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Clean Language in health care cuts to the chase

Q guest contributor Judy Rees, co-author of Clean Language: Revealing Metaphors and Opening Minds, discusses how Clean Language in health and care can save clinical time and improve communication between clinicians, patients and colleagues. 

Have you ever worried about the time it takes to ask good questions in a diagnostic conversation? Paediatric consultant Hesham Abdalla has. ‘I’ve only got seven minutes for this consultation! There’s no way I’m going to finish in the time,’ is a thought he tells me he had.

But he found that Clean Language questions helped him to cut to the chase.

‘What matters to these people, and what matters to me, suddenly becomes very clear, crisp, concise, and actually abbreviates the time – and means that the time we do have is much more valued,’ Hesham said.

Hesham’s was just one of the compelling stories people told about using Clean Language questions in health care, especially in the NHS, during a half-day Open Space online event supported by the Q community.

About 45 people took part, co-creating a series of interlinking conversations around the theme of Clean Language in health care. Most were from the UK, with small contingents from The Netherlands and the US.

What is Clean Language?

There are millions of conversations every day in health care. But sometimes those conversations don’t cover what’s really important.

We end up talking in circles, covering the same old ground without resolving the issue. We miss the point. Costs escalate, tensions rise and everyone suffers.

How can we enable better conversations with patients, with colleagues, with each other?

Clean Language can help with this. It’s a set of precision questions, and a way of asking them, devised by the late David Grove (1950 – 2009). The structure of these questions forces the questioner to listen well and to set aside, at least to some extent, their assumptions and biases.

The result is that the questioner typically elicits a higher quality of information, more quickly, than using other methods.

The process of being asked these questions helps people feel heard and understood, and to discover things about themselves that they didn’t know. This, in turn, strengthens relationships. Hence the questions can be useful in developing effective communication between colleagues, as well as between clinicians and patients.

How is Clean Language being used to improve health and care services?

Using Clean Language can build genuine rapport AND gather high-quality information at the same time. It can help to make care both personalised and efficient.

Hesham’s comments came during an inspirational whole-group kick-off session in which I demonstrated how I could use the Clean Language questions to interview first Hesham, and then Palliative Care Consultant Saskie Dorman, about how Clean Language helped them in their work.

Since the event itself, I’ve interviewed other attendees about how they are using Clean Language to improve health and care. Advanced Palliative Care nurse Siobhan Aris is asking, ‘What kind of support?’ every time someone requests support, and has been getting some very surprising answers. Check out the video.

And Kath Rooksby, a senior manager in NHS South West Integrated Personalised Care, has found Clean Language valuable in conversations with colleagues – and her teenage children. Check out the video.

What happened next?

After the opening interviews, the event used a version of Open Space to self-organise a mini-conference. You can find a list of the sessions, with notes, summaries or transcripts of most of them, in the notes from the event.

Popular topics included:

  • How can Clean Language facilitate true collaborative working between different teams
  • Does Clean Language cost less?
  • Overcoming blockers to adopting Clean Language
  • The value and use of CLQ with metaphor in health conversations.

The event organising team – Hesham, Saskie, Judy, with Kath Rooksby (NHS England South West personalised care and end of life) and Steve McCann (Clean Language trainer and online event designer) – were delighted with how it went.

Kath said: ‘What a brilliant morning it was! Thank you everyone for sharing such curious topics that led to such generative conversations. Fascinating! I’m looking forward to learning more.’

But they are even more excited by what could happen next.

As a first step, a Clean Language in Healthcare Special Interest Group has been established as a place to hold ongoing conversations.

Get involved

Join the Special Interest Group, or contact any of the event organisers, to learn more about how Clean Language might help you.

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