Hospital Communications

Background

Hospital admissions in children with long-term neurological conditions are common. It is therefore crucial that communication between staff and families is clear and that a therapeutic relationship is formed, for the benefit of the child. Communication is particularly likely to be a major issue for children with a learning disability or those who find social interaction difficult. A review of the scientific literature by researchers at the Peninsula Childhood Disability Research Unit (PenCRU) found that many parents perceive that health professionals do not have the necessary skills to communicate successfully with these children, and that this lack of skills and experience is recognised by many health professionals.

Project aims

The Hospital Communications project aims to improve staff communication with disabled children in hospital. Our work should result in more effective communication, meaning that time spent in hospital is less stressful for children and families.

We have developed a training package to improve hospital staffs’ communication with disabled children when they are inpatients. This work was funded through the RD&E NHS Foundation Trust Small Grants scheme.

Project activity

This study involves parents, clinicians and researchers co-developing and piloting a training package through several stages.

We carried out a structured review of previous research studies about factors affecting disabled children’s experience of being in hospital. The findings suggest that communication plays a key role. A paper describing this work has been published online. A plain language summary is also available.

We completed a qualitative analysis of interviews with parents of children that had recently stayed in hospital, and interviews or focus groups with hospital staff working on children’s wards. The findings identify barriers to effective communication, and also some factors that helped to improve communication. A published article and a plain language summary of the paper is available.

We used the information from the review and qualitative study to develop a training package for hospital staff, delivered by peers. The training is for all staff who interact with disabled children when they are inpatients, including receptionists, porters and cleaners, as well as clinical staff, such as doctors, nurses and allied health professionals. The training has been delivered on four occasions with 80 staff from different professions participating. A manual and a film have been produced to deliver the training. The film contains clips of parents’ experiences of staff’s communication with their child when they are in hospital to prompt reflection and discussion in the training. A published article on the development and pilot work is available.

In the latest study we assessed feasibility of staff in other hospitals implementing the training using our package materials. Training sessions were delivered in paediatric wards across four hospitals in England, with 123 staff taking part. Facilitators found the training easy to deliver, and participants felt they took away important messages to improve their practice. In a new development our nursing students in Exeter provided positive feedback when it was delivered to them online. This low-cost, minimal-resource training package is now available free of charge to support staff training in communication with disabled children and their families in hospitals.

Related publications

Sharkey S, Lloyd C, Tomlinson R, Thomas E, Martin A, Logan S, Morris C. Communicating with disabled children when inpatients: barriers and facilitators identified by parents and professionals in a qualitative study. Health Expectations 2014, 19:3.

Shilling, V., Edwards, V., Rogers, M. and Morris, C. (2012). The experience of disabled children as inpatients: a structured review and synthesis of qualitative studies reporting the views of children, parents and professionals. Child: Care, Health and Development, 38: 778–788.

Gumm, R., Thomas, E., Lloyd, C., Hambly, H., Tomlinson, R., Logan, S. and Morris, C. (2017) Improving communication between staff and disabled children in hospital wards: Testing the feasibility of a training intervention developed through Intervention Mapping. BMJ Paediatrics Open; 1:e000103.

Wilkinson, K, Gumm, R, Hambly, H, Logan, S, Morris, C. Implementation of training to improve communication with disabled children on the ward: A feasibility study. Health Expect. 2021; 00: 1– 10.