Guidelines for health staff

Monitoring effectiveness

unrecognised miscommunication is dangerous - it can have serious consequences for the quality of care and patient outcomes

never assume communication has been effective - miscommunication if often masked by the efforts of participants to make it work

Participants (staff or patients) might not be comfortable interrupting to clarify information when they are unsure - or they might be totally unaware when they have misunderstood.

There is a particularly high risk of miscommunication going unnoticed when the patient is relatively fluent in conversational English: it is easy to incorrectly assume a shared understanding of concepts that may not be familiar - or are understood differently - by the patient / family even though they can converse confidently in English.

check the patient's understanding

Asking ' do you understand?' is not a valid comprehension check; you also need to check the interpreter's accuracy - try asking the patient to repeat your message in their own words..

check your own understanding

summarise what you think the patient has told you and try to find out if your understanding is accurate - this is challenging as the patient is unlikely to disagree with what you say directly (verbal agreement with the speaker, regardless of the listener's actual opinion, is a strong politeness convention in some cultures). Ask the interpreter to help you verify that your understanding is accurate.

look for evidence that communication has been successful - or unsuccessful