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Communications
How important do you think communication is? Did you know...
- More than 60% of medication errors are caused by mistakes in communication?
- There is mounting evidence that healthy work environments decrease medical errors, increase effectiveness of care, and decrease conflict and stress?
- Skilled communication has been identified as an essential standard in establishing and sustaining a healthy work environment by the American Association of Critical-Care Nurses (AACN)?
- Creation of healthy work environments is imperative to ensure patient safety, enhance staff recruitment and retention, and maintain an organization’s financial viability?
Communications are an important part of healthcare, but most hospitals struggle with improvement because large numbers of staff from different departments provide patient care.
Therefore, The Joint Commission (TJC) determined improving effective communication among caregivers should be included in the National Patient Safety Goals. Hospitals with TJC Accreditation must optimize communications. Along with read back on verbal or telephone orders, standard abbreviation usage, and timeliness of calling critical test results, there is added focus on communication during transfers from one caregiver to another. To assure patient safety, a short, verbal report allowing time for questions and understanding is needed.
TJC National Patient Safety Goal, 2E - HAND-OFF COMMUNICATIONS
Policy HADM/C-16 states that all necessary communication must occur at the time of transfer of responsibility from one person to another. This includes an opportunity to ask questions.
Examples in which hand off communication is needed include, but are not limited to:
- Shift change for nurses
- Ambulatory Services
- Physician offices
- Transferring facilities
- Physician to physician
- Ambassadors
- ER staff to floor staff
- PACU to floor staff
- Unit staff to surgery and back
- Radiology staff
For most people, the SBAR system of communication will suffice. This consists of quickly referencing in your memory the following acronym, to assure adequate communication. (The use of SBAR is a best practice from the Institute of Healthcare Improvement, and has been used successfully in other organizations):
- Situation
- Background
- Assessment
- Recommendation
This is a clear, simple method that many people can memorize—and it does not include required documentation.
The use of this method is verified and measured during mock TJC surveys. It is a responsibility of healthcare providers to understand the method chosen by UHC and how it is carried out.
Educators will detail the SBAR method on each unit. Look for neon pink reminders at the telephone and in the front of charts, as well as inclusion in annual competencies and guidelines for communicating with physicians. SBAR is fast, accurate and very effective in providing a consistent standard of communication in patient care.
Please focus on using it consistently and requiring it when you receive a patient. It must become part of our everyday excellence to consistently be the Best of the Best!
IS IT WORKING?
Your feedback is necessary to assure successful implementation. Tell us if it IS or IS NOT working. Your manager, clinical director or physician making executive rounds will gladly communicate your comments back to the team. You can also use the Virtual Suggestion Box under Hot Spots on the Intranet.
FUTURE WORK
Clinical directors will work with nurse managers and staff to create a standardized method for shift change report. As we gather information for this standardization, please be sure to tell us what method works best for you.
Please focus on the National Patient Safety Goals and how you apply them to your everyday work. More education on updates is forthcoming. This is a way of life for nursing across the nation. It has improved patient care across the nation and at UHC.
Thank you for making UHC Patient Safety the Best of the Best!
- Jean Smith, RN, MBA, FACHE
Chief Nursing Officer
Adult Services
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