Improving Patient Safety Through Communication · Learning Activity 5. 5. Introduced SBAR Tool and...
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Improving Patient Safety Through Improving Patient Safety Through Communication: Communication: An Interprofessional Education An Interprofessional Education Learning Session with Learning Session with Radiologic Radiologic Science and Physical Therapy Students Science and Physical Therapy Students Leigh Ann Hewston, PT, Leigh Ann Hewston, PT, MEd MEd Frances Gilman, MS, RT, CT, MR Frances Gilman, MS, RT, CT, MR
Transcript of Improving Patient Safety Through Communication · Learning Activity 5. 5. Introduced SBAR Tool and...
Improving Patient Safety Through Improving Patient Safety Through Communication: Communication:
An Interprofessional Education An Interprofessional Education Learning Session with Learning Session with RadiologicRadiologic
Science and Physical Therapy StudentsScience and Physical Therapy Students
Leigh Ann Hewston, PT, Leigh Ann Hewston, PT, MEdMEdFrances Gilman, MS, RT, CT, MRFrances Gilman, MS, RT, CT, MR
ObjectivesObjectives
Overall Goal of the Presentation Overall Goal of the Presentation
To present the design, To present the design, implementation and evaluation implementation and evaluation of a learning module on patient of a learning module on patient
safety and communication.safety and communication.
ObjectivesObjectivesThe learner will be able to develop an interprofessional The learner will be able to develop an interprofessional
learning module that will use video, role playing, learning module that will use video, role playing, personal stories and discussion to:personal stories and discussion to:
1. discuss the benefits of interprofessional 1. discuss the benefits of interprofessional communication and collaboration in enhancing communication and collaboration in enhancing patient care safety and outcomes.patient care safety and outcomes.
2. identify verbal and non2. identify verbal and non--verbal behaviors and verbal behaviors and discuss how these support or hinder discuss how these support or hinder interprofessional educationinterprofessional education
3. apply the use of a communication tool using a 3. apply the use of a communication tool using a case scenario.case scenario.
BackgroundBackground
Involve Involve RadiologicRadiologic Students in an Students in an Interprofessional Learning Activity Interprofessional Learning Activity
Partnered with Physical TherapyPartnered with Physical Therapy
Chose a topic that would include essential Chose a topic that would include essential skills for both groups of studentsskills for both groups of students——safety safety and communicationand communication
Background Background 1,21,2
Poor Communication among health Poor Communication among health professionals is often the root cause of professionals is often the root cause of medical errors. medical errors.
Joint CommissionJoint Commission’’s Hospital National Patient s Hospital National Patient Goal #2 Goal #2
““Improve the effectiveness of Improve the effectiveness of communication among caregiverscommunication among caregivers””““ Implement a standardized approach to Implement a standardized approach to
handoff communicationshandoff communications, including an , including an opportunity to ask and respond to questionsopportunity to ask and respond to questions””
Background Background 33
Handoff Procedure is applicable to PT and Handoff Procedure is applicable to PT and RadiologicRadiologic SciencesSciences
SBAR is one of the standardized SBAR is one of the standardized tools/techniques that structures the tools/techniques that structures the communication communication
BackgroundBackground--SBAR SBAR 11
S = S = SituationSituationDescribe the Situation Describe the Situation
B = B = BackgroundBackgroundProvide Background InformationProvide Background Information
A = A = AssessmentAssessmentProvide the Assessment Provide the Assessment
R = R = Recommendation Recommendation Make a RecommendationMake a Recommendation
Learning ModuleLearning Module17 17 RadiologicRadiologic StudentsStudents
End of 1End of 1stst Year of Radiography ProgramYear of Radiography Program
40 PT Students40 PT Students——Start of 2Start of 2ndnd Year of DPT ProgramYear of DPT Program
2 Faculty Facilitators2 Faculty Facilitators——RadRad SciSci and PT and PT
1 hour session1 hour session
Integrated into two classesIntegrated into two classesRadiographic Procedures Class Radiographic Procedures Class Cardiopulmonary Physical TherapyCardiopulmonary Physical Therapy
Learning ActivitiesLearning Activities1.1. PrePre--Test : 5 questions on a 5 point scale (5 Test : 5 questions on a 5 point scale (5
minutes)minutes)
2.2. Objectives of the Class (5 minutes)Objectives of the Class (5 minutes)
3.3. Showed short scenes from a previously Showed short scenes from a previously developed video (3 min) with focus on developed video (3 min) with focus on interactions between health care interactions between health care professionalsprofessionalshttp://http://jeffline.jefferson.edu/jcipe/projectsjeffline.jefferson.edu/jcipe/projects//
Leaning ActivitiesLeaning Activities
4.4. Discussion of Video with Guided Discussion of Video with Guided QuestionsQuestions (10 minutes)(10 minutes)
Examples:Examples:What interactions did you observe between the What interactions did you observe between the health professionals in the video?health professionals in the video?
What are some negative outcomes that could What are some negative outcomes that could occur?occur?
What could have been done better and What could have been done better and recommendations for improvement?recommendations for improvement?
Learning ActivityLearning Activity5.5. Introduced SBAR Tool and give exampleIntroduced SBAR Tool and give example
(10 min(10 min))
SSituation ituation –– BBackground ackground –– AAssessment ssessment ––RRecommendationecommendationStructured communication tool that helps set up Structured communication tool that helps set up expectations for what is communicated and how expectations for what is communicated and how communication is handled by team memberscommunication is handled by team membersPromising results shown in highPromising results shown in high--risk health care risk health care settingssettingsMay seem elementary at first but if it becomes a habit, May seem elementary at first but if it becomes a habit, patient outcomes are enhanced significantly patient outcomes are enhanced significantly
Learning ActivityLearning Activity
6.6. Role Play with SBAR using Case Role Play with SBAR using Case ScenarioScenario (10 min)(10 min)
RadRad SciSci Student and PT studentStudent and PT student
Learning ActivityLearning Activity7. Large Group Discussion (57. Large Group Discussion (5--10 minutes)10 minutes)
Example Questions:Example Questions:
What was the process using the SBAR like?What was the process using the SBAR like?
LetLet’’s go back to one of the negative s go back to one of the negative interactions that you mentioned and think interactions that you mentioned and think about how it could have been improved with about how it could have been improved with the SBARthe SBAR
Learning ActivityLearning Activity
8. Faculty Shared Personal Stories of Poor 8. Faculty Shared Personal Stories of Poor Communication between two health Communication between two health professionals (10 minutes)professionals (10 minutes)
How SBAR could have helped the situationHow SBAR could have helped the situation
Learning ActivityLearning Activity9. Post Test ( 39. Post Test ( 3--5 minutes)5 minutes)
Repeated Post Test with additional questions:Repeated Post Test with additional questions:
•• What did you like best about this class?What did you like best about this class?
•• List two things you learned in this List two things you learned in this session today.session today.
•• Give specific examples of what could be Give specific examples of what could be included next yearincluded next year
Pre test Post test ResultsPre test Post test Results
1= strongly agree; 3 = neutral; 5 = strongly disagree1= strongly agree; 3 = neutral; 5 = strongly disagree
Item PretestM (sd)
Post testM(sd)
Pre testM (sd)
Post testM (sd)
Rad Sci Rad Sci PT PT
N=15 N=11 N=45 N=38
Quality of team interaction NOT shown to affect outcomes of pt. care, safety
(higher more positive)
4.00(1.34) 4.11(0.98) 4.13(1.16) 4.03(1.52)
Verbal communication more important that non verbal
(lower more positive)
3.55(1.13) 2.72(1.75) 3.2(0.84) 3.39(1.1)
Structured communication methods improve IP communication
(lower more positive)
1.45(0.52) 1.18(0.40)p=.03
2.16(0.67) 1.74(0.55)p=.001
IPE classes are waste of time(higher more positive)
4.09(0.54) 3.91(1.3) 3.6(0.78) 3.39(1.08)
Evaluation of Learning ModuleEvaluation of Learning Module--ResultsResults
•• Both groups of students were Both groups of students were more positive about the statement more positive about the statement ““structured communication structured communication methods improve methods improve interprofessional communicationinterprofessional communication””. .
Emerging Themes Emerging Themes of the Open Ended Questionsof the Open Ended Questions
What did you like most?What did you like most?Personal StoriesPersonal StoriesPT Students learned about PT Students learned about RadiologicRadiologicStudentsStudentsSBAR and importance of SBAR and importance of communicationcommunication
““I liked the personal stories because they put I liked the personal stories because they put everything in perspectiveeverything in perspective”” PT StudentPT Student
Representative QuotesRepresentative Quotes
What did you like most?What did you like most?
““ I like that another discipline was actually I like that another discipline was actually with us during the session. It helped to with us during the session. It helped to give their point of view on the situation as give their point of view on the situation as wellwell””
PT StudentPT Student
Open Ended QuestionsOpen Ended QuestionsWhat did you like most? All quotes from What did you like most? All quotes from RadiologicRadiologic StudentsStudents…………..
““Learning how to communicate with out Learning how to communicate with out pointing the finger at someonepointing the finger at someone’’s wrong doings wrong doing””
““Communication awarenessCommunication awareness””
““The intercommunication between two The intercommunication between two different professionsdifferent professions””
Results of Open Ended Results of Open Ended QuestionsQuestions
List two things you learnedList two things you learned…….. All quotes .. All quotes from PT Students:from PT Students:““RadRad techs interpret the physiciantechs interpret the physician’’s orders and s orders and may need to have orders modifiedmay need to have orders modified””
““ RadRad SciSci and PT both have to keep in check and PT both have to keep in check PCP when errors may happenPCP when errors may happen””
““RadRad techs need to also know techs need to also know contraindicationscontraindications””
Summary of ResultsSummary of Results
Both groups of students saw Both groups of students saw significance of the use of the SBAR significance of the use of the SBAR and communication and/or handoffs and communication and/or handoffs but PT students learned more about but PT students learned more about educational background of educational background of RadiologicRadiologicStudentsStudents
SummarySummary
This Learning Module is easily adapted to This Learning Module is easily adapted to any groups of health care students.any groups of health care students.
Added benefit of having students from Added benefit of having students from different professions interact so they can different professions interact so they can learn about each other. learn about each other.
DonDon’’t underestimate the power of personal t underestimate the power of personal stories from your own clinical experiences.stories from your own clinical experiences.
AcknowledgmentsAcknowledgments
Our deepest thanks to Molly Rose, RN, PhD Our deepest thanks to Molly Rose, RN, PhD for spearheading IPE on our campus and for spearheading IPE on our campus and assisting us with this learning module.assisting us with this learning module.
ReferencesReferences1.1. On Demand: Effective Teamwork as a Care StrategyOn Demand: Effective Teamwork as a Care Strategy--SBAR and Other Tools for Improving SBAR and Other Tools for Improving
Communication Between Caregivers, Michael Leonard, MD. AvailableCommunication Between Caregivers, Michael Leonard, MD. Available at: at:
http://http://www.ihi.org/IHI/Programs/AudioAndWebProgramswww.ihi.org/IHI/Programs/AudioAndWebPrograms. Last Accessed Feb 28, 2010. Last Accessed Feb 28, 2010 ..2.2. The Joint Commission. National Patient Safety Goals. January 200The Joint Commission. National Patient Safety Goals. January 2006. Available at: 6. Available at:
http://www.jointcommission.org/PatientSafety/NationalPatientSafehttp://www.jointcommission.org/PatientSafety/NationalPatientSafetyGoals/06_npsg_cah.httyGoals/06_npsg_cah.ht mmLast Accessed Feb 28, 2010. Last Accessed Feb 28, 2010.
3. The Joint Commission. National Patient Safety Goal (NPSG.3. The Joint Commission. National Patient Safety Goal (NPSG.02.05.01). Hand02.05.01). Hand--off off communication. Dec 9, 2008. Available at: communication. Dec 9, 2008. Available at: http://www.jointcommission.org/AccreditationPrograms/HomeCare/Sthttp://www.jointcommission.org/AccreditationPrograms/HomeCare/Standards/09_FAQs/andards/09_FAQs/
PSG/Communication/NPSG.02.05.01/hand_off_communications.htmPSG/Communication/NPSG.02.05.01/hand_off_communications.htmLast accessed Feb28, 2010Last accessed Feb28, 2010. .
4. Jefferson Center for Interprofessional Education. Projects. 4. Jefferson Center for Interprofessional Education. Projects. Available at: Available at: http://http://jeffline.jefferson.edu/jcipe/projectsjeffline.jefferson.edu/jcipe/projects// Last accessed Feb 28, 2010. Last accessed Feb 28, 2010.
