SMART Goal: Evidence and Review

Effective communication is crucial aspect of nursing yet too often is placed low on the priority list, especially at shift change. Information related to the care of patients is frequently disseminated at a crowded, noisy nurse station with several nurses rushing to leave and others attempting to get the information necessary to plan care and limit the constant distractions. It is this interaction that allows for information vital patient safety information to be communicated including the acuity of patients.

“Errors in communication give rise to substantial clinical morbidity and mortality (Riesenberg, Leitzsch, & Cunningham, 2010).” As a result, the Joint Commission has identified effective communication as one of its National Patient Safety Goals (Dunsford, 2009).

This article was selected as it explained and discussed the probable standardized procedure that health care organizations may have to follow for improvements in patient safety. This article explains how the inter-personal and professional relationship of different health care providers need to be maintained for better health care as explained in one of the chapters of health care management.

Effective communication is one of the utmost characteristics of a high-quality health care model that responds to the existing needs of the general population. However, communication may sometimes be taken for granted and therefore fail to relay important information between health care providers within the interprofessional team. In today’s health care setting, communication is particularly challenging due to the limited time constrain in the workplace. In spite of the utilization of existing charts and documentation, errors are made. In this paper, a real life clinical scenario is discussed which involved a breakdown of

It has been reported by various studies that most patient care errors occur during the handoff due to miscommunication between the caregivers and their reports regarding inaccurate information about the patient’s care, treatment and current condition.

For this study the authors instituted a change to bedside handover on a surgical unit. Staff members were invited to participate in pre and post implementation and as well as 60 patients (30 pre and 30 post implementation). Survey questions for the nursing staff measure perceptions of changes in accountability, quality of communication, medication reconciliation, workload prioritization and ability to communicate with other members of the healthcare team after receiving handoff. Patients were surveyed on their perceptions of input into the plan of care, understanding of plan of care, professionalism of staff during handoff, confidentiality during handoff and open communication between health team members.

Upon close examination, and the study of materials and data gathered, it was established that the breakdown of communication remains to be the main culprit in handoff deviations. One survey concluded that up to 59% of all participants had, at least, one patient who suffered from medical errors as a result of an ineffective handoff report (Barry, 2014). Many efforts are being expended to counter these instances; nevertheless, it seems that many of these issues persist to this date. Additionally, as stated above, over 70% of all adverse effects have to do with communication errors; a recent study indicates that approximately only 43.9% of all pertinent information gets relayed accurately to the care unit and that as much as 43% of all malpractice

One of the goals that I would implement in this program from the SMART goal would be making sure that freshmen students are motivated and meaningfully understand the concept of staying healthy. This aligns with the alphabet ‘M’ of the SMART acronym, which means motivational, meaningful, and measurable. Often times we always provide students with a lot of knowledge through freshmen enquiry classes, but it would be more helpful if we are able to measure and see if the students are motivated to make a healthy choice.

With the introduction of the SBAR tool, it is critical that leaders as well as all members of the health team demonstrate effective communication skill. As a result of leadership and communication, there are rules and processes according to (ACOG, 2012) there a process for guiding the handoff process includes; interactive communications, limited interruptions, a process for verification and an opportunity to review any relevant historical data. According to (ACOG, 2012), Properly executed hand-offs are interactive and include the opportunity for questions and answers. It continued by saying that every important aspect of the patient's condition and circumstances must be accurately communicated and acknowledged from one party to the other for a safe and effective handoff to occur. Communication at the time of handoff should result in a clear understanding by each team member. Patient handoff report and clinical communication can be improved to promote high quality medical and nursing care. Hand off reports are the most common type of communication between nurses. Ineffective hand offs can have negative consequences on a client's health. There can be delay in care if the information received is not clear and concise. The wrong type of treatment and a risk for inadequate care may also occur. Effective and efficient communication during hand offs in the clinical setting not only increased client satisfaction and outcomes, but created an environment that promoted staff fulfillment as well. A nurse’s primary concern is the safety of patients. Effective communication is a necessary tool in minimizing client harm and maximizing quality of

The NPSG identified new actions with intent to protect patient safety which recommends that healthcare systems utilize a standardized approach to handoff communications which should allow for feedbacks, questions and responses. The issues of increased patient injury secondary to medical errors from ineffective handoff communication remains a pressing problem despite the recommendation and mandates of the NPSG and the Joint Commission (Joint Commission, 2008).

Effective communication is imperative in the health care environment, and is extremely important to patient safety. The SBAR communication technique provides an organized logical sequence to improve communication between health care professionals. A study published in January 2015 found several barriers to effective communication in a handoff report were related to failures to understanding the information and information disorganization. Therefore, they found using that a structured tool for communication with categories assisted in ensuring information completeness, as well as understanding the context of the hand off

Additional research concerning this topic will provide additional knowledge and a better understanding of how this process can improve patient care, outcomes and satisfaction. I feel the use of a whiteboard and a unit tailored report template will provide important tools that a nurse can use to implement and sustain this change process. Research should be done to investigate whether the use of a whiteboard during the handover process will increase not only patient satisfaction, but also that of nurses (Vines, Dupler, Van Son, & Guido, 2014). The use of the whiteboard is part of the implementation process of achieving a smooth transition of handover report from the nursing station to the bedside.

Communication in a health care setting is vital for the continuation of care. The change-of-shift report is the approach nurses from one shift communicate and transfer information, liability and accountability to nurses on the next shift. Potter and Perry (2013) define the change-of-shift report also known as nursing hand-off as a method used by incoming and off going nurses to transfer information about the patients they will be caring for and or cared for. During this change of shift report, the off going nurse reviews information about the patients such as the patient’s condition, their medical history, their course of treatment to the incoming nurse and if they met their daily goals. This vital information helps the incoming nurse to continue with the plan of care for the patients and patient safety by avoiding setbacks and errors.

Participative Leadership is one of the recent unconventional leadership styles and is wonderful of promoting professional and personal growth for the employee and leader. However, I recommend placing time constraints (deadlines) on the process of decision making, in order to avoid prolonged or delayed action on deliverables. These time constraints with develop individuals cognizance to time-sensitivity, focus on increase productivity through problem-solving and developing the blueprint for future goals and plans for the organization.

Vital information about all areas of the patient care is processed through one care giver to another or other health professional groups. It is stated by the AMA (Australia Medical Association) to achieve a safe and accurate handover it must be lead by good communication and to be backed up by appropriate patient documentation, correct doctor referral letters and completed discharge planning. Therefore, handover contains large amounts of content and should be followed through a systematic approach (Lim et al., 2016). Clinical handovers can be held in multiple locations of the health precinct such as; patients bedside, common staff rooms and different wards upon transfers, admissions or discharges. They can be given or received through different modes like face to face, through the telephone or via written orders. According to the NSQHSS (National Safetly and Quality Health Service Standards) clinical handover is classified as high risk toward to patients safety. It is known that poor clinical handover skills can have vast effects on the patients health outcomes and in some cases the cause of potential adverse events and cause patient