3 Communication and Collaborative Care

Communicating with patients

Patient-centered communication treats the patient as a partner in care. The clinician seeks to understand the patient’s concerns, goals, values, culture, preferred way of communicating, and desired level of involvement. Explain options in plain language, invite questions, and ask what matters most rather than making assumptions.

Introduce yourself and your role, and use the patient’s preferred name and form of address. Open-ended questions such as “What concerns you most today?” give patients room to explain; allow time for their answers. Listen actively by attending to the patient, avoiding unnecessary interruptions, reflecting or summarizing what you heard, and clarifying uncertain details. Acknowledge feelings without judgment, for example: “It sounds as though managing this at home feels overwhelming.”

Explain information in short, clear segments and avoid unexplained medical terms. Use Teach-back to check whether an explanation was clear. For example: “I want to make sure I explained this well. How will you take this medicine when you get home?” If the response shows a misunderstanding, explain the information another way and check again. Teach-back assesses the clarity of the explanation, not the patient’s intelligence.

Communication access is part of safe, equitable care. Ask whether the patient needs an interpreter, sign-language assistance, accessible materials, or another accommodation. Use qualified language-assistance services when needed; do not rely on children or untrained companions to interpret important clinical information. Speak directly to the patient even when an interpreter is present.

For wound-care instructions, instead of asking, “You understand your wound-care instructions, right?” a nurse might say, “Please show me how you’ll change the dressing at home. I can go over any step that isn’t clear.”

Building therapeutic relationships

A therapeutic relationship is purposeful and professional, unlike a social relationship: the clinician’s attention, communication, and boundaries serve the patient’s health and well-being. Trust develops through reliability, respect, empathy, privacy, and follow-through. Active listening and nonjudgmental responses can help patients share concerns that affect care.

Therapeutic communication includes asking open questions, reflecting feelings, clarifying meaning, summarizing key points, and allowing silence when a patient needs time to think. Avoid dismissing concerns, offering false reassurance, blaming, or shifting the focus to the clinician. Ask permission before touch or sensitive examinations, and respect personal and professional boundaries. When appropriate, ask whom the patient wants involved in conversations and decisions while protecting confidentiality.

Coordinating team care

Healthcare teams may include nurses, physicians, nursing assistants, pharmacists, therapists, social workers, interpreters, patients, and family caregivers. Collaboration depends on clear roles, shared goals, mutual respect, and timely communication. Team members should share relevant observations, ask questions when information is unclear, and raise concerns about a change in condition—even when doing so feels difficult.

Structured team communication

SBAR organizes a focused message into four parts:

• Situation: What is happening.

• Background: Relevant context.

• Assessment: What you think is happening.

• Recommendation: What action or response is needed.

For example, a nurse calling about a patient with new shortness of breath can state the change, relevant history, current findings and concern, then request an immediate assessment.

Check-back closes the communication loop. The sender gives a message, the receiver repeats or confirms the key information, and the sender verifies it was understood. It is especially useful for verbal instructions and urgent tasks.

Briefs, huddles, and debriefs help teams plan work, adapt to changing conditions, and reflect on what went well or needs improvement. The TeamSTEPPS framework presents communication, leadership, situation monitoring, and mutual support as connected teamwork skills.

Transferring care safely

A handoff transfers patient information and responsibility from one caregiver or team to another, such as during a shift change, transfer, referral, or discharge. A safe handoff is organized, accurate, and interactive: the receiver has an opportunity to ask questions, clarify details, and confirm the plan.

Prepare by reviewing current information and distinguishing confirmed facts from concerns or pending results. Include information relevant to continuity of care, tailored to the patient and transition:

• Patient identity and current condition, including illness severity or recent changes.

• Relevant history, treatment, allergies, medications, and code status, as appropriate to the handoff.

• Important assessment findings and pending tests or results.

• Tasks still to be completed, who is responsible, and when they are due.

• Anticipated risks, contingency plans, and when to escalate concerns.

I-PASS is one option for structuring handoffs: Illness severity; Patient summary; Action list; Situation awareness and contingency planning; Synthesis by receiver. In the final step, the receiver summarizes key points and asks questions, helping the team catch omissions or misunderstandings. SBAR may also be used for a concise update or escalation. Use the tool required by the organization and tailor the content to the patient and transition.

When appropriate and consistent with privacy and safety needs, include the patient in bedside handoffs and invite corrections and questions. Avoid discussing confidential information where others can overhear. Document the handoff according to workplace policy; documentation supports communication but does not replace the direct transfer of responsibility.