Communication: Classroom Slides

TeamSTEPPS® Long-Term Care Version: Module 6

The Long-Term Care version of TeamSTEPPS adapts the core concepts of the TeamSTEPPS program to reflect the environment of nursing homes and other other long-term care settings such as assisted living and continuing care retirement communities. The examples, discussions, and exercises below are tailored to the long-term care environment.

Contents


 

Slide 1: Communication

Text Description is below the image.

Image: Two penguins are trying to communicate across a wall labeled assumptions, fatigue, distractions, and HIPAA (the Health Insurance Portability and Accountability Act of 1996). 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.

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Slide 2: Objectives

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  • Describe the importance of communication.
  • Recognize the connection between communication and medical error.
  • Define communication and discuss the standards of effective communication.
  • Describe strategies for information exchange.
  • Identify barriers, tools, strategies, and outcomes to communication.

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Slide 3: TeamSTEPPS

TeamSTEPPS logo. For details, go to [D] Text Description.

[D] Select for Text Description

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Slide 4: Importance of Communication

Ineffective communication is a root cause of nearly 66 percent of all sentinel events reported*

* (The Joint Commission Root Causes and Percentages for Sentinel Events (All Categories) January 1995-December 2005).

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Slide 5: Communication is...

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  • 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.

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.

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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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Brief:

Image: A sign posted on the ice says: Notice: Public Water. Our Public Water is Currently CLOSED Because it is not OPEN. The MANAGEMENT.

Clear:

Image: A puzzled penguin and a post with several signs of fish and arrows pointing in all directions.

Timely:

Image: 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: Information Exchange Strategies

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

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Slide 9: 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 resident?
    • Background—What is the clinical background or context?
    • Assessment—What do I think the problem is?
    • Recommendation—What would I recommend?

Remember to introduce yourself.

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Slide 10: SBAR Example

Photo of nurse talking on the phone. Select the penguin director icon below to access the video.

Select the penguin director icon below to access the video.

'Roll 'Em!' Play Video (icon: penguin film director)
SBAR (Flash video, 1 min., 10 sec.; 14.1 MB) (Plugin Software Help)

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Slide 11: SBAR Exercise

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Create an SBAR example based on your role.

  • Situation—What is happening?
  • Background—What is the background?
  • Assessment—What do I think the problem is?
  • Recommendation—What would I recommend?

Exercise icon: Penguin on a stationary exercise bicycle.

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Slide 12: Call-Out is...

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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.

Image: A penguin wearing a scrub top shouting, "Seal!"

On your unit, what information would you want called out?

Select the penguin director icon below to access the video.

'Roll 'Em!' Play Video (icon: penguin film director)
Call-Out (Flash video, 27 sec.; 5.5 MB) (Plugin Software Help)

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Slide 13: Check-Back is...

Text Description is below the image.

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 penguin director icon below to access the video.

'Roll 'Em!' Play Video (icon: penguin film director)
Check-Back (Flash video, 36 sec.; 7.3 MB) (Plugin Software Help)

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Slide 14: Handoff

Text Description is below the image.

The transfer of information (along with authority and responsibility) during transitions in care; to include an opportunity to ask questions, clarify, and confirm.

Image: Two racing penguins passing the baton.

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Slide 15: Handoff

Handoff. Includes photo of nurse talking to doctor. Select the penguin director icon below to access the video.

  • Optimized Information.
  • Responsibility—Accountability.
  • Uncertainty.
  • Verbal Structure.
  • Checklists.
  • IT Support.
  • Acknowledgment.

Great opportunity for quality and safety.

Select the penguin director icon below to access the video.

'Roll 'Em!' Play Video (icon: penguin film director)
Handoff (Flash video, 23 sec.; 4.9 MB) (Plugin Software Help)

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Slide 16: "I PASS the BATON"


I PASS the BATON. Includes photo of doctor at workstation. Select the penguin director icon below to access the video.

Introduction:Introduce yourself and your role/job (include resident).
Patient/Resident:Identifiers, age, sex, location.
Assessment:Relevant diagnoses and complaints, vital signs and symptoms
Situation:Current status (e.g., ADL status, intake, elimination, behavior, cognition), including code status, level of uncertainty, recent changes, and response to treatment
Safety:Critical lab values/reports, allergies, and alerts (falls, isolation, etc.)
THE 
Background:Other diagnoses, previous episodes, current medications, 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/APRN/nursing assistant)? Include patient/family responsibilities
Next:What will happen next? Anticipated changes?
What is the plan? Are there contingency plans?

Question, Clarify, and Confirm

Select the penguin director icon below to access the video.

'Roll 'Em!' Play Video (icon: penguin film director)
I PASS the BATON (Flash video, 1 min., 26 sec.; 17.3 MB) (Plugin Software Help)

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Slide 17: Communication Challenges

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

Great Opportunity for Quality and Safety.

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Slide 18: Barriers to Team Effectiveness

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BarriersTools and StrategiesOutcomes
  • 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 Co-Workers.
  • Distractions.
  • Fatigue.
  • Workload.
  • Misinterpretation of cues.
  • Lack of Role Clarity.
  • Brief.
  • Huddle.
  • Debrief.
  • STEP.
  • Cross-Monitoring.
  • Feedback.
  • Advocacy and Assertion.
  • Two-Challenge Rule.
  • CUS.
  • DESC Script.
  • Collaboration.
  • SBAR.
  • Call-Out.
  • Check-Back.
  • Handoff.
  • Shared Mental Model.
  • Adaptability.
  • Team Orientation.
  • Mutual Trust.
  • Team Performance.
  • Resident Safety!!

 

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Slide 19: Teamwork Actions

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  • Communicate with team members in a brief, clear, and timely format.
  • Seek information from all available sources.
  • Verify and share information.
  • Practice communication tools and strategies daily (SBAR, call-out, check-back, handoff).

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Page last reviewed November 2012
Internet Citation: Communication: Classroom Slides: TeamSTEPPS® Long-Term Care Version: Module 6. November 2012. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/professionals/education/curriculum-tools/teamstepps/longtermcare/module6/slltccommunication.html