improving the communication skills

1. Communication Skills
TO BE PRESENTED BY: Asmaa
Fayez
Risk Manager

2. ISBAR a simple ,structured way to communicate
effectively and ensure patient safety

3. Where can ISBAR be used??
ISBAR can be used on the following situations but not
limited to:
 shift changes
Time –Critical Situations
Discharge to community services
Procedure documents
Inter-Hospital transfers
Reports ,memorandums and briefings
Intra-Hospital transfers
Medical emergencies or evacuations

4. Who can use
ISBAR?
Physicians
Nurses
Allied Health
Administration
To and between ward staff ,
housekeeping and clerical staff

5. Think ,Talk
,Write
ISBAR
Yourself, your role ,your patient ,location
Identify
What’s going on with the patient ; current
problem or reason for admission
Situation
What is the clinical background and context?
Background
What do I think the problem is? Risks needs?
Current Observations / Trends? Treatments?
Assessment
What do I recommend ?Assign and accept
responsibility /Accountability recommend
timeframe .Repeat back for shared
understanding
Recommenda
tion

6. Before Making a
Call
Assess the
patient
Read most
recent notes
Have the chart
in-hand if
possible
1 2 3

7. Identif
y
Hello Dr Lili , I am Dr Ali the
obes/gyne Resident, I am calling you
about the patient called Mrs :Nawal
Saleh Ali Al-Shamri
With MRN 0132245
Senior
physician /
The On-Call

8. Situation
Current
condition I am calling because she
is complaining of
shortness of breath and
her RR is 38 bpm ,HR 130
bpm, and BP of 90/60 mm
hg.

9. Backgroun
d
History of the
case in brief
The patient’s primary
diagnosis is premenopausal
bleeding ,she was admitted
two days ago , and she is
currently on medications
after surgical curettage for
biopsy of her endometrial
hyperplasia, she received 1
PRBC’s

10. Assessment
I stopped the blood
transfusion as I think
the patient is having
a blood transfusion
reaction

11. Recommendations
I would like you
to come and
assess the patient
, please
Is there anything
you would like
me to do before
you get here ?
The
instruction
s !!!!!

12. Walk-rounds , who should conduct?
• The team include :
Hospital Director
Medical Director
Q& Patient Safety Director
Nursing Director
Risk Manager
A Pharmacist
Directors responsible for Finance ,performance ,operations and Human Resources
Patient Safety Officer
Unit’s Clinician Physician.
Unit’s nurse Manager or charge nurse
Scribe (usually a member of the executive team’s secretariat)

13. Key elements of IDEAL discharge
planning

14. Safety Briefing (Huddle )
Briefing
• is
defined
as a
dialogue
between
two or
more
people
Goals
• Discuss the
actions and
thought
processes
involved in a
particular
patient care
situation
• Encourage
Feedback on
those actions
and thought
processes
• Incorporate
improvement
into future
Briefing as well as
Debriefing can
answer the
questions :-
• What went
well?
• What did
not go well
?
• What can
we do
differently
or what
needs to
change to
improve
care?

15. Aims of implementing Safety Briefings
Increase staff awareness of patient safety issues
Create an environment where staff freely share information about
safety issues without fear of reprisal
Integrate safety into the daily routine
Change the culture or transformation

16. How will we know that a change is an
improvement ??
Number of safety issues identified by staff
Amount of information shared among staff
Number of “ near misses” errors caught before reaching the patient
,reported
Number of patients raising safety questions
Number of errors prevented by patient questions
Percentage of staff who perceive safety Briefing as valuable

17. Take Home Message
It is your duty to know and follow the
standards of care (SOC) in your discipline ,set
by the relevant regulatory bodies
Work within the limits of your knowledge
,skills & competencies
You hold the duty to know, apply and
advocate for the patients’ rights ,including
those related to medical errors
Your ignorance of any ethical ,professional or
legal aspects of practice is not an acceptable