Module #3: Collaboration and Teamwork
What does the "A" represent in ISBARR?
Assessment: Give a brief evaluation of the situation.
What does the "B" represent in ISBARR?
Background: Provide pertinent clinical background.
Is the use of standardized terminology and procedures to ensure that messages between the sender and the receiver are received, clarified, and correctly interpreted. Many tools for enhanced communication procedures among team members have been developed, standardized, and implemented in the health care arena in an effort to avert medical errors. Handing off care of a client from one provider to another is a period particularly prone to error. Clear, accurate, and concise information should be transferred from one team member to another without interruptions, language barriers, hurried activity, or intimidation.
Closed-Loop Communication
Is an intellectual therapeutic technique in which one envisions or visualizes an overwhelming, or an anxiety-producing situation. Mentally rehearsing different reactions or behaviors, or even repeating constructive statements, can positively affect coping skills. __________ ________ has been documented to improve communication during uncivil encounters. Involves visualizing a difficult scenario ahead of time, so as to prepare for constructive action and responses when that situation arises in real time. This evidence-based approach empowers individuals and gives them a greater sense of confidence in overcoming barriers to communication. Defensive responses may perpetuate a problem, whereas ignoring or minimizing a problem sends a message that the behaviors are accepted and tolerable.
Cognitive Rehearsal
Or a consult, is when one provider formally requests another provider's input or advice about how to approach or treat a condition.
Consultation
What considerations should be addressed regarding discharged planning?
Determine the home environment will be like, medications, client and/or caregiver education, follow up appointments, when to call the provider, readiness for discharge. Must be documented on a EHR. All must be discussed on day of discharge.
What five approaches can be used for handling conflict?
Domination is to have a high concern for oneself and low concern for others. Obliging and avoiding demonstrate low concern for oneself and for others. Compromising and integrating occur when both parties collaborate to create a solution that is mutually acceptable and satisfying.
What consists of effective discharge planning?
Effective discharge planning can decrease the client's length of stay, avoid readmission to the hospital, decrease health care costs, and increase reimbursement for the hospital. Utilizing a systematic approach to develop a thorough plan of care will help the client transition from the hospital to either home, another facility, or another level of care
Involves visualizing a difficult scenario ahead of time, so as to prepare for constructive action and responses when that situation arises in real time. This evidence-based approach empowers individuals and gives them a greater sense of confidence in overcoming barriers to communication. Defensive responses may perpetuate a problem, whereas ignoring or minimizing a problem sends a message that the behaviors are accepted and tolerable.
Emotional Intelligence
Is an evidence-based strategy to improve client safety and quality of care, improve communication among the nurses and the client or the client's caregiver, and increase client satisfaction with the health care experience. Giving and receiving the report at the bedside presents each provider with an opportunity to see and verify the client's condition (e.g., check the client's surgical site or an IV site or lung sounds) and address or question issues. It also allows clients to participate in their own care planning. The enhanced communication attained through a bedside handoff, which includes the incoming nurse, the outgoing nurse, and the client, has been favorably received by nurses. N
Hand Off Report
What are some identified barriers to interprofessional collaboration?
Hierarchy of professions or roles, Lack of knowledge of health care team member's role/title and scope of practice, Poor communication or lack of communication, Lack of trust in the competence of other team members, Lack of cultural competency, Inability to resolve conflicts, Structural factors such as time
What assessment tool is used among health care with the intentional of ensuring uniform delivery of medical information?
ISBARR
What are the benefits of an interprofessional team?
Improved access to and coordination of health care services. Greater efficiency of client referral and client-care services Increased quality of community health services. Decrease in complications, length of stay, sentinel events, mortality, and staff turnover.
Building strong relationships helps to improve performance, job satisfaction, and social skills, also known as _________ _________ ________. Developing these skills enables effective communication with clients, families, coworkers, and other health care providers. Effective communication reduces errors, improves clients' health outcomes, and increases satisfaction with care.
Interpersonal Communication Skills
The skill of all participants in a client's care working as a team has become an important factor in health care improvement. Developing effective ___________ ______, in which two or more professionals work together, is a goal shared by many leaders, hospitals, and institutions.
Interprofessional Teams
What does the "I" represent in ISBARR?
Introductions: Give your name and client care role, ask the receiver for their name and client care role.
What are the benefits of providing a safe and satisfying work environment?
Is vital to interprofessional collaboration, reducing medical errors, decreasing staff turnover, and increasing quality of care and outcomes for clients.
What does the second "R" represent in ISBARR?
Read back/Repeat: Summarize, allow time for questions, and repeat or reread information, as needed.
What does the "R" represent in ISBARR?
Recommendation: Give suggestion(s) for care.
When the provider refers a client, or makes a request for a ________, that provider is delegating responsibility for management of the client's specific condition to another provider.
Referral
What factors affect emotional intelligence?
Self-awareness, self-regulation, motivation, empathy, and social skills are the major elements that determine a person's emotional intelligence. Many factors affect emotions. Recognizing, understanding, and controlling those emotions can impact how a person adapts to change, problem solves, or even copes with challenges and everyday stressors
What does the "S" represent in ISBARR?
Situation: Describe what is currently happening to the client that needs to be addressed.
What considerations should be taken by the interprofessional team regarding transition of a client?
Successful outcomes depend on considering the proposed environment, the social conditions, and the design of the program to which the client is being transitioned.
What are primary teamwork skills?
Team structure: Identify who is on the team or who should be included in the team. Communication: Utilize strategies to communicate effectively among the identified team. Leadership: Identify strategies to effectively lead teams and support the team's use of these strategies. Situation monitoring: Encourage team members to be aware of and understand the teams' performance and the impact it has on the clients' outcomes. Mutual support: Support the team by providing feedback to assist them to function better as a team (distribute workload, manage conflict).
What assessment tool is used to enhance interprofessional teams?
TeamSTEPPS. Team Strategies, Tools to Enhance Performance and Patient Safety
What nursing considerations should be taken when receiving provider's prescriptions?
The nurse must verify that the order is for the correct client; that the prescription is correct for the current treatment plan; and that the client rights are all met (e.g., right client, right medication, right dose, right time). They must make sure that they write down all parts of the prescription and then transcribe it into a more permanent document, such as an EHR or electronic medical record (EMR) or a Kardex (paper document). When doing so, nurses must record the provider's full name and title, the date/time of the prescription, and the full prescription without abbreviation.
What are two key considerations when performing interprofessional communication skills?
Two key considerations in communication are who are you communicating with and how that communication will occur. Interprofessional communication occurs primarily through two means. First, it can occur in real time with all team members present, such as in a meeting, during interprofessional rounds on the unit, or even in impromptu conversations. This both permits questions to be asked to clarify information provided and allows the receiver of the information to acknowledge their understanding of the information received. Second, interprofessional communication can occur through written documents, such as provider prescriptions, nurses' notes, or providers' progress notes
Is a client-centered approach in which members of different health care professions come together and work toward a common goal of improving or restoring a client's health. Client safety, quality of care, and health care outcomes are significantly improved when strong collaborative relationships are in place.
Collaborative Health Care
Is a method to settle disagreements peacefully and respectfully, through compromise and accommodation to each other's needs, by sharing goals and avoiding competition with the other party. Various communication techniques can be employed for handling external conflict during collaboration with others, such as mutual respect or active listening. Other therapeutic techniques are appropriate for resolving internal or personal discord, such as deep breathing (especially before speaking), using empathy, or creative problem solving. ________ _________ can be practiced by using simulation training or cognitive rehearsal of adverse situations, both of which can decrease anxiety and improve levels of self-efficacy.
Conflict Management
What facility changes should be implemented for effective prevention of incivility?
Leadership responsibility for zero-tolerance. New-employee onboarding to include information on acceptable language, behaviors, and reporting procedures. Formal training for all employees. Shared language in discussing workplace violence. Culture of accountability with reporting procedures in place. Take action on reports of these behaviors. Share results of actions taken. Communicate the organization's commitment
What considerations should be taken regarding discharge planning?
Planning for a client's discharge should begin upon the client's admission to a health care facility. A safe, timely, and effective discharge plan requires input from the interprofessional team as well as the client and the client's family or caregivers.
What are the benefits of utilizing interprofessional rounds?
Utilizing interprofessional rounds permits each member of the team that is providing care for the client, in collaboration with the client, to provide an assessment of the client's progress, contribute to developing and revising a plan of care, set realistic goals, and make care recommendations. In addition, such interprofessional engagement has been shown to improve quality of and satisfaction with care, as well as the client's overall experience.
What four core competencies should be utilized to assist in the development of teamwork and collaboration to bring about optimal care of the client?
Values/ethics: Mutual respect and shared values and shared decision making. Roles and responsibilities: Recognize the scope of practice of the various professions to address the needs of the client. Interprofessional communication: Communication with clients and professionals from all disciplines that are contributing to the client's care. Teams and teamwork: Use relationship-building principles to effectively deliver safe timely, efficient client-centered care.