Assessing Teamwork and Communication in the Authentic Patient Care Learning Environment

Abstract

Failures of communication are a significant threat to patient safety and contributed to 65% of sentinel events in 2006, half of which were a result of communication failure at the time of handover of care.1 In To Err Is Human: Building a Safer Health System ,2 the Institute of Medicine made recommendations to enhance patient safety and expected health care organizations to establish patient safety programs. In its 2008 report on resident duty hours, the Institute of Medicine stated that residency programs “should train residents in how to hand over their patients using effective communications.”3 There is a clear mandate to teach the elements of teamwork and communication that will lead to improved patient safety, but currently these skills are not well taught, or well learned, during residency training. Our project studies handovers (the transfer of patients from 1 team member to another) and teamwork to inform future teaching of critical interprofessional communication skills and collaborative care, and the subsequent effect on patient safety. Our central hypothesis is that education in both teamwork and hand-off skills will improve team functioning, improve transfer of care, and lead to improved quality of care and patient outcomes. Our main innovation is to capture these behaviors in the authentic environment of in-hospital patient rounds. In this article we share our findings from the literature that led to our Initiative for Innovation in Pediatrics Education (IIPE) project design. Specifically, we examine how teamwork and communication have been taught and how the effectiveness of those curricula have … Address correspondence to Hilary M. Haftel, MD, MHPE, Department of Pediatrics and Communicable Diseases, University of Michigan Medical School, D3220 Medical Professional Building, SPC 5718, Ann Arbor, MI 48109-5718. E-mail: hils{at}umich.edu