1. A Strategy for Patient Safety in HealthcareDr. Taher Y. Kagalwala, M. D.(Paediatrics), IndiaSpecialist Paediatrician, Head of the Department of Paediatricsand Director, Patient Safety,Al Muwayh General Hospital, Al Muwayh, Taif, Makkah Region, K. S.A.

2. Communication is the response you get when yousend a message, regardless of YOUR intent.Dr. Taher Y. K. ps/eff comm 15-10-2014 2 3. Dr. Taher Y. K. ps/eff comm 15-10-2014 3 4. Communication is an interaction between two individuals in thetransfer of information. It is important because it is the front-line safety net at the front-lineof patient care in critical and urgent situations. It is also important because effective communication, or the lack ofit, has been strongly linked to adverse events and medical errors.Dr. Taher Y. K. ps/eff comm 15-10-2014 4 5. THIS1. Identify challenges to effective communication in health-caresettings2. Discuss the characteristics of assertive communication3. Describe three effective communication strategies theSBARQ, CUS and the Two-challenge RuleDr. Taher Y. K. ps/eff comm 15-10-2014 5 6. Affects the entire teams functioningNumerous endorsements (hand-overs) level of care, 24/7environments, shiftsShared Responsibilities M.D.s, R.N.s, Therapies,Consults, Ancillary services, etc.Establish diagnosis and plan procedures and therapy Patient outcomes depend on accurate transfer ofinformation from one care-provider to another in the rightmanner and at the right time in the right context.Dr. Taher Y. K. ps/eff comm 15-10-2014 6 7. Effective communication ischallenged by the co-existenceof intra-personal, inter-personaland organisationaldynamics.Dr. Taher Y. K. ps/eff comm 15-10-2014 7 8. Disposition positive, negative Cognitive load too much to think aboutCompetence Are you knowledgeable and are you able toapply that knowledge?Confidence Your level of confidence can either beinspiring to others or dampen their enthusiasm Stress Can be internal, or due to external factors(financial, matrimonial, familial, etc.)Dr. Taher Y. K. ps/eff comm 15-10-2014 8 9. Dr. Taher Y. K. ps/eff comm 15-10-2014 9 10. Past experience with the sender of the messageConflict between the two sender and recipientLanguage and cultural differences between twohealth providers or between the provider and thepatientGender issuesHierarchy issuesMisinterpreting non-verbal communicationDr. Taher Y. K. ps/eff comm 15-10-2014 10 11. Dr. Taher Y. K. ps/eff comm 15-10-2014 11 12. Production pressures Resources to do your work effectively human resources, supplies,equipment, etc. Diffusion of responsibility too many of us are responsible for health-careand this can create problems in the flow of work if clear guidanceis not available Authority gradient can either be a boon or a bane, depending onwhere you are in relation to the hierarchy Interruptions, distractions, etc. can hamper effective communicationand even prevent smooth transfer of information, putting the safety ofthe patient and/or provider at risk.Dr. Taher Y. K. ps/eff comm 15-10-2014 12 13. 1.ADVOCATE for the patient or the health colleague2.ASSERT for your point of view3.RESPECTFULLY CHALLENGE4.RESOLVE CONFLICT within theframework of the guidance provided by the hospitalDr. Taher Y. K. ps/eff comm 15-10-2014 13 14. StructuredCommunicationStrategiesDr. Taher Y. K. ps/eff comm 15-10-2014 14 15. Dr. Taher Y. K. ps/eff comm 15-10-2014 15 16. Dr. Taher Y. K. ps/eff comm 15-10-2014 16 17. S: RN identifies self, patient and states purpose of the call andinforms the physician of the deterioration of the patient B: RN gives the background of the patient A: RN describes the change in the patients assessment R: RN recommends what he/she thinks should be done Q: She listens to the physician and then asks question on any doubtsthat he/she may have Note: Repeating the instructions of the physician BACK isextremely important in ensuring that the communication was error-freeand effectiveDr. Taher Y. K. ps/eff comm 15-10-2014 17 18. Dr. Taher Y. K. ps/eff comm 15-10-2014 18 19. Dr. Taher Y. K. ps/eff comm 15-10-2014 19 20. C: I am CONCERNED U: I am UNCOMFORTABLE S: I do not think the current situation is SAFEThe CUS is a SIGNAL PHRASE. It is like a red light that asks the person oppositeto stop and listen, and act accordinglyIf the recipient of the CUS signal IGNORES or DISREGARDS the signal, it isDISRUPTIVE BEHAVIOUR or IRRESPONSIBLE BEHAVIOUR and then you needto evoke the next technique of conflict resolution.Let us listen to an audio for demonstration purposes.Dr. Taher Y. K. ps/eff comm 15-10-2014 20 21. Dr. Taher Y. K. ps/eff comm 15-10-2014 21 22. If you believe that the patients health is being compromisedand You have been assertive in your communicationand You have failed to get the providers attention or he is acted in adisruptive manner,Then Let the provider know you are going up the CHAIN OF COMMAND And will STOP ONLY WHEN YOUR CONCERN IS RESOLVED.Dr. Taher Y. K. ps/eff comm 15-10-2014 22 23. Dr. Taher Y. K. ps/eff comm 15-10-2014 23 24. NORMALThe provider must listen attentively to the CUSHe/she must acknowledge the concerns mounted by thecommunicator Both the parties should maintain a mutually respectfuldemeanour If there is disagreement, the provider must provide a clearexplanation or rationale for disregarding the otherpersons concern or for not changing the line of thinking ortreatmentDr. Taher Y. K. ps/eff comm 15-10-2014 24 25. We have discussed what communication means What are the challenges to effective communication What are the ways to communicate effectively Assertive communication and theSBARQ What are the methods to resolve conflict the CUS and the Two challenge RuleRemember: Effective Communication is the Human Connection; it isthe KEY to your personal and career success. In the field ofHealthcare, which is a very complex system, it can preventdisruptions, medical errors and even save lives.Dr. Taher Y. K. ps/eff comm 15-10-2014 25 26. Dr. Taher Y. K. ps/eff comm 15-10-2014 26