TeamSTEPPS 2.0 | Communication
Communication
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Communication
Assumptions Fatigue Distractions HIPAA
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Objectives Describe how communication affects team
processes and outcomes
Define effective communication
Identify communication challenges
Identify TeamSTEPPS tools and strategies that can improve a team’s communication
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Communication Effective
communication skills are vital for patient safety
Enables team members to effectively relay information
The mode by which most TeamSTEPPS strategies and tools are executed
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Importance of Communication
Joint Commission data continues to demonstrate the importance of communication in patient safety
1995 - 2005: Ineffective communicationidentified as root cause for nearly 66 percent of all reported sentinel events*
2010 - 2013: Ineffective communication among top 3 root causes of sentinel events reported**
* (JC Root Causes and Percentages for Sentinel Events (All Categories) January 1995−December 2005)
** (JC Sentinel Event Data (Root Causes by Event Type) 2004-2012)
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The process by which information is exchanged between individuals, departments, or organizations
The lifeline of the Core Team
Effective when itpermeates every aspect of an organization
Communication is…
Assumptions Fatigue Distractions HIPAA
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Standards of Effective Communication
Complete
Communicate all relevant information
Clear
Convey information that is plainly understood
Brief
Communicate the information in a concise manner
Timely
Offer and request information in an appropriate timeframe Verify authenticity Validate or acknowledge information
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Brief Clear
Timely
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Communication Challenges Language barrier Distractions Physical proximity Personalities Workload Varying communication styles Conflict Lack of information verification Shift change
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Information Exchange Strategies
Situation – Background – Assessment –Recommendation (SBAR)
Call-Out
Check-Back
Handoffs
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SBAR Provides…
A framework for team members to effectively communicate information to one another
Communicate the following information:
Situation―What is going on with the patient?
Background―What is the clinical background or context?
Assessment―What do I think the problem is?
Recommendation―What would I recommend?
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SBAR example:
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SBAR Video
http://www.ahrq.gov/teamstepps/instructor/videos/ts_SBAR_NurseToPhysician/SBAR_NurseToPhysician-400-300.html
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SBAR Exercise
Create an SBAR example based on your role.
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Call-Out is…
A strategy used to communicate important or critical information
It informs all team members simultaneously during emergency situations
It helps team members anticipate next steps
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Call-Out example:
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Check-Back is…
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Check-Back example:
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Handoff is… The transfer of information during transitions in care
across the continuum
Includes an opportunity to ask questions, clarify, and confirm
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Handoff Consists of…
Transfer of responsibility and accountability Clarity of information Verbal communication of information Acknowledgment by receiver Opportunity to review
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“I PASS THE BATON”Introduction: Introduce yourself and your role/job (include patient)
Patient: Identifiers, age, sex, location
Assessment: Present chief complaint, vital signs, symptoms, and diagnosis
Situation: Current status/circumstances, including code status, level of uncertainty, recent changes, and response to treatment
Safety: Critical lab values/reports, socioeconomic factors, allergies, and alerts (falls, isolation, etc.)
THE
Background: Comorbidities, previous episodes, current medications, and family history
Actions: What actions were taken or are required? Provide brief rationale
Timing: Level of urgency and explicit timing and prioritization of actions
Ownership: Who is responsible (nurse/doctor/team)? Include patient/family responsibilities
Next: What will happen next? Anticipated changes? What is the plan? Are there contingency plans?
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I PASS the BATON example
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Other Example Handoff Tools
ANTICipate Administrative Data; New clinical information; Tasks
to be performed; Illness severity; Contingency plans for changes
I PASS Illness severity; Patient Summary; Action list for the
new team; Situation awareness and contingency plans; Synthesis and “read back” of the information
SHARQ Situation; History; Assessment;
Recommendations/Result; Questions
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Tools & Strategies Summary
TOOLS and STRATEGIES
Communication
• SBAR
• Call-Out
• Check-Back
• Handoff
OUTCOMES
Shared Mental Model
Adaptability
Team Orientation
Mutual Trust
Team Performance
Patient Safety!!
BARRIERS
Inconsistency in Team Membership
Lack of Time Lack of Information Sharing Hierarchy Defensiveness Conventional Thinking Complacency Varying Communication Styles Conflict Lack of Coordination and
Followup with Coworkers Distractions Fatigue Workload Misinterpretation of Cues Lack of Role Clarity
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Applying TeamSTEPPS Exercise
1. Is your teamwork issue related to communication?
2. If yes, what is the communication issue?
3. Which TeamSTEPPS tools and/or strategies might you consider implementing to address the issue?