SPECIAL INTEREST REPORT POSTER DISPLAY

ENHANCING EFFECTIVE TEAM COMMUNICATION FOR PATIENT SAFETY. Fancott C¹, Andreoli A¹, Trentham B², Velji K¹, Baker R², Aimone E¹, Sinclair L¹, Tardif G¹, Boaro N¹; ¹Toronto Rehabilitation Institute, Toronto, Canada. ²University of Toronto, Toronto, Canada

PURPOSE: This pilot study aims to improve health care team communications and patient safety by adapting and implementing the SBAR technique (Situation-Background-Assessment-Recommendation) as a formal communication tool for both urgent and non-urgent patient safety issues within a rehabilitation and complex continuing care setting. RELEVANCE: Effective communication and teamwork have been identified in the literature as key enablers of patient safety. The SBAR process has proven to be an effective communication tool in acute care settings to structure high urgency communications, particularly between doctors and nurses. However, little is known of the effectiveness of such communication tools within a rehabilitation settings where there are different clinical issues, team composition, availability of physicians,and participation of patients and family members within a client-centred model. DESCRIPTION: This project consisted of three phases: Phase I: Adaptation of SBAR tool. In order to adapt the SBAR tool, a review of the literature was conducted as well as consultations with communications and SBAR experts. Clinical staff, patient, and family input gathered in a focus group format was essential to help guide, validate, and further refine adaptations to the SBAR tool. Phase II: Implementation of SBAR tool in clinical rehabilitation team. Eighty-five percent of all clinical and non-clinical staff members on the study unit participated in two educational sessions. Topics included: patient safety culture; the importance of communication in patient safety; awareness of diverse and discipline-specific communication styles and hierarchical barriers to communication. Real life case examples were used as the basis for role-play scenarios, which proved to be a powerful educational strategy for participants to gain comfort in using the SBAR process. Phase III: Evaluation of the effectiveness of the adapted SBAR tool. An outcome evaluation on the impact of the SBAR tool on patient safety from a staff and patient perspective, will be presented separately. EVALUATION: A process evaluation of the educational workshops and implementation of SBAR as a communication tool within the clinical team has been conducted. Through individual interviews and team discussions, team members reported on their response to the frequency, usefulness, benefits and limitations of the SBAR process. The team also used formal tracking forms to facilitate their recall and reflections. CONCLUSIONS: Adaptation of the SBAR communication tool has been successful through the use of input from key stakeholder groups to guide, validate and refine changes made to the tool. Educational workshops that were interprofessional in nature were key to the successful implementation of the adapted SBAR tool, broadening its use for both urgent and non-urgent patient safety situations to be used by all team members. Though team response to the SBAR tool varied, information acquired through interviews and team meetings convey a positive response to the potential usefulness of the SBAR to facilitate team communication. IMPLICATIONS: The adapted SBAR tool may improve team communications by providing a non-hierarchal, structured means of communication to discuss patient care and safety issues. This innovative approach may help to build capacity and capability of the physical therapist within the interprofessional team and within a culture of patient safety. KEYWORDS: patient safety, team communication, interprofessional development. FUNDING ACKNOWLEDGEMENTS: Canadian Patient Safety Institute. CONTACT: andreoli.angie@torontorehab.on.ca

ETHICS COMMITTEE: Research Ethics Board, Toronto Rehabilitation Institute; Chair, Dr. Gaetan Tardif