Understanding and Improving Communication for Patient Safety

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Chapter 3 focuses on using structured communication as a key approach to enhancing patient safety by improving communication. It discusses effective communication, tools like SBAR and CUSS, and reasons for breakdowns in communication. The chapter emphasizes improving the message and mechanisms of communication to ensure all stakeholders leave with the same understanding.


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  1. Chapter 3 Using Structure Communication @SAFE_QI

  2. Chapter 3: Using Structured Communication A key approach to improving patient safety is improving communication. This Chapter will focus on understanding where communication can break down and the tools that can be used to establish effective communication. @SAFE_QI

  3. Resources Situation Background Assessment Recommendation (SBAR) Concern, Uncomfortable, unSafe, Stop (CUSS) @SAFE_QI

  4. What is effective communication? Effective communication is an open dialogue, in which everyone leaves with a shared mental model @SAFE_QI

  5. Is this effective communication? @SAFE_QI

  6. Was the message structured in an easy to follow format? ? @SAFE_QI

  7. Is this effective communication? @SAFE_QI

  8. Understanding why breakdown in communication occurs Not including all stakeholders in the conversation Individuals are afraid of speaking up for fear of blame or having an opinion being dismissed Nurses, doctors and other clinicians have all been taught to communicate in different ways @SAFE_QI

  9. Improving communication takes two forms Improving the message being communicated Improving the mechanisms for communicating @SAFE_QI

  10. How do we get everyone to leave with the same message? Identify all of your stakeholders The Undertake a stakeholder analysis Role play and train Message All want to impeove @SAFE_QI

  11. I S B A @SAFE_QI R The I-SBAR team

  12. Key driver Communication remains the foundation of patient safety. Numerous reviews of SI indicated poor levels of communication in the handover of patient details contributed to the incident Improved communication = improved care @SAFE_QI

  13. Aims Patients, and families are safe in the hospital Patients have timely and equitable access to services Improve the cost and efficiency of care delivery @SAFE_QI

  14. What is I-SBAR? Communication framework- avoid failures in communication Originating from the nuclear submarine service Used extensively in medicine Safety focused Sets expectations Teamwork Acute clinical situations @SAFE_QI

  15. I S B A R Identify yourself and the patient Situation what is the problem Background information to contextualise the problem Assessment your clinical assessment and prediction Recommendation what you think should happen @SAFE_QI

  16. Key tasks Adapt the SBAR tool for your environment Test the tool in the ward environment @SAFE_QI

  17. I S B A R D Identify Situation Background Assessment Recommendation Decision @SAFE_QI

  18. Communicating with who? Nurses Doctors Admin Porter Patient Consultant @SAFE_QI

  19. Key tasks Develop an education package to train staff in the use of I-SBAR Test the education package Implement I-SBAR for nurses and doctors @SAFE_QI

  20. Objectives Implement I-SBAR Spread I-SBAR across the team Spread I-SBAR across the organisation Refine I-SBAR training Establish I-SBAR as the tool of communication @SAFE_QI

  21. Process measures % of staff trained in I-SBAR % always using I-SBAR for critical communication % always including all essential elements in their report % where physician always agrees with recommendation @SAFE_QI

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