What is the PICOT question?
Does the implementation of a standardized communication tool result in its comprehensive use in the hospital area in comparison to current “cheat sheets” for all surgical patients and peri-operative staff in a 30-day period?
- P- (Patient, population, or problem): All surgical patients and peri-operative staff.
- I- (Intervention): Implementation of a standardized communication tool.
- C- (Comparison with other treatment/current practice): The use of “cheat sheets” and non-standardized communication.
- O- (Desired outcome): The comprehensive use of a standardized communication tool in all relevant hospital areas.
- T- (Time Frame): 30 days.
What is the practice issue/problem? What is the scope of the issue? What is the need for change?
One of the primary processes of healthcare is communication. A poorly developed communication system creates significant room for error, inconsistency, and inefficiency. A time when communication is critical is during patient handoff when the care and responsibility of patient are transferred from one medical professional or department to another. Human factors include fatigue, peer relationship, language barriers, flawed decision-making, and inaccuracy or irrelevancy of report contents. Furthermore, the problem can be exacerbated by organizational and environmental factors. The issue is widespread as many of popular communication tools are not effective, standardized or compatible with healthcare technology (Jukkala, James, Autrey, & Azuero, 2012).
The need for change calls for a reduction in communication errors and negatively influencing factors by introducing a standardized tool. The intervention will seek to address any sources of error and inefficiency in the communication mechanism by adapting to the complex healthcare delivery process. A standardized communication tool should create structure and framework for communicating amongst medical staff.
Handoff communication must provide critical information about a patient and provide a starting point for treatment. It is a 2-way communication process which creates a variety of challenges within complex care environments (Jukkala et al., 2012). Therefore, changes should come in terms of addressing these barriers to communication as well as logistical aspects such as quality of information and technology compatibility.
What is the practice area?
- Clinical
- Administration
How was the practice issue identified?
- Safety/risk management concerns
- Wide variations in practice
- Procedure or process is a time waster
What evidence must be gathered?
- Literature search
- Guidelines
- Clinical Expertise
- Standards (Regulatory, professional, community)
Search terms/How to narrow the search?
Communication, patient handoff, staff communication, standardized communication tool, shift report, SBAR, interdepartmental collaboration, quality of care
References
Jukkala, A. M., James, D., Autrey, P., & Azuero, A. (2012). Developing a standardized tool to improve nurse communication during shift report. Journal of Nursing Care Quality, 27(3), 240-246. Web.