Health Information Management Communication skills

Nelson Ochekpe Michael Bayo Adeniyi

Communication
Passing across the right message by the right person to the right person using the right channel at the right time to achieve the intended purpose. It involves the interchange of facts, thoughts, value judgments and opinions

communication process
may take many forms;
face-to-face conversations, telephone calls, informal and formal meetings, conferences, letters, reports, memoranda etc.

Quizz
Good communication results when the sender and receiver are in accord over the meaning of a particular message, discuss the advantages and disadvantages of the communication processes outline above?

Good Communication
Components of good communication include:
Perceptions Listening behaviour Interpretation Understanding and Verbalization of ideas

Elements of Interpersonal Communication

Sender: encodes or deliver a message Receiver: decodes message and makes sense of Message: message can be transmitted verbally and/or non-verbally message will usually contain both factual and feeling information; most factual information is conveyed verbally while most feeling information will be communicated by non-verbal means

NON-VERBAL COMMUNICATION (NVC)

Definition: NVC can be said to include all forms of communication other than verbal messages. NVC includes both body language and how something is said (vocals)

NVC
Research findings indicate: that people use NVC more than verbal communication in expressing themselves. that over 90% of social meaning (attitudes, feelings, emotions) is conveyed non-verbally. it is very difficult to lie non-verbally

Attributes of NVC
- Highly believable - Either integrates with the verbal message to reinforce it or indeed contradict it. - Non-verbal behavior always communicate so that by saying nothing, we are in fact nonverbally saying something. - Always go - directed

Attributes Cont.
- Governed by strict rules in that, for example, in bereavement, high levels of touch will be acceptable in contrast to other social settings. - occur in a specific context, which in turn can affect the meaning of particular non-verbal behavior. - Thus a prolonged eye contact may signal great affection on the one hand (e.g. a courting couple) or overt aggression on the other hand (e.g. two boxers).

Examples: Head and Shoulders

Head titled back - Dominance Shaking head slowly - I dont really agree Shaking head quickly - I definitely disagree Shrug of shoulders - I dont know Stiffening of shoulders - Tension

Class assignment 1
Eyes: Different patterns of gaze can serve a variety of purposes during interpersonal communication. Eye contact is an important prerequisite at the beginning of any interaction, in that without it, communication does not usually occur. Identify and demonstrate (at least 5) eye NVC signs.

Class assignment 2
Face: One of the central functions of facial expressions is to provide information about emotional states Identify some (at least 5) face NVC signs.

Class assignment 3
Posture: There are a wide range of meanings associated with different types of posture including welcoming, rejection, suspicious, puzzled, anger and indifferent Identify and demonstrate (at least 5) postures of NVC.

Class assignment 4
Vocals: This refers to how something is said as opposed to what is said an area of study known as paralanguage Identify and demonstrate (at least 5) vocals of NVC.

Class assignment 5
Appearance: Our appearance influences on how people perceive us. Therefore, it is important for pharmacists and their assistants to portray a professional image in terms of appearance, so that they look acceptable when dealing with patients Identify and demonstrate (at least 5) appearances of NVC.

Interpersonal Communication (IPC)

Interpersonal Communication (IPC)

Interpersonal communication is a person to person, two way, verbal and non-verbal interaction that includes the sharing of information and feelings between individuals or in small groups that establishes trusting relationships

IPC
IPC takes place in the health care setting and out in the community between health care providers and their clients, It is a key element in maximizing access to quality pharmacy care It is influenced by the attitudes, feelings, values, social norms, and the environment it complements, reinforces and elaborates other messages, e.g. through the mass media

Challenge of IPC
How to apply IPC skills especially when confronted with anxious, impatient and/or confrontational patients and/their relations. Narrate any experience you have had recently and how you were able to handle it.

Components of a good IPC

Be responsive the first order of business is to be available, accessible, and responsive. It is important to serve the client : make time in your schedule to be available, respond to phone calls, e- mails, and other enquires in a timely manner develop back up mechanisms for responding when you are unavailable

Components of a good IPC (2)

Be engaging be alive! look the client squarely in the eyes! Be an active listener. Connecting with the client often takes some work, and it is important to make the effort to focus attention on the request or issues at hand. Paraphrasing and other methods are helpful to assure clients that you hear and are interested in what they say. Most often this approach leads to the most effective and efficient outcome

Components of a good IPC (3)

Be pleasant Work should be fun! A smile and some humor go a long way towards breaking the ice, easing anxiety, defusing conflict, and thereby increasingly the channels of communication.

Components of a good IPC (4)

Be patient treat impatient with patience is one of the most difficult skills in interpersonal communication, but one of the most important for public officials and marketers. Give clients the opportunity to vent before trying to get to the root of the problem and find solutions

Components of a good IPC (5)

Be clear clarity of communication is critical. Active listening and paraphrasing are a critical first step. It is also important to leave the client with a clear idea of where you stand, what to expect, and what next step to take

Components of a good IPC (6)

Be positive it is easy to look at the dark side: of any situation. One of the important skills of interpersonal communication is to
look at a situation in a positive light, to empathize with the client, and to seek solutions

Components of a good IPC (7)

Be realistic while it is important to be positive, it is critical to be realistic. If there are difficult or insurmountable problems, the clients need to know

Components of a good IPC (8)

Be a problem solver All of these skills amount to being a problem solver, or one actively involved in trying to resolve a clients concern. Helping people solve their problems through responsiveness, engagement, patience, clarity and a positive, empathetic and realistic approach is the best way to perform the role of Pharmacist and to win friends and influence people

EXCERCISE
A healthy looking individual showed up to donate blood to save life but has just been confirmed to be hepatitis B positive. Demonstrate how you would make this known to him in a positive manner.

PUBLIC SPEAKING AND PRESENTATION

Public speaking & Presentations

Golden rule Ensure your words are always understood Ensure that your verbal message are understood time and time again by:
be prepared be natural keep the message clear keep the message simple keep the message concise be vivid when delivering the message

Be Prepared
Preparation is underrated. It is one of the most important factors in determining your communication successes When possible, set, meeting times and speaking and presentation times well in advance Ask your self: who? What? How? When? Why?

Who
Who are you speaking to? What are their interests, presuppositions and values? What do they share in common with others; how are they unique?

What
What do you wish to communicate? One way of answering this question is to ask your self about the success criteria;
how do you know if and when you have successfully communicated what you have in mind

How
How you can best convey your message? Language is important here, as are the nonverbal cues discussed earlier. Chose your words and your nonverbal cues with your audience in mind. Plan a beginning, middle and end. If time and place allow, consider and prepare audio visual aids

When
When timing is important, develop a sense of timing, so that your contributions are seen and heard as relevant to the issue or matter at hand
There is a time to speak and a time to be silent. Its better to be silent than sing a bad tune.

Where
what is the physical context of the communication in mind? Visit the room, for example, and rearrange furniture. Check for availability and visibility if you are using audio or visual aids

Why
To convert hearers into listeners, Need to know they should listen to you What disposes them to listen? Know why you are seeking to communicate the value or worth or interest of what you are going to say

COUNSELLING
Patient counseling may be defined as an interactive session between patient, Physican, health workers and pharmacist Counseling is one of the extended roles of the pharmacy profession and if it is well performed the pharmacist will be happy that he/she has made use of his knowledge and contributed to the recovery of a patient

 The patient will be happy for the information received and appreciative of the pharmacists role towards his/her recovery

PRINCIPLES OF COUNSELLING
ACCEPTANCE INDIVIDUALISATION CONFIDETIALITY

ACCEPTANCE
Respect the client, whatever his/her circumstances Leads the counselor to an understanding of the meaning and causes of his/her behavior A mode of interacting with the client that is nonjudgmental Means recognizing the capacities and limitations of the clients

INDIVIDUALISATION
This means recognizing and understanding each persons unique qualities, and calls for the need to know the specifics in every clients situation.

CONFIDENTIALITY
This means that all information received from the client should be held in confidence. The client has a right to expect that his/her needs will be kept in confidence and that pharmacist will not discuss his/her situation inappropriately with other clients or within earshot

CONTROLLED EMOTIONAL INVOLVEMENT

This means being sensitive and responsive to the clients feelings without being emotionally involved

NON-JUGMENTAL ATTITUDE
This means being conscious that one does not have pre-conceived notions or premature conclusions about the clients; Dont allow personal biases/prejudices to affect the relationship.

SELF DETERMINATION
This means that the client should determine what his/her needs are and how they should be met; the counselor does not decide for him/her, does not manipulate his/her affairs, but guides him/her problem objectively, understand the choices or alternatives open to him/her, and their implications and consequences.

APPROPRIATE VERBAL BEHAVIOURS

Clarify Listen Encourage Acknowledge Reflect and Repeat

APPROPRIATE VERBAL BEHAVIOURS

KISS K= Keep I= It S= Short & S= Simple

APPROPRIATE NON VERBAL BEHAVIOURS

Relax Open and Approachable Listen and Lean towards Client Eye Contact Sit Straight and Smile

THE COUNSELING PROCESS

six steps in the counseling process (GATHER) G- greet the client in a friendly, warm respectful and helpful way. Create confidence, develop rapport and make them feel at ease. A- ask clients about their needs. Know your clients. Obtain medication history for proper counseling. If you need to ask the client about sensitive matters, wait until he/she feels at ease with you.

GATHER cont.
T- tell the client about choices available. H- help the client to make decision about a choice. Allow your client plenty of time to ask questions and air concerns . E- Explain the correct use of the medication.

GATHER cont.
R- repetition of the instructions by the client to help assess clarity at communication. Tell the clients they should report back at an appointed time to assess the recovery and also they may visit the pharmacy anytime as needed for concerns or problems

Qualities of a good counselor

Knowledgeable Ensure confidentiality Good listener Shows interest Has self control and tact

Qualities of a good counselor cont.

Non-Judgmental Emphathetic Honest and acknowledges limitations Approachable Ability to create rapport

Challenging counseling scenarios

Silent client Crying client Counselor believes no solution Client threatens suicide Counselor is short on time Counselor cannot establish good rapport Counselor frustrated or embarrassed by topic

Challenging counseling scenarios cont.

Client refuses help Counselor makes a mistake Client is uncomfortable with counselor gender Client and counselor know one another Client talks continuously Client asks counselor a personal question Customer Centered Approach

EXCERCISE
Lets know your experience Q&A

Thank you

CONFLICT MANAGEMENT (1)

Win win negotiation finding a fair compromise Negotiation skills help you to resolve situations where what you want conflicts with what someone else wants. The aim of negotiation is to explore the situation to find a solution that is acceptable to both parties. There are different styles of negotiations, depending on circumstances. Where you do not expect to deal with people ever again and you do not need their goodwill, then it may be appropriate to play hardball seeking to win a negotiation while the other person loses out. Many people go through this when they buy or sell a house this is why house buying can be such a confrontational and unpleasant experience. Similarly, where there is a great deal at stake in a negotiation (for example, in large sales negotiations) then it maybe appropriate to prepare in detail and use a certain amount of subtle gamesmanship to gain advantage.
26/10/2010 Nelson & Michael @ WAPCP Jos centre

CONFLICT MANAGEMENT(2)
Both of these approaches are usually wrong for resolving disputes with people you have an on going relation with: if one person plays hardball then this disadvantages the other person - this may quite fairly, lead to reprisal later. Similarly, using tricks and manipulation during a negotiation can severely undermine trust and damage teamwork. While a manipulative person may not get caught out if negotiation is infrequent, this is not the case when people work together on a frequent basis. Honesty and openness are the best policies in this case.
26/10/2010 Nelson & Michael @ WAPCP Jos centre

CONFLICT MANAGEMENT(3)
Preparing for a successful negotiation.. Depending on the scale of the disagreement, a level of preparation may be appropriate for conducting a successful negotiation. For small disagreements, excessive preparation can be counter productive because it takes time that is better used elsewhere. It can also be seen as manipulative because just as it strengthens your position, it can weaken the other persons. If a major disagreement needs to be resolved then it can be worth preparing thoroughly. Think through the following point before you start negotiating
26/10/2010 Nelson & Michael @ WAPCP Jos centre

CONFLICT MANAGEMENT(4)
Goals what do you want to get out of the negotiation? What do you expect the other person to want? Trades what do you and the other people have that you can trade? What do you each have that the other might want? What might you each be prepared to give away?
26/10/2010 Nelson & Michael @ WAPCP Jos centre

CONFLICT MANAGEMENT(5)
Alternatives if you dont reach agreement with the other person, what alternative do you have? Are these good or bad? How much does it matter if you do not reach agreement? Does failure to reach agreement cut you out of future opportunities? What alternative might the other person have. Relationship what is the history of the relationship? Could or should this history impact the negotiation? Will there be any hidden issues that may influence the negotiation? How will you handle these?
26/10/2010 Nelson & Michael @ WAPCP Jos centre

CONFLICT MANAGEMENT(6)
Expected outcomes what outcomes will people be expecting from this negotiation? What has the outcome been in the past, and what precedent has been set? The consequences what are the consequences for you losing or winning this negotiation? What are the consequences for the other person?
26/10/2010 Nelson & Michael @ WAPCP Jos centre

CONFLICT MANAGEMENT(7)
Power which has what power in the relationship? Who controls resources? Who stands to lose the most if agreement isnt reached? What power does the other person have to deliver what you hope for? Possible solution based on all the considerations, what possible compromises might there be?
26/10/2010 Nelson & Michael @ WAPCP Jos centre

CONFLICT MANAGEMENT(8)
Style is critical For a negotiation to be win-win, both parties should feel positive about the situation when the negotiation is concluded. This helps to maintain a good working relationship afterwards. This governs the style of the negotiation histrionics and display of emotions are clearly inappropriate because they undermine the rational basis of the negotiation and because they bring a manipulative aspect to them.
26/10/2010 Nelson & Michael @ WAPCP Jos centre

CONFLICT MANAGEMENT(9)
Despite this, emotion can be an important subject of discussion because peoples emotional needs must fairly be met. If emotion is not discussed where it needs to be, then the agreement reached can be unsatisfactory and temporary. Be as detached as possible when discussing your own emotions perhaps discuss them as if they belong to someone else.
26/10/2010 Nelson & Michael @ WAPCP Jos centre

CONFLICT MANAGEMENT(10)
Negotiating successfully The negotiation itself is a careful exploration of your position and the other persons position with the mutually acceptable compromise that gives you both as much of what you want as possible. Peoples positions are rarely as fundamentally opposed as they may initially appear the other person may quite often have very different goals from the ones you expected!
26/10/2010 Nelson & Michael @ WAPCP Jos centre

CONFLICT MANAGEMENT(11)
In an ideal situation, you find that the other person wants what you are prepared to trade, and that you are prepared to give what the other person wants. If this is not the case and one person must give way, then it is fair for this person to try to negotiate some form of compensation for doing so the scale of this compensation will often depend on the many of the factors we discuss above. Ultimately, both sides should feel comfortable with the final solution if the agreement is to be considered win win.

26/10/2010

Nelson & Michael @ WAPCP Jos centre

BARRIERS TO EFFECTIVE COMMUNICATION

1. PHYSICAL BARRIERS (staff located in different building, or different sites, marked out territories, Empires, closed office doors, barrier screens, separate areas for people of different status, poor or outdated equipment, staff shortages, distractions/noise poor lighting, unhygienic room, too hot or cold environment.

2. ATTITUDINAL BARRIER

(Come as a result of problems with staff in an organization, which may be brought about as a result of poor management, lack of consultation with employees, personality conflicts, the personal attitudes of individual).

3. EMOTIONS OR PSYCHOLOGICAL BARRIERS (Peoples state of mind: It is comprised mainly of fear, mistrust, suspicion, hostility, anger, resentfulness or worries about their health or marriage). To overcome emotional barriers, be aware of the feelings that arise in your self and in others as you communicate, and attempt to control them. Most important, be alert to the greater potential for misunderstanding that accompanies emotional messages.

4. PERCEPTUAL BARRIERS (Perception is generally how each individual interprets the world around him. We all see the world differently. All generally want to receive messages which are significant to them. But any message which is against their values is not accepted).

5. PHYSIOLIGAL BARRIERS

(May result from individuals personal discomfort, caused, for examp le, by ill health, poor eye sight or hearing difficulties).

6. INDIVIDUAL LINGUISTIC ABILITY

(The use of difficult or inappropriate words in communication can prevent people from understanding the message. Poorly explained or misunderstanding messages can also result in confusion).

7. POOR LISTENING (Lack of attention on the receivers part. We all let our minds wander now and then, regardless of how hard we try to concentrate.

POOR LISTENING CONTD.

People are essentially likely to drift off when they are forced to listen to information that is difficult to understand or that has little direct bearing on their own lives.

POOR LISTENING CONTD. To overcome barriers, paraphrase what you have understood, resist jumping to conclusions. Clarify meaning by asking non threatening questions, and listen without interruption).

8. LACK OF SUBJECT KNOWLEDGE

If a person who sends a message lacks subject knowledge then he may not be able to convey his message clearly.

When a person is under immense stress, he may find it difficult to understand the message, leading to communication distortion.
9. STRESS:

STRESS CONTD. As this stage our psychological frame of mind depends on our beliefs, experience, goals and values.

10. DIFFERING BACKGROUNDS

Age, education, gender, social status, economic position, cultural background, temperament, health, beauty, popularity, religion, political belief, even passing mood can all separate one person from another and make understanding difficult

DIFFERING BACKGROUNDS CONTD.

To overcome the barriers associated with differing backgrounds, avoid projecting your own background or culture onto others.

DIFFERING BACKGROUNDS CONTD.

Clarify your own and understand the background of others, spheres of knowledge, personalities and perceptions and dont assume that certain behaviors mean the same thing to everyone.

11. TIME PRESSURES:In a haste to meet deadliness, the formal channels of communication are shortened, or messages are partially given, i.e. not completely transferred.

12. POOR RETENTION:

Human memory cannot function beyond a limit one cant always retain what is being told especially if he is not interested or not

13. INFORMATION OVERLOAD:-

Managers are surrounded with a pool of information this may lead to information being misinterpreted or forgotten or overlooked.

14. LANGUAGE PROBLEMS:

Words can be interpreted in more than one way. To overcome language barriers, use the most specific and accurate words possible.

LANGUAGE PROBLEMS CONTD.

Always try to use words your audience will understand. Increase the accuracy of your messages by using language that describes rather than evaluates and by presenting observable facts, events, and circumstances.

15. INCORRECT FILTERING (Screening out before a message is passed on to someone else. (filters include secretaries, personal assistances, receptionists, answering machines etc.

INCORRECT FILTERING CONTD.

To overcome filtering barriers, try to establish more than one communication channel, eliminate as many intermediaries as possible, and decrease distortion by condensing message information to the bare essentials.

16. INTERPERSONAL BARRIERS (Withdrawal, Rituals, Pastimes, Working, Games, Closeness is the aim of interpersonal contact where there is a high level of honesty and acceptance of yourself and others.

17. EMPATHY Lack of empathy can create a barrier between the sender and receiver. Empathy is understanding so intimate that the feelings, thoughts, and motives of one are readily comprehended by another.

EMPATHY CONTD.

You can transmit a better message if you can put yourself in the receivers place and analyze the message from his viewpoint.

EMPATHY CONTD.

The same holds true for the receiver. He must be able to empathize with you. That is, the sender, as well as the receiver, must try to project himself into the others personality if he wants to increase his potential for effective communication.

In Nigeria we have hundreds of different cultures, therefore effective communication is especially challenging given that Nigerians speaks different languages.
18. CULTURES:

CULTURES CONTD

And when languages are different, and translation has to be used to communicate, the potential for misunderstanding is increased.

19. GENDER BARRIERS

There are distinct differences between the speech patterns in a man and those in a woman. A woman speaks between 22,000 and 25,000 words a day whereas a man speaks between 7,000 and 10,000

GENDER BARRIERS CONTD

In childhood, girls speak earlier than boys and at the age of three, have a vocabulary twice that of boys. The reason for this lies in the wiring of a mans and womans brains.

GENDER BARRIERS CONTD

When a man talks, his speech is located in the left side of the brain but in no specific area. When a woman talks, the speech is located in both hemispheres and in two specific locations.

GENDER BARRIERS CONTD

This means that a man talks in a linear, logical and compartmentalized way, features of leftbrain thinking;

GENDER BARRIERS CONTD

whereas a woman talks more freely mixing logic and emotion, features of both sides of the brain.

GENDER BARRIERS CONTD

It also explains why women talk for much longer than men each day.

 WEB DEMO

Thank you.