• expert panels,
• quality improvement committees,
• task forces, and
• Patient and Family Advisory Councils.

The Six Essential Elements in this guide were gleaned from a number of reputable sources, as well as from recent experiences by the Betsy Lehman Center, including members of the public in our expert panels and other convening activities.

• Family liaison within the NHS.
• The role of family liaison.
• Supporting and working with families and/or carers-what do they want and/or need?
• What type of cases can family liaison handle and where they can’t support a family/carer.
• A case study.

CAHPS surveys ask patients to report on their experiences with a range of health care services at multiple levels of the delivery system. Some CAHPS surveys ask about patients' experiences with providers, such as medical, groups, practice sites, and surgical centers, or with care for specific health conditions. Other surveys ask enrollees about their experiences with health plans and related programs. Finally, several surveys ask about experiences with care delivered in facilities, including hospitals, dialysis centers, and nursing homes.

CAHPS databases

For each survey, you can download formatted survey instruments, guidance for administering them, and information on analysing and using the results. Information in the guidance documents is based on the survey developers' extensive research into best practices in survey design and administration as well as analyses of data collected during the field testing of each instrument. AHRQ does not require the use of any surveys or the use of a specific methodology for sampling or survey administration.

CAHPS Ambulatory Care Improvement Guide

The CAHPS Ambulatory Care Improvement Guide is a comprehensive resource for health plans, medical groups, and other providers seeking to improve their performance in the domains of patient experience measured by CAHPS surveys of ambulatory care. Use this guide to help your organization:

• Cultivate an environment that encourages and sustains improvements in patient-centered care.
• Analyze the results of CAHPS surveys and other forms of patient feedback to identify strengths and weaknesses.
• Develop strategies for improving performance.

The report calls for:

• All public services to become trauma- and agenda-informed.
• NICE to incorporate trauma-informed principles into guidance.
• Service commissioners to adopt trauma-informed principles.
• All inspectorate bodies to incorporate trauma-informed principles.
• Government to lead the way in putting these principles into practice.

The facilitator, a community nurse, told us a story of when she was looking after patients who'd had knee replacements. She noticed very few were recovering at home as quickly as she might have expected. It wasn't until she unpicked the advice given to them and the language used that she found the answer. Language. 

Her patients had all been advised to elevate their leg. It turned out that many of her patients didn't know what it meant to 'elevate' their leg. And because of this, their recovery had been set back.  

This story really struck a chord with me because I would have happily used the word elevate in my writing without thinking twice. I was clearly not as aware as I had thought. 

This was an important example though. An example that highlights a direct impact on patient safety and care, and raises concerns about the more complex terminology often used by clinicians when talking to patients. 

So, it begs the question... if there is a simpler way of describing or saying something, then why don't clinicians do it?

• Maybe because it requires more words in a world where efficiency is crucial... 'keep your foot up on a stool or something like that'. 
• Maybe it's difficult to switch from essential medical speak to less technical language so many times a day depending who you are speaking to? 
• Maybe it's hard to remember that certain well-used words in their day-to-day lives are not common place elsewhere? 
• Maybe, in some cases, it makes them feel powerful, respected, superior? 

Whatever the reason, surely the communication itself is pointless if ultimately the message is not being clearly communicated?  

As a writer, for me everything comes down to the key messages and key objectives. What do you want people to know? What do you want them to do? Often in healthcare, the motivation behind these questions is based on a desire to keep a patient safe.

Having worked in the health industry for many years, I can't help but feel frustrated by the jargon often used by health and care professionals – verbally and on paper. I guess I just feel they are shooting themselves in the foot (perhaps they should consider elevating it...). 

I have watched passionate and conscientious staff work tirelessly to put patients at the heart of their practice. I do wonder if they have a second to even think about language on top of everything else. But I believe that using clear and simple language is key to keeping patients safe... which is surely their raison d'etre while at work. 

So what can we do about it? 

I would challenge teams to put themselves to the test. Why not bring a bell to your next team meeting and ask colleagues to ring it every time they hear a word that could be said more simply? To avoid tinnitus, it might be wise to start by using the bell for just five minutes. 

There are so many benefits to this exercise: 

• It encourages an internal culture where colleagues are able to speak up if they don't feel something is made clear – to know that there will always be things others know that you don't, and vice versa. To celebrate those who assertively seek out clarification and shun any shame that can accompany lack of understanding. 
• It helps people really start to develop an awareness of the words they use and to differentiate between professional speak and human speak. To know their audience and to adapt quickly when needed. 
• Learning to use clearer language when writing or talking about health can only be a good thing. It will increase the chances of key messages being received and patients feeling informed and better equipped to take part in their care.

In my experience, language can act very powerfully to either include or exclude people. In an industry where patient engagement is key to outcomes, surely it's time we ditched the jargon? 

Have you tried any exercises as a team to help improve communication, in order to improve patient safety? 

View video (3:39)

• improve patient understanding and adherence
• decrease call backs and cancelled appointments
• improve patient satisfaction and outcomes.

Studies have shown that 40-80% of the medical information patients are told during office visits is forgotten immediately, and nearly half of the information retained is incorrect.