Improving Communications in Obstetrics Taking SBAR R To A

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Labor and Delivery,Communication,How Would You Score. Common EFM language,Do you use a structured communication tool. Effective sign outs between all caregivers,Absent disruptive or intimidating behavior. The physician CNM always comes when asked,JCAHO Sentinel Event Alert. 47 Cases Perinatal Death or,Permanent Disability,July 21 2004.
Root causes,Communication issues 72,Organizational culture is a barrier to effective. communications and teamwork 55,Hierarchy and intimidation. Failure to function as a team,Failure to follow the chain of command. Structured Communication,z A preset organized way to present information. between individuals or groups of individuals that is. part of the culture of the entire organization,z Other high consequence industries have long.
recognized the need for structured communication,critical language and repeat backs. z Aviation,z Military,Structure Works,z Michael Leonard physician leader for patient. Safety at Kaiser s Colorado division, In almost all serious avoidable episodes of patient harm. communication failures play a central role By teaching. care givers new models of structured communication we. can make sure that we are all in the same movie,z OSF St Joseph Medical center in Bloomington. Cases of harm fell by more than half in the year after the. SBAR program was implemented in October 2004,Structured Communication.
z How do we organize and relay information,z Is it consistent. z Does it place the problem first,z Are all the relevant data elements included. z Did you both all agree on the course of,action Are you on the same page. z Did you confirm Close the loop,z Is this done in real time. Structured Communication,z Situation,z Background,z Assessment.
z Recommendation,z Response with repeat back,Why Isn t It Better. z The lines are drawn between us and them,z It s not my job. z They get paid the big bucks to make the decisions. z An emergency to one provider is routine to another how are. we supposed to know which it is today,z I am not going to say anything. z We don t ever get the information we need, z It all depends on who you are working with if it is going to be. a good team or not, z We are afraid to make a recommendation to some providers.
if we re wrong we ll pay for it,Taking SBAR R To A Higher. z It is not just enough to say I have an SBAR R,z Necessary to consider the context and. relationships in every SBAR R conversation,z Examine and perfect the mental processes and. conditions that are required for conversations,that allow for the right exchange of information. to get the job done safely,P U R E Conversations,z P Purposeful Prepared.
z What is the purpose of the conversation, z What do you want the product of the conversation to be. z Are you prepared, z Do you have all the information you need to achieve your action. z U Unambiguous,z Do you have the data,z Are you using facts. z Are you using NICHD nomenclature,z Did you choose terminology to avoid confusion. z How is the message delivered,P U R E Conversations.
z R Respectful,z What tone of voice are you using, z Is there respect for the others time with adequate preparation. z What response are you giving,z What words have you chosen to use. z Does your behavior verbal and non verbal send a negative message. z E Efficient,z What was the outcome of the conversation. z Are you still on the same page,z Do both of you have the same expectations. z Do both of you have the same time frame,z Do you feel positive after the conversation.
z What if it doesn t work,Why P U R E,P U R E is about. z A consistent mental process, z Mental preparation planning prior to a conversation. z Mutual respect for each others needs,z Reaching an agreed upon plan. z Eliminating any confusion or misinterpretation about. z Real time monitoring of progress and effectiveness. of the conversation,Why P U R E,z Requires a change in human behavior. z Must haves for success,z Team training for Nurses MDs CNMs together.
z Tools P U R E SBAR R communication,templates in EMR hardwire the process. z Practice mental process of conversation,Purposeful Prepared. Productive,Great minds have purposes others have,Washington Irving. P Productive Purposeful,Begin with a mental process that. occurs before any conversation,z Identify a purpose.
z What needs to be done,z Why am I calling,z Prepare based on the purpose. z Proceed with the conversation using the,necessary data and the interpersonal skills. that will fulfill the purpose,z Insure the purpose is fulfilled. Improving Communications in Obstetrics Taking SBAR R To A Higher Level Larry Veltman MD Kristine Larison RNC BSN MBA August 20 2007 Labor and Delivery Communication How Would You Score Common EFM language Do you use a structured communication tool Effective sign outs between all caregivers Absent disruptive or intimidating behavior The physician CNM always comes when asked JCAHO

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