TeamSTEPPS Fundamentals Course: Module 3. Communication

Classroom Slides

TeamSTEPPS is a teamwork system developed jointly by the Department of Defense (DoD) and the Agency for Healthcare Research and Quality (AHRQ) to improve institutional collaboration and communication relating to patient safety.
  Two penguins are trying to communicate across a wall labeled assumptions, fatigue, distractions, and HIPAA. The source penguin is thinking about a message. The receiver penguin is holding a sign with the same message. The source sends a message to the receiver and the receiver sends feedback to the source.

Contents:

Slide 1: Communication
Slide 2: Objectives
Slide 3: Communication
Slide 4: Importance of Communication
Slide 5: Communication is...
Slide 6: Standards of Effective Communication
Slide 7: Brief, Clear, Timely
Slide 8: Communication Challenges
Slide 9: Information Exchange Strategies
Slide 10: SBAR Provides...
Slide 11: SBAR Video
Slide 12: SBAR Exercise
Slide 13: Call-Out is...
Slide 14: Check-Back is...
Slide 15: Handoff is...
Slide 16: Handoff Consists of...
Slide 17: "I PASS the BATON"
Slide 18: Other Example Handoff Tools
Slide 19: Tools & Strategies Summary
Slide 20: Applying TeamSTEPPS Exercise


  Slide 1: Communication

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 Slide 2: Objectives

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  • Describe how communication affects team processes and outcomes.
  • Define effective communication.
  • Identify communication challenges.
  • Identify TeamSTEPPS tools and strategies that can improve a team’s communication.

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  Slide 3: Communication

The TeamSTEPPS Logo. Select [D] Text Description below the image for details.

[D] Select for Text Description

  • Effective communication skills are vital for patient safety. 
  • Enables team members to effectively relay information. 
  • The mode by which most TeamSTEPPS strategies and tools are executed.

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  Slide 4: Importance of Communication

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  • Joint Commission data continues to demonstrate the importance of communication in patient safety: 
    • 1995 - 2005: Ineffective communication identified as root cause for nearly 66 percent of all reported sentinel events.*
    • 2010 - 2013: Ineffective communication among top 3 root causes of sentinel events reported.**

*(JC Root Causes and Percentages for Sentinel Events (All Categories) January 1995−December 2005).
**(JC Sentinel Event Data (Root Causes by Event Type) 2004-2012).

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  Slide 5: Communication Is...

Text Description is below the image. Image: Two penguins are trying to communicate across a wall labeled assumptions, fatigue, distractions, and HIPAA. The source penguin is thinking about a message. The receiver penguin is holding a sign with the same message. The source sends a message to the receiver and the receiver sends feedback to the source.

  • The process by which information is exchanged between individuals, departments, or organizations. 
  • The lifeline of the Core Team.
  • Effective when it permeates every aspect of an organization.

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  Slide 6: Standards of Effective Communication

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  • Complete:
    • Communicate all relevant information.
  • Clear:
    • Convey information that is plainly understood.
  • Brief:
    • Communicate the information in a concise manner.
  • Timely:
    • Offer and request information in an appropriate timeframe.
    • Verify authenticity.
    • Validate or acknowledge information.

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  Slide 7: Brief, Clear, Timely

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Cartoon images illustrate these three points with bad examples:

  • Brief: A sign posted on the ice says: "Notice: Public Water. Our Public Water is Currently CLOSED Because it is not OPEN. The MANAGEMENT." 
  • Clear: A puzzled penguin looks at a signpost with several signs of fish and arrows pointing in all directions. 
  • Timely: Two penguins in the water watch a penguin on land who is putting up a sign stating "DANGER. SEALS in WATER Don't SWIM."

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  Slide 8: Communication Challenges

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  • Language barrier.
  • Distractions.
  • Physical proximity.
  • Personalities.
  • Workload.
  • Varying communication styles.
  • Conflict.
  • Lack of information verification.
  • Shift change.

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  Slide 9: Information Exchange Strategies

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  • Situation—Background— Assessment—Recommendation (SBAR).
  • Call-Out.
  • Check-Back.
  • Handoffs.

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  Slide 10: SBAR Provides...

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A framework for team members to effectively communicate information to one another.

Communicate the following information:

  • Situation—What is going on with the patient?
  • Background—What is the clinical background or context?
  • Assessment—What do I think the problem is?
  • Recommendation—What would I recommend?

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  Slide 11: SBAR Video

Image: Nurse talking on the phone.

Select the link below to access the video.


SBAR (Flash video, 1 min., 35 sec.; 9.8 MB)

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  Slide 12: SBAR Exercise

Text Description is below the image. Image: A penguin riding an exercise bicycle is captioned 'EXERCISE'.

Create an SBAR example based on your role.

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  Slide 13: Call-Out is...

Text Description is below the image. Image: A penguin wearing a scrub top shouting, 'Seal!'

A strategy used to communicate important or critical information.

  • It informs all team members simultaneously during emergency situations.
  • It helps team members anticipate next steps.

Select the link below to access the video.


Call-Out (Flash video, 18 sec.; 2 MB)

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  Slide 14: Check-Back is...

Image: Check-back is a circular process with three parts; Communication goes through Sender initiates message. This leads to Closed, which goes through Receiver accepts message and provides feedback confirmation. This leads to Loop, which goes through Sender verifies message was received. This leads back to Communication, which continues the process.

Select the link below to access the video.


Check-Back (Flash video, 15 sec.; 1.7 MB)

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  Slide 15: Handoff

Text Description is below the image. Image: Two racing penguins passing the baton.

  • The transfer of information during transitions in care across the continuum.
    • Includes an opportunity to ask questions, clarify, and confirm.

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  Slide 16: Handoff Consists of...

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  • Transfer of responsibility and accountability.
  • Clarity of information.
  • Verbal communication of information.
  • Acknowledgment by receiver.
  • Opportunity to review.

Select the link below to access the video.

Handoff (Flash video, 15 sec.; 1.7 MB)

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  Slide 17: "I PASS the BATON"

Text Description is below the image. Image: Close-up of penguins' flippers passing the baton.

Step Description
Introduction: Introduce yourself and your role/job (include patient).
Patient: Identifiers, age, sex, location.
Assessment: Present chief complaint, vital signs, symptoms, and diagnosis.
Situation: Current status/circumstances, including code status, level of uncertainty, recent changes, and response to treatment.
Safety: Critical lab values/reports, socioeconomic factors, allergies, and alerts (falls, isolation, etc.).
THE  
Background: Comorbidities, previous episodes, current medications, and family history.
Actions: What actions were taken or are required? Provide brief rationale.
Timing: Level of urgency and explicit timing and prioritization of actions.
Ownership: Who is responsible (nurse/doctor/team)? Include patient/family responsibilities.
Next: What will happen next? Anticipated changes? What is the plan? Are there contingency plans?

Select the link below to access the video.

I PASS the BATON (Flash video, 1 min., 14 sec.; 7.5 MB)

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  Slide 18: Other Example Handoff Tools

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  • ANTICipate: 
    • Administrative Data; New clinical information; Tasks to be performed; Illness severity; Contingency plans for changes.
  • I PASS:
    • Illness severity; Patient Summary; Action list for the new team; Situation awareness and contingency plans; Synthesis and "read back" of the information.
  • SHARQ: 
    • Situation; History; Assessment; Recommendations/Result; Questions.

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  Slide 19: Tools & Strategies Summary

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Barriers Tools & Strategies Outcomes
  • Inconsistency in Team Membership
  • Lack of Time
  • Lack of Information Sharing
  • Hierarchy
  • Defensiveness
  • Conventional Thinking
  • Complacency
  • Varying Communication Styles
  • Conflict
  • Lack of Coordination and
    Followup with Coworkers
  • Distractions
  • Fatigue
  • Workload
  • Misinterpretation of Cues
  • Lack of Role Clarity

Communication: 

  • SBAR
  • Call-Out
  • Check-Back
  • Handoff
  • Shared Mental Model
  • Adaptability
  • Team Orientation
  • Mutual Trust
  • Team Performance
  • Patient Safety!!

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  Slide 20: Applying TeamSTEPPS Exercise

Text Description is below the image. Image: A penguin riding an exercise bicycle is captioned 'EXERCISE'.

  1. Is your teamwork issue related to communication? 
  2. If yes, what is the communication issue? 
  3. Which TeamSTEPPS tools and/or strategies might you consider implementing to address the issue?

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Page last reviewed March 2014
Internet Citation: TeamSTEPPS Fundamentals Course: Module 3. Communication: Classroom Slides. March 2014. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/professionals/education/curriculum-tools/teamstepps/instructor/fundamentals/module3/slcommunication.html