Chapter 3 Using Structure Communication SAFEQI Chapter 3

Chapter 3 Using Structure Communication @SAFE_QI

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

Resources • Situation Background Assessment Recommendation (SBAR) • Concern, Uncomfortable, un. Safe, Stop (CUSS) @SAFE_QI

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

Is this effective communication? @SAFE_QI

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

Is this effective communication? @SAFE_QI

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

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

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

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

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

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

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

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

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

I–S–B–A–R–D • Identify • Situation • Background • Assessment • Recommendation • Decision @SAFE_QI

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

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

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

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