A Systems-Thinking and Person-Centred Approach to Healthcare Communication

Abstract

Objectives: Healthcare communication occurs within a complex system. Systems-thinking is an aspect of complexity science suited to integrating existing interpersonal, interprofessional, community and technological perspectives on communication, but there is a risk of depersonalising care. We therefore explored the role of systems-thinking and person-centred care in healthcare communication. Method: We applied a system-thinking “toolbox” to the Institute of Medicines definition of the healthcare system to develop a concept map, and to explore implications on practice and person-centred care of systems-thinking in healthcare communication. Results: The concept map integrated perspectives on communication and identified the central role of the electronic health record. Systems-thinking promotes a dynamic and interconnected view of communication; focused on improving the quality of care and reflecting important values such as person-centred care. Quality communication requires that outcomes of conversation are captured in a way that is findable, accessible, interoperable, and reusable. Conclusion: System thinking alters our conceptualisation of healthcare communication and identified neglected communication interactions. Ways of integrating systems-thinking and person-centred care were identified. It is proposed that the clinical encounter be imagined as having three communication functions: exchanging information (task focused), building connections (relationship focused) and curating the medical record (documentation focused).