Patient safety incidents associated with failures in communication reported from critical care units in the North West of England between 2009 and 2014

March 23, 2016

Source:  Journal of the Intensive Care Society [Epub ahead of print]

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Date of publication: February 2016

Publication type:  Journal article

In a nutshell:  Communication is central to the safe and effective delivery of critical care. This article presents a retrospective analysis of hospital incident reports attributed to communication that were generated by 30 intensive care units in the North West of England from 2009 to 2014. The study reviewed when during the critical care pathway incidents occur, the personnel involved, the method of communication used, the type of information communicated and the level of harm associated with the incident. The study found that patient safety incidents tend to occur when patients are transferred into or out of the intensive care unit and when information has to be communicated to other teams during the critical care stay. Ways that the patient handover process may be modified to improve communication and safety are also examined.

Length of publication:  1 webpage

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Situation, background, assessment, and recommendation-guided huddles improve communication and teamwork in the emergency department

December 23, 2015

Source:  Journal of Emergency Nursing 41/6 pp. 484–488

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Date of publication:  October 2015

Publication type:  Journal article

In a nutshell:  A performance-improvement project with the structured processes of a joint patient evaluation and huddle was implemented within a US pediatric emergency department. The following outcomes were measured: presence or absence of joint patient evaluation and SBAR-guided huddle, verbalization of treatment plan, communication, teamwork, and nurse satisfaction. This project showed the feasibility of a simple and inexpensive joint nurse practitioner–registered nurse patient evaluation followed by a structured huddle, which improved communication, teamwork, and nurse satisfaction scores. This performance-improvement project has the potential to enhance efficiency by reducing redundancy, as well as to improve patient safety through the use of structured communication techniques.

Length of publiction:  5 pages

Some important notes:  Please contact your local NHS Library for the full text of the article. Follow this link to find your local NHS Library


Smartphones let surgeons know WhatsApp: an analysis of communication in emergency surgical teams

March 25, 2015

Source:  American Journal of Surgery 209/1 pp. 45-51

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Date of publication:  January 2015

Publication type:  Journal article

In a nutshell:  The authors say that outdated communication technologies in healthcare can place patient safety at risk. They set out to evaluate implementation of the WhatsApp messaging service within emergency surgical teams in a London hospital. The initiator and receiver of communication were compared for response times and communication types. Safety events were reported using direct quotations. The authors conclude that WhatsApp represents a safe, efficient communication technology.

Length of Publication:  7 pages

Some important notes: Please contact your local NHS Library for the full text of the article. Follow this link to find your local NHS Library


Improving communication with primary care to ensure patient safety post-hospital discharge

March 25, 2015

Source:  British Journal of Hospital Medicine 76/1 pp. 46-9

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Date of publication:  January 2015

Publication type:  Journal article

In a nutshell: Successful communication between hospitals and primary care is vitally important to enable continuity of care and maintain patient safety post-discharge. Discharge summaries are the simplest way for GPs to obtain information about a patient’s hospital stay. A quality improvement study was conducted with the aim of increasing the content of discharge summaries for inpatients in the authors’ department. The content of discharge summaries was reviewed in accordance with local trust guidelines. Initial results pre-intervention confirmed suboptimal content of discharge summaries. Post-intervention results showed each component of discharge summaries improved in terms of content, with six of eight components having a statistically significant (P<0.05) increase. This was maintained after 12 months. Simple, intensive educational sessions can lead to an improvement in discharge summaries and communication with primary care.

Length of Publication:  4 pages

Some important notes: Please contact your local NHS Library for the full text of the article. Follow this link to find your local NHS Library


Creating spaces in intensive care for safe communication: a video-reflexive ethnographic study

January 28, 2015

Source:  BMJ Quality & Safety 23/12 pp. 1007-13

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Date of publication:  December 2014

Publication type:  Journal article

In a nutshell: This study says that the built environment in acute care settings is a new focus in patient safety research. This was an interventionist video-reflexive ethnographic (VRE) study, exploring how clinicians used the built environment to achieve safe communication in an intensive care unit (ICU) in a hospital in Sydney. The authors found that ICU staff enable safe communication in their wards by creating temporary spaces that are both ‘connected’ and ‘protected’.

Length of Publication:  1 web page

Some important notes: Please contact your local NHS Library for the full text of the article. Follow this link to find your local NHS Library


Situation, Background, Assessment, Recommendation (SBAR)

November 28, 2010

Source;  NHS Institute for Innovation and Improvement 

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Publication Type: Resource

In a nutshell:  SBAR is a toolkit for improving the communication of critical information so that patient safety can be increased by ensuring action is taken quicker. 

Length of publication:  webpage

Acknowledgement:  Trust News, Cumbria Partnership NHS Foundation Trust