us to publicise his fund-raising efforts.
After further clarification, it became clear he had a tumour but when he said it was ‘benign’, alarm bells rang. Even my younger self knew ‘benign’ didn’t mean cancerous so I asked him to please go back to the hospital or speak to his GP for a full explanation of his diagnosis.
We didn’t hear from the man again and hopefully, all was well, but the call is a reminder of how poor communication, verbally and written, can adversely affect patients. Did the doctor fully explain what ‘benign’ meant and the patient didn’t understand, or did he or she assume the patient would know the meaning?
Assuming a patient’s understanding can be dangerous when you take into account our literacy skills as a nation. A 2011 Government study revealed that 15 per cent of the English working-age population has literacy skills below the level of an 11-year-old child (with 43 per cent of the working-age population’s literacy skills equal to 13- or 14-year-olds). This is why patient information guidance pegs the reading age to a 10 or 11-year-old as do tabloid newspapers.
Alongside anecdotal evidence, there are plenty of studies showing that poor communication leads to poor health outcomes. If patients don’t understand their diagnosis, take their medication properly or follow a treatment plan correctly, then their health will suffer. This means clinicians communicating clearly with patients and providing them with high-quality information after a consultation. The latter is important because evidence shows that patients remember less than half of what they are told during a consultation.
In today’s world, where knowledge is at the end of our fingertips and technology allows healthcare professionals to communicate using text, videos, audio and mobile phone messages, there is no excuse for not only providing clear and timely patient information but also keeping a patient engaged in their treatment.
One of the key areas for many hospitals is making sure patients have informed consent. Written and verbal patient information about operations and procedures needs to be up to date and clearly outline the risks and adverse effects as well as provide details on reasonable alternative treatments, or else hospitals can find themselves facing lawsuits.
In 2020, Queen Mary’s University London found that legal cases relating to consent have risen dramatically since a landmark ruling in March 2015 when the Supreme Court changed the balance of power in the patient’s favour. Instead of asking what a reasonable doctor would warn about, it now asks what a reasonable patient would expect to know. As a consequence, lawsuits relating to consent increased fourfold and where failure to inform was added as a contributory claim, it was nearly tenfold.
Informed consent means giving patients reasonable treatment and patient information. However, reasonable treatment can be skewed as we saw in the vaginal mesh scandal where manufacturers had financial links to research, royal colleges, and clinicians. At First Do No Harm, the Independent Medicines and Medical Device Safety report, revealed patients' mesh complications were under-reported and their complaints disregarded. It also showed patients were not informed well enough about the risks or reasonable alternatives to mesh.
Failing to communicate properly, whether on purpose or because of poorly written material, isn’t the preserve of healthcare though. Many sectors could benefit from using an informed consent model so that consumers know exactly what they are letting themselves in for.
