Nassau University Medical Center Uses AHRQ Resources to Improve Communication with Patients

Nassau University Medical Center in New York is using TeamSTEPPS® ("Team Strategies and Tools to Enhance Performance and Patient Safety") to improve communication between patients and their health care team. The 530-bed tertiary care teaching hospital is located outside New York City.

TeamSTEPPS is an evidence-based system developed by AHRQ and the Department of Defense. It works to optimize patient outcomes by improving communication and teamwork skills among health care professionals.

"TeamSTEPPS offers tools and strategies that promote information sharing, such as having nurses participate in a briefing session at the start of the day to discuss each patient's condition. Then they huddle midway through the day for updates as necessary, and debrief at the end of the shift," explains Lorinda Bauer, R.N., M.B.A., clinical director of cardiac services.

The TeamSTEPPS strategy of holding scheduled briefings during the day is being implemented in all patient care units of the hospital, following its success in the telemetry cardiac services unit in late 2011, notes Ms. Bauer.

"Improved communication promotes an improvement of team dynamics, which translates into better patient care," explains Amgad N. Makaryus, M.D., chairman of the hospital's department of cardiology. "TeamSTEPPS has helped our medical staff be able to discuss each patient's condition in a standardized manner so that communication remains open and consistent."

He continues, "Several physicians and nurses have told me it's so much better and more efficient to have specific times set aside for discussion about each patient's condition."

Another TeamSTEPPS strategy being implemented throughout the hospital is having the nurse join the physician for the daily assessment of patients.

"The pairing of nurse and physician during patient rounds has led to more effective dialogue with patients," says Kathy Skarka, R.N., chief executive nurse. "This TeamSTEPPS strategy is extremely beneficial in putting all of our medical staff on the ‘same page' from the perspective of the patient. By being together, they will be communicating the same thing to the patient rather than conflicting messages."

The hospital uses another AHRQ resource, the HCAHPS® ("Hospital Consumer Assessment of Healthcare Providers and Systems") survey, to ask patients how well the hospital medical staff communicates with them. Since the introduction of TeamSTEPPS, survey results have shown that communication with patients has steadily improved.

According to Dr. Makaryus, HCAHPS survey results show that patients' views about physician and nurse communication are targeted to improve by 10 percentage points, to an estimated 75 percent overall average favorability rating, which will coincide with the hospital's goal of implementing TeamSTEPPS hospital-wide.

"Our goal is to maintain the momentum, to keep our medical staff focused on improved processes with TeamSTEPPS, and to help them really understand the benefits that will result from it," he says.

To read more about TeamSTEPPS, visit: http://www.ahrq.gov/professionals/education/curriculum-tools/teamstepps/index.html.

To learn more about the HCAHPS survey, go to: http://www.hcahpsonline.org/home.aspx.