Discussion Topic-Ch 6,7

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Communicating With Others and Working With the Interprofessional Team

Chapter 6

Communication

Giving information is only a small part of communication.
Occurs on several levels
Involves different factors
Requires active listening skills

Factors Affecting Communication

Emotional state of individuals
Outside distractions
Cultural background
Superficial listening
Individual attitudes regarding the content of the communication

Assertiveness in Communication

Allows people to stand up for themselves
Respects the rights of others
Clearly states an individual’s position
Uses “I” statements
Assumes a greater importance in the interprofessional environment

Interpersonal Communication

Most daily communication falls into this category.
Interactions that occur on a personal level
Process that gives individuals the opportunity to construct personal knowledge
Used to establish relationships
Differs from general communication

Interpersonal Communication (cont'd)

Occurs on a more intimate level
Systematic process
Individuals hold a specific role within the communication
Dynamic and ongoing process

Transactional Models of Communication

Differ from earlier linear models
Consider all individuals communicators
Allow that communication among and between individuals occurs simultaneously
Acknowledge that “noise” occurs in all interactions
Include the concept of time

Barriers to Communication Among Health-Care Providers and Health-Care Recipients

Challenges

Low health literacy
Cultural diversity
Cultural competence of health-care providers
Lack of interprofessional communication education among providers

Electronic Forms of Communication

Information Systems

Communication through the use of health documents
The Health Information Technology for Economic and Clinical Health (HITECH)
Electronic Medical Records (EMRs)
Electronic Health Records (EHRs)

Advantages of EMR

Track data over time
Identify which patients need preventive screenings or checkups
Monitor patient status
Evaluate and improve overall quality

Advantages of EHR

Documents are shared among varying institutions/individuals
Focus on the total health of a patient
Provide a more inclusive view of a patient’s care over time
Designed to share information with other health-care providers
Assist in maintaining patient confidentiality

E-mail

Used both within and outside of organizations
Same communication principles that apply to traditional letter writing apply to e-mail
Requires good writing skills
Rules in the workplace different from personal e-mail

Text Messaging

Evolved as a quick method of communication
Brief informal method
No “texting rules”
Business consultants predict that this communication method will evolve
Important to follow the same rules that apply to e-mail

Reporting Patient Information

Hand Off Communications

Previously referred to as “change of shift” report in nursing
Move toward an interprofessional team philosophy has changed the way reports are given
Ensures continuity of care from one area to another
Part of the TJC “National Patient Safety Goals”

Communicating With the Health-Care Provider

Communicate changes in patients’ conditions.
Share pertinent information.
Discuss modifications in the treatment plan.
Clarify orders.

Before Calling the Health-Care Provider

Have all the information available.
Be prepared to provide general assessment information.
Pertinent information
Most recent vital signs and trends
Laboratory values
Medications and times the patient received the most recent dose

After Calling the Health-Care
Provider

Document time of the call in the patient record.
If the health-care provider needed to return the call, document the time the call was returned in a health-care provider call log.
Follow the chain of command if a call is not returned within an appropriate amount of time.

ISBARR

Introduction
Situation
Background
Assessment
Recommendation
Read-back

Health-Care Provider Orders

Written
Telephone
Fax
EMR orders

Teams

Purpose

Bring professionals together
Common goal: quality patient care
Collaborative focus

Teamwork

QSEN definition

The ability to “perform effectively within nursing and interprofessional teams, fostering open communication, mutual respect, and shared decision making to achieve quality patient care.”

(http://qsen.org)

Learning to Become a Team Player

Recognize that every member brings value to the team.
Treat each team member with dignity and respect.
Understand the role of each team member.
Support each other in achieving the team’s goals.

Building a Working Team

Identify the team players.
Make sure the team members understand the goals and are committed to achieving the outcomes.
Act as a role model and exhibit expected behaviors.

Interprofessional Collaboration and the Interprofessional Team

Interprofessional Collaboration

“Occurs when multiple health workers from different professional backgrounds work together with patients, families, caregivers, and communities to deliver the highest quality care.”

(WHO, 2010)

Components of Collaboration

Sharing
Partnership
Interdependency
Power

Interprofessional Communication

TJC attributes a high percentage of sentinel events to breakdowns in communication among health-care providers.
Core competency for interprofessional collaborative practice
ISBARR
Team STEPPS

Team STEPPS

Leadership
Situation
Monitoring
Mutual support
Communication

Building an Interprofessional Team

Communicate through conferences.
Focus on the needs of the patients and/or clients.
Each member has roles and functions that contribute to patient care.
Each member contributes and the contributions are valued.
Monitor and/or evaluate effectiveness of team goals.

Methods for the Hand-Off Report

Traditional face-to-face
Audiotape
Computer reporting

Conclusion

Communication skills are needed to deliver safe, quality, and effective patient care.
TJC, IOM, QSEN, and MAGNET promote interprofessional communication.
Use of Team STEPPS and IBARR promote interprofessional team work and communication.