Communication: Stagtegies to Improve Nurse to Nurse Handoff and Nurse-Provider Communication

Significance & Background: The IOM identified that communication failures were one of the leading causes of care breakdown. Communication failures had been identified in our facility specifically between nurse and providers and at nurse to nurse handoffs.

Purpose: The goal of this project was to improve communication at time of patient hand-offs and to increase communication between clinical nurses and providers to decrease errors that reach our patients.

Intervention:This project included an institutional endeavor which implemented nurse to nurse bedside report.  At the unit level we also implemented structured verbal and written report and nurse led multi-disciplinary rounds.  Our written report tool is utilized to guide both the nurse to nurse handoff and our nurse led rounds.

Evaluation:  We our now 100% compliant with our bedside report metrics .  We have been able to identify medication errors through bedside report.  Our structured report helped to maintain our incremental time while being able to convey our complex patients concisely and quickly.  Nurse led rounds has empowered nurses to be advocates and opened up the communication between disciplines.

Discussion: our stategies to increase communication has been successfully incorporated into our units culture.  It took nursing leadership, transparency and linking these changes to our organizations primary value to gain full adoption.