Mobile Logo in White
Search/Quicklinks

An Environment of Excellence: Improving Interprofessional Communication

Primary Author: Kim M DeMasi, MSN, RN, CEN, LADC
Co-Principal Investigators/Collaborators: Ernest Daniels, RN, Jodie Drapeau, RN, Mary Fenn, RN, Donna Fife, LPN, Gisele Pellizzari, RN
Organization Providence Veteran Affairs Medical Center

Abstract

Purpose

The purpose of the project was to increase interprofessional staff satisfaction through improved communication.

Background

While the Inpatient Mental Health Unit at the Providence Veteran Affairs Medical Center had successfully demonstrated trended performance outcomes, staff identified dissatisfaction within the interprofessional team. A lack of interprofessional teamwork, specifically, effective communication was identified as impeding staff satisfaction. Literature review yielded evidence to support the importance of teamwork in the quality and safety of patient care, as well as the well being of staff.

Materials & Methods

Baseline staff satisfaction data was collected and confirmed dissatisfaction with interprofessional communication. A Unit Practice Council (UPC) was established, 100% of staff participated. Interventions included unit education specifically UPC and self governance. A structured meeting forum was used to drive the project and track progress. A standardized “code of conduct” was developed. The UPC created a poster, “Promoting an Environment of Excellence,” to be hung throughout the unit. A celebration of “Promoting an Environment of Excellence,” kicked off the new standard code of conduct. Badge cards were given to all staff as reminder of communication expectations.

Results

Staff satisfaction was reassessed three months post introduction of the Code of Conduct roll-out with marked improvement. The PVAMC Equal Opportunity Office adopted the “Promoting an Environment of Excellence” poster for distribution throughout the medical center.

Conclusion

While a code of conduct was not new to staff, the project highlighted the importance of, and need for respectful treatment and communication among interprofessional team members. Developing and adopting a code of conduct served as a valuable tool that improved team dynamics through collaboration overtime. The project served as the foundation for developing a well-defined UPC with tools and a structure to continue improvement work. Recent outcomes include development of a patient handbook and redesign of documentation instruments. There is a noted change in unit culture, to one more focused on patient-centered care, supported through interprofessional collaboration, shared purpose, and respectful communication.

Bibliography

  • Agency for Healthcare Research and Quality. (2010). AHRQ Health Care Innovations Exchange. Medical team training using crew resource management principles enhances provider communication and stimulates improvements in patient care. Rockville, MD. Retrieved April 7, 2011 from http://www.innovations.ahrq.gov/content.aspx?id=1809
  • Agency for Healthcare Research and Quality. (nd). TeamSTEPPS National Implementation. TeamSTEPPS curriculum tools and materials. Rockville, MD. Retrieved from http://teamstepps.ahrq.gov/abouttoolsmaterials.htm
  • American Association of Colleges of Nursing and Association of American Medical Colleges. (2010). Lifelong learning in medicine and nursing. Washington, DC: American Association of Colleges of Nursing.
  • Aston, S. (2011). Interprofessional education: Big picture perspectives from the field. Panel presentation at Joint AACOM & AODME annual meeting. Meeting future health care needs. The role of interprofessional education, Baltimore, MD.
  • Blue, A. V., Mitcham, M., Smith, T., Raymond, J., & Greenberg, R. (2010). Changing the future of health professions: Embedding interprofessional education within an academic health center. Academic Medicine, 85, 1-6.
  • Blue, A. V., Zoller, J., Stratton, T.D., Elam, C. L., & Gilbert, J. (2010). Interprofessional education in U.S. medical schools. Journal of Interprofessional Care, 24, 204-206.
  • Canadian Patient Safety Institute. (2008). The safety competencies: Enhancing patient safety across the health professions. Ottawa, ON: Author.
  • Chesluk, B. (2010). Assessing physician competency in teamwork. Conference presentation. interprofessional education: The new foundation for healthcare delivery. Indiana University. Indianapolis, IN.
  • Cox, K.R., Scott, S.D., Hall, L.W., Myra, A., Headrick, L.A., & Madsen, R. (2009). Uncovering differences among health professions trainees exposed to an interprofessional patient safety curriculum. Quality Management in Health Care, 18, 182-193.
  • Manojlovich, M., Antonakos, C. L., & Ronis. D.L. (2009). Intensive care units, communication between nurses and physicians, and patients’ outcomes. American Journal of Critical Care, 18, 21-30.
  • Manojlovich, M., & DeCicco, B. (2007). Healthy work environments nurse-physician communication, and patients’ outcomes. American Journal of Critical Care, 16, 536-543.
  • Manser, T., (2009) Teamwork and patient safety in dynamic domains of healthcare: A review of the literature. Acta Anaesthesiologica Scandinavica. 53, 143-151.
  • Manser, T. (2008). Team performance assessment in healthcare: Facing the challenge. Simulation Healthcare, 3, 1–3.
  • Oandasan, I., Baker, G. R., Barker, K., Bosco, C., D’Amour, D., Jones, L., Kimpton, S., L. Lemieux-Charles,L., Nasmith, L., San Martin Rodriguez, L., Tepper, J., & Way, D. (2006). Teamwork in Healthcare: Promoting Effective Teamwork in Healthcare in Canada. Ottawa: Canadian Health Services Research Foundation.
  • Reader, T. W., Flin, R., Mearns, K., & Cuthbertson, B. H. (2007). Interdisciplinary communication in the intensive care unit. British Journal Anesthesia, 98, 347–352.
  • Stein-Parbury, J., & Liaschenko, J. (2007). Understanding collaboration between nurses and physicians as knowledge at work. American Journal of Critical Care, 16, 470–477.
  • The Joint Commission. (2009). Sentinel Event Statistic. Retrieved from http://www.jointcommission.org/sentinelevents/statistics
  • The Joint Commission. Improving America’s Hospitals: The Joint Commission’s Annual Report on Quality and Safety 2007. Retrieved from http://www.jointcommission.org/asset/1/18/2007_Annual_Report.pdf

© Improvement Science Research Network, 2012

The ISRN published this as received and with permission from the author(s).