Culture of Poor Communication + Collaboration Contribute to Med Errors,Staff Turnover

  1. from pnd news briefs - philadelphia metro edition jan 27, 2005;

    culture of poor communication and collaboration among
    health professionals relates significantly to continued
    medical errors and staff turnover.

    a national study of 1,700 nurses, physicians, clinical
    care staff and administrators - co-sponsored by the
    american association of critical-care nurses and
    vitalsmarts - found that fewer than 10 percent address
    behavior by colleagues that routinely includes trouble
    following directions, poor clinical judgment or taking
    dangerous shortcuts.

    among the study's key findings were that:
    * 84 percent of physicians and 62 percent of nurses and
    other clinical care providers have seen coworkers
    taking shortcuts that could be dangerous to patients.
    * 88 percent of physicians and 48 percent of nurses and
    other providers work with people who show poor clinical
    * fewer than 10 percent of physicians, nurses and other
    clinical staff directly confront their colleagues about
    their concerns, and one in five physicians said they
    have seen harm come to patients as a result.
    * the 10 percent of health care workers who raise these
    crucial concerns observe better patient outcomes, work
    harder, are more satisfied and are more committed to
    staying in their jobs.

    american association of critical-care nurses, january 26, 2005

    new study finds u.s. hospitals must improve workplace communication to reduce medical errors, enhance quality of care: expert panel issues call-to-action with new national standards and training recommendations
    Last edit by NRSKarenRN on Jan 30, '05
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  3. by   Spidey's mom
    Interesting . . .

    I have seen nurses pre-pour.

    Shortly thereafter a memo came out about how dangerous that is.

  4. by   NRSKarenRN
    above article is actually 44 page document:

    aacn standards for establishing and sustaining healthy work environments

    the standards are designed to be used as a foundation for thoughtful reflection and engaged dialogue about the current realities of each work environment. critical elements required for successful implementation accompany each standard. working collaboratively, individuals and groups within an organization should determine the priority and depth of application required to implement each standard.

    the standards for establishing and sustaining healthy work environments are:

    [font=agaramond-bold][color=#4d00da]skilled communication
    nurses must be as proficient in communication skills as they are in clinical skills.
    true collaboration
    nurses must be relentless in pursuing and fostering true collaboration.
    effective decision making
    nurses must be valued and committed partners in making policy, directing and evaluating clinical care and leading organizational operations.
    appropriate staffing
    staffing must ensure the effective match between patient needs and nurse competencies.
    meaningful recognition
    nurses must be recognized and must recognize others for the value each brings to the work of the organization.
    [font=agaramond-bold][color=#f80097]authentic leadership

    nurse leaders must fully embrace the imperative of a healthy work environment, authentically live it and engage others in its achievement.
    Last edit by NRSKarenRN on Jan 30, '05
  5. by   Spidey's mom
    I know - saving it for when I'm not so sleepy. Thanks Karen for keeping us updated so well.

  6. by   EricTAMUCC-BSN
    Quote from nrskarenrn
    * the 10 percent of health care workers who raise these
    crucial concerns observe better patient outcomes, work
    harder, are more satisfied and are more committed to
    staying in their jobs.


    because these are the people passing judgements and backstabbing to save their own hides in a broken system. they run the good healthcare providers off.
  7. by   EricTAMUCC-BSN
    Many nurses fail to recognize the difference between communication and slander.
  8. by   pickledpepperRN
    Thank you Karen. I have the AACN e-mail still unopened.
    I think it is excellent the AACN is addressing these issues. I also think eliminating the 'culture of blame' as recommended by the Institute of Medicine and Dr. O' Leary of the JCAHO is necessary/ Otherwise there will not be honest communication.

    I agree we need thoughtful reflection and engaged dialogue about the current realities of our workplace. If not in formal sessions we can get together outside work and create a plan to engage management. I truly think nurse managers welcome such opportunities.

    I intend to take the standards to our practice committee.
  9. by   CarolineRn
    Last edit by CarolineRn on Jan 30, '05 : Reason: wrong topic
  10. by   Clipper
    I'm not sure what this thread is asking of us in that we just read it and go away or respond to it. So I'm going to throw caution to the wind and respond to it.

    I liked the article as it raised some points that are not only not addressed in the workplace but in the training either. In my course, we covered one subject - professional communication - which dealt with communication in a technical manner and on paper. My course comprised of 2% of a skill that constitutes 90% of my job. I would find this imbalance of the scales almost laughable if it didn't impact so heavily on me in the workplace environment. Not taking the time to explain the vision, not explaining the vision in clear, understandable language, or not "walking the talk" are some common ways that I think organizations fail to achieve their goals.

    Someone mentioned the AACN standards for establishing and maintaining healthy work environments. These simple points don't tell me nearly enough (or is that an abbreviated version?), they're flimsy in their setting because, in my view, they're far too brief. If a need is expressed it must be expanded upon by listing the hows, whys, whats and wherefores. To assume one knows the tenets of effective communication is, I believe, a big downfall in any setting.

    One of the primary problems in society, in my view, is borne from people not understanding each other. But as I sadly acknowledge the points listed in the article I would put forth that it's not the culture of poor communication that sparks this but the culture of fear that pre-empts it. It's rare I see the community spirit in a clinical setting and that's not to say it's a nursing thing but that perhaps it's a societal one. When effective communication is not used or learned, people learn unhealthy tactics to cope and meet their needs, an unhealthy cycle is developed and self perpetuates breathing life into the virus that entrenches itself as fear. Not enough time is spent educating ourselves on what constitutes the masterful art of meaningful communication and this, not the list, is where my bone of contention lies.