Handoff Communication in Critical Care Can the use of Insitu simulation improve communication and patient safety? Fairview Southdale Hospital Edina, Minnesota Intensive Care Unit & Operating Room The Objectives for this presentation • Review Team STEPPS communication • Describe Team STEPPS in this project • Define Insitu simulation • Describe how Insitu simulation was used • Identify communication gaps in patient hand off • Describe the research project “Public speaking is the art of diluting a two-minute idea with a two-hour vocabulary.” (JFK) In 2008 our hospital adopted a Team STEPPS initiative. What is Team STEPPS? Goal is to develop highly skilled teams in order to improve patient outcomes How does this apply to our project? According to Team STEPPS (2006), hand off communication conveys information, transfers authority and responsibility during transitions in patient care. • According to Joint Commission a “sentinel event is an unexpected occurrence involving death or serious physical or psychological injury, or the risk thereof”. “The single biggest problem in communication is the illusion that it has taken place” George Bernard Shaw What is insitu simulation? • • • • Training approach Uses a human patient simulator (Sim Man) Multidisciplinary Conducted in patient care unit (Miller, 2008) Why Insitu Simulation? • Mistakes • Teams work • Simulatiion (Miller, et al, 2008). The purpose of our Insitu project was to examine communication skills between the OR and the Intensive Care Unit teams during the critical hand off of a cardiovascular surgical patient. Method Using the OR and ICU teams: • Sim Man as a fresh post op CV surgical patient. • Critical event requiring staff to react and communicate. • Immediately as the team members came together for the transition of care. • Our observations-communication during this transition. This is what we found! Barriers to effective communication Random, chaotic and inconsistent. Communication is a patient safety issue. What we found out. The outcome of this project revealed that more work is needed to improve communication between the two teams. The Design of the Research Project Includes: • Filming a scripted scenario. • Education • Ongoing evaluation of communication between the teams Experience after simulation-one of our ICU nurses When all other means of communication fails, try words References Agency for Healthcare Research and Quality (AHRQ). (2006) Team STEPPS. Malec, J., et al (2007). The mayo high performance teamwork scale: Reliability and validity for evaluating key crew resource management skills. Simulation in healthcare. 2(1), pp. 4-10. Miller, K., et al (2008).In situ simulation; A method of experiential learning to promote safety and team behavior. Journal of perinatal neonatal nurse 22(2), pp.105-113.