Difficult Conversations Within Healthcare: a Pilot Study

Exploration of difficult conversations among Australian paramedics

“…The aim of the study was to explore the workplace experiences of difficult conversations in paramedics employed by Ambulance Victoria in Australia. This study was informed by the Vital Smarts study, The Silent Treatment, (Maxfield et al, ) conducted in the USA, and a pilot study conducted in a healthcare service in Australia (Williams et al, ). To the best of our knowledge, such a study has not been previously conducted in the paramedic profession.…”

Avoiding Difficult Conversations in the Australian Health Sector

“…In addition, fewer than 50% of these nurses have spoken to their managers about the person who concerns them the most; and fewer than 33% of these nurses have spoken up and shared their full concerns with the person who concerns them the most. To explore these same issues in Australia, Williams et al (2017) carried out a small pilot study informed by the Silence Kills and The Silent Treatment studies.In this study, 65% of participants believed that some colleagues demonstrate behaviors which could be dangerous for clients. Participants also reported that a client had been affected due to the poor performance of someone in their health-care team and 35% said that they would feel uncomfortable to have that person look after a family member.…”

“…Most of the literature about difficult conversations in the health sector are related to those between medical professionals and their patients and/or patients’ families ( Corless et al., 2009 ; Davenport & Schopp, 2011 ; Kalra et al., 2013 ; Lamiani et al., 2012 ; Meyer, 2014 ; Stott, 2007 ).There is however, a gap in the literature about difficult conversations that take place between health-care professionals including students. Avoiding these conversations is associated with higher rates of medical errors and poorer patient outcomes ( Williams et al., 2017 ). For example, the “Silence Kills” study that used focus groups, interviews, workplace observations, and survey data from more than 1,700 nurses, physicians, clinical staff, and administrators identified seven different crucial conversations that are often avoided and correlate strongly with medical errors, patient safety, quality of care, staff commitment, employee satisfaction, discretionary effort, and turnover ( Maxfield et al., 2005 ).…”

“…Some studies have estimated the human and financial cost of avoiding conversations by linking these conversations to adverse events (AEs; Williams et al., 2017 ). An AE is an “unintended injury or complication resulting in prolonged hospital stay, disability at the time of discharge, or death, and caused by healthcare management rather than the patient’s underlying disease process” and it is estimated that approximately half of these events are preventable ( de Vries et al., 2008 ).…”

“…Today, over 20 years after the QAHCS, the impact of medical errors and how avoiding difficult conversations contributes to these errors is still a major concern in Australia ( Williams et al., 2017 ). The issues surrounding why people avoid difficult conversations are complex and varied, as are the potential impacts to patients when such conversations are avoided.…”