1. @SAFE_QI Chapter 3 Using Structure Communication

2. @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.

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

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

5. @SAFE_QI Is this effective communication?

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

7. @SAFE_QI Is this effective communication?

8. @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

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

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

11. @SAFE_QI ISBARISBAR The I-SBAR team

12. @SAFE_QI 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

13. @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

14. @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

15. @SAFE_QI I – S – B – A – R I dentify – yourself and the patient S ituation – what is the problem B ackground –information to contextualise the problem A ssessment – your clinical assessment and prediction R ecommendation – what you think should happen

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

17. @SAFE_QI I – S – B – A – R – D I dentify S ituation B ackground A ssessment R ecommendation D ecision

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

19. @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

20. @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

21. @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