Interpersonal Skills Lacking in Healthcare

It is estimated that 70- 80% of serious medical errors involve miscommunication. These events of miscommunication could occur between members of the healthcare team or between patients or their families and caregivers. These errors, in turn, cost the U.S. approximately $17 billion per year and more importantly, risk patient safety. One of the most critical points for effective communication is during care transfer of patients. Care transitions occur from one provider to another or from one institution to another.

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Interpersonal Skills Lacking in Healthcare

Communication and team-building issues can be mitigated through proper training. Every member of a health care team has the responsibility to the patient to step up, be vocal and demonstrate mutual respect toward his or her colleagues. These types of responsibilities don’t always come naturally and this makes it exceedingly important to provide training aimed at improving team function and effective communication. This allows the trained team members to follow tactical training until it becomes second nature.

One organization has adopted the U.S. Department of Health’s Agency for Healthcare Research and Quality approach in providing such tactics. Team Strategies & Tools to Enhance Performance & Patience Safety (TeamSTEPPS) is an evidence-based set of teamwork tools, aimed at optimizing patient outcomes by improving communication and teamwork skills among health care professionals.

The TeamSTEPPS core curriculum is comprised of the development of four universal skills: leadership, situation monitoring, mutual support and communication. Implementing these skills can build a healthy work environment where care providers can communicate effectively to improve patient outcomes.

Leveraging Leadership

Oftentimes, leadership can quickly turn into tyranny in health care situations. When health care teams operate with lopsided power, both the care and the recipient of the care suffer. TeamSTEPPS teaches providers to quickly identify the designated and situational leaders in situations and to appreciate the fluidity of leadership. Leadership shifts as the situation shifts if appropriate. The best leader in a given situation may not be the provider if another team member is more experienced or more equipped to provide leadership. ” All team members must be supportive, yet assertive. An effective leader is one who can identify a goal, define a plan to achieve the goal, and assign the tasks and responsibilities that are expected of the team.

Situation Monitoring to Create a Shared Mental Model

A continuous, fluid process, the skill TeamSTEPPS calls “situation monitoring” is a practice made up of three components. It is an individual skill that produces an individual outcome that can result in a shared mental model. Elements of each situation are scanned and assessed through each team member’s eyes. Of course, everyone will bring a unique perspective about the situation. When members communicate their observations in real-time, a team creates a shared mental model from which it can give more effective care. This shared mental model supports a united and strong approach to problem-solving.

Showing Mutual Support

Nurses and advanced practice nurses working with a team can often feel like their opinions are insignificant and contributions unimportant. Sadly, this can negatively impact both the patient’s care and the nurse’s morale. As mutual support is the essence of teamwork, TeamSTEPPS recommends three strategies: task assistance, feedback, and advocacy and assertion. As teammates assist one another, provide and receive honest feedback, and exert assertive behaviors when necessary, the team grows more connected while the patient receives better care.

Effective Healthcare Team Communication

TeamSTEPPS curriculum encourages complete, clear, brief and timely communication amongst team members. Often, this is done both verbally and non-verbally. Patients receive better care when providers huddle up, debrief and otherwise communicate to keep each other in the know about each facet of the care model. Communication models and tools are presented to support effective communication within the team and when transitioning patients within an established team, between healthcare providers, or from one agency to another.

How Frontier Nursing University Seeks to Improve Maternal Care Outcomes

Frontier Nursing University (FNU) has recently implemented the TeamSTEPPS framework in the development of its Quality Enhancement Program (QEP). The QEP aims to broaden and enhance healthcare team communication and teamwork skills by focusing on four specific aims:

  • Demonstrate an understanding of Healthcare Team Communication
  • Apply principles of Healthcare Team Leadership
  • Recognize Healthcare Team Situation Monitoring
  • Examine strategies for Healthcare Team Mutual Support

Frontier believes teaching these skills will have a significant impact on maternal health around the country. t FNU currently educates a significant portion of the nurse-midwives in the US and has students all over the country. As Frontier integrates the TeamSTEPPS model into its curriculum, the nurse-midwife and nurse practitioner graduates will be poised to positively affect healthcare team function across the country. ..

Ultimately, the goal of implementing interpersonal skill training in the health care setting is to empower all team members and improve patient outcomes. When individuals feel mutually respected and valuable to the team, they can do their best work with a greater focus on a patient’s wellbeing.

What are some other interpersonal skills that are lacking in the healthcare field today? Share with us in the comments below!

Tonya Nicholson, DNP, CNP, WHNP-BC is the Associate Dean of Midwifery and Women's Health for Frontier Nursing University. She has a rich history with FNU as a 1999 graduate for midwifery, the first DNP graduate in 2009, and a WHCP graduate in 2011. In 2006, she joined the Frontier faculty and then became the Programs Director in 2010 and the Associate Dean in 2015. She has a variety of teaching experience, but the majority has been focused on the prenatal period and in clinical courses.

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Frontier Nursing University was founded in 1939 by Mary Breckinridge and was originally established as the Frontier Graduate School of Midwifery.

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Specializes in ICU, trauma, neuro.

My only problem with these "huddles" is that they can take away from time to access the patient, and review patient data. The biggest problem with proper communication is having too few providers (including MD's, RN's, and Allied Health like RT's) for too many patients. When providers are perpetually rushed, and overworked no communication tool in the world is going to fix the problem. What will? Responsible and caring administration, unions, California ratio laws, and caring MD's/RN's. Give people time to do their jobs properly and most will communicate exponentially better.

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Specializes in Psychiatry.
On 7/10/2019 at 7:35 PM, myoglobin said:

My only problem with these "huddles" is that they can take away from time to access the patient, and review patient data. The biggest problem with proper communication is having too few providers (including MD's, RN's, and Allied Health like RT's) for too many patients. When providers are perpetually rushed, and overworked no communication tool in the world is going to fix the problem. What will? Responsible and caring administration, unions, California ratio laws, and caring MD's/RN's. Give people time to do their jobs properly and most will communicate exponentially better.

Great article! It really does touch an a huge issue in healthcare as a whole.

The idea of huddles is great! The reality of huddles, not so much. Huddles should incorporate all members of the healthcare team, pharmacy and other allied health, nurses and physicians/NPs. The reality of the situation is there are too many units and too many hurdles for these pertinent people to attend, and therefore it ends up being nursing and physician heavy, with very few members of other significant professions (i.e. pharmacy, social work, etc.). Competing demands and the general lack of resources (hospitals are more frequently turning to fewer pharmacists and allied workers) makes allocating time for huddles impossible if these professionals are to get their primary duties done.

The other issue with huddles is the lack of structure. Many times, huddles become toxic ranting parties that become more about venting and less about patient care.

I think proposing a model for huddles and for effective communication strategies is absolutely pertinent in healthcare today, as well as proper allocation of resources. But it all comes down to money in the end.

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Specializes in ER OR LTC Code Blue Trauma Dog.

Great article.

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