- 1. A Strategy for Patient Safety in HealthcareDr. Taher Y.
Kagalwala, M. D.(Paediatrics), IndiaSpecialist Paediatrician, Head
of the Department of Paediatricsand Director, Patient Safety,Al
Muwayh General Hospital, Al Muwayh, Taif, Makkah Region, K.
S.A.
2. Communication is the response you get when yousend a message,
regardless of YOUR intent.Dr. Taher Y. K. ps/eff comm 15-10-2014 2
3. Dr. Taher Y. K. ps/eff comm 15-10-2014 3 4. Communication is an
interaction between two individuals in thetransfer of information.
It is important because it is the front-line safety net at the
front-lineof patient care in critical and urgent situations. It is
also important because effective communication, or the lack ofit,
has been strongly linked to adverse events and medical errors.Dr.
Taher Y. K. ps/eff comm 15-10-2014 4 5. THIS1. Identify challenges
to effective communication in health-caresettings2. Discuss the
characteristics of assertive communication3. Describe three
effective communication strategies theSBARQ, CUS and the
Two-challenge RuleDr. Taher Y. K. ps/eff comm 15-10-2014 5 6.
Affects the entire teams functioningNumerous endorsements
(hand-overs) level of care, 24/7environments, shiftsShared
Responsibilities M.D.s, R.N.s, Therapies,Consults, Ancillary
services, etc.Establish diagnosis and plan procedures and therapy
Patient outcomes depend on accurate transfer ofinformation from one
care-provider to another in the rightmanner and at the right time
in the right context.Dr. Taher Y. K. ps/eff comm 15-10-2014 6 7.
Effective communication ischallenged by the co-existenceof
intra-personal, inter-personaland organisationaldynamics.Dr. Taher
Y. K. ps/eff comm 15-10-2014 7 8. Disposition positive, negative
Cognitive load too much to think aboutCompetence Are you
knowledgeable and are you able toapply that knowledge?Confidence
Your level of confidence can either beinspiring to others or dampen
their enthusiasm Stress Can be internal, or due to external
factors(financial, matrimonial, familial, etc.)Dr. Taher Y. K.
ps/eff comm 15-10-2014 8 9. Dr. Taher Y. K. ps/eff comm 15-10-2014
9 10. Past experience with the sender of the messageConflict
between the two sender and recipientLanguage and cultural
differences between twohealth providers or between the provider and
thepatientGender issuesHierarchy issuesMisinterpreting non-verbal
communicationDr. Taher Y. K. ps/eff comm 15-10-2014 10 11. Dr.
Taher Y. K. ps/eff comm 15-10-2014 11 12. Production pressures
Resources to do your work effectively human resources,
supplies,equipment, etc. Diffusion of responsibility too many of us
are responsible for health-careand this can create problems in the
flow of work if clear guidanceis not available Authority gradient
can either be a boon or a bane, depending onwhere you are in
relation to the hierarchy Interruptions, distractions, etc. can
hamper effective communicationand even prevent smooth transfer of
information, putting the safety ofthe patient and/or provider at
risk.Dr. Taher Y. K. ps/eff comm 15-10-2014 12 13. 1.ADVOCATE for
the patient or the health colleague2.ASSERT for your point of
view3.RESPECTFULLY CHALLENGE4.RESOLVE CONFLICT within theframework
of the guidance provided by the hospitalDr. Taher Y. K. ps/eff comm
15-10-2014 13 14. StructuredCommunicationStrategiesDr. Taher Y. K.
ps/eff comm 15-10-2014 14 15. Dr. Taher Y. K. ps/eff comm
15-10-2014 15 16. Dr. Taher Y. K. ps/eff comm 15-10-2014 16 17. S:
RN identifies self, patient and states purpose of the call
andinforms the physician of the deterioration of the patient B: RN
gives the background of the patient A: RN describes the change in
the patients assessment R: RN recommends what he/she thinks should
be done Q: She listens to the physician and then asks question on
any doubtsthat he/she may have Note: Repeating the instructions of
the physician BACK isextremely important in ensuring that the
communication was error-freeand effectiveDr. Taher Y. K. ps/eff
comm 15-10-2014 17 18. Dr. Taher Y. K. ps/eff comm 15-10-2014 18
19. Dr. Taher Y. K. ps/eff comm 15-10-2014 19 20. C: I am CONCERNED
U: I am UNCOMFORTABLE S: I do not think the current situation is
SAFEThe CUS is a SIGNAL PHRASE. It is like a red light that asks
the person oppositeto stop and listen, and act accordinglyIf the
recipient of the CUS signal IGNORES or DISREGARDS the signal, it
isDISRUPTIVE BEHAVIOUR or IRRESPONSIBLE BEHAVIOUR and then you
needto evoke the next technique of conflict resolution.Let us
listen to an audio for demonstration purposes.Dr. Taher Y. K.
ps/eff comm 15-10-2014 20 21. Dr. Taher Y. K. ps/eff comm
15-10-2014 21 22. If you believe that the patients health is being
compromisedand You have been assertive in your communicationand You
have failed to get the providers attention or he is acted in
adisruptive manner,Then Let the provider know you are going up the
CHAIN OF COMMAND And will STOP ONLY WHEN YOUR CONCERN IS
RESOLVED.Dr. Taher Y. K. ps/eff comm 15-10-2014 22 23. Dr. Taher Y.
K. ps/eff comm 15-10-2014 23 24. NORMALThe provider must listen
attentively to the CUSHe/she must acknowledge the concerns mounted
by thecommunicator Both the parties should maintain a mutually
respectfuldemeanour If there is disagreement, the provider must
provide a clearexplanation or rationale for disregarding the
otherpersons concern or for not changing the line of thinking
ortreatmentDr. Taher Y. K. ps/eff comm 15-10-2014 24 25. We have
discussed what communication means What are the challenges to
effective communication What are the ways to communicate
effectively Assertive communication and theSBARQ What are the
methods to resolve conflict the CUS and the Two challenge
RuleRemember: Effective Communication is the Human Connection; it
isthe KEY to your personal and career success. In the field
ofHealthcare, which is a very complex system, it can
preventdisruptions, medical errors and even save lives.Dr. Taher Y.
K. ps/eff comm 15-10-2014 25 26. Dr. Taher Y. K. ps/eff comm
15-10-2014 26