Better communication enhances quality of care.A national study of more than 1,700 nurses, physicians, clinical-care staff and administrators, referred to as Silence Kills, was released in January, 2005. It found that fewer than 10 percent of those surveyed address behavior by colleagues that concerns them. In all, the study pinpoints seven categories of problems (broken rules, mistakes, lack of support, incompetence in·com·pe·tence or in·com·pe·ten·cy n. 1. The quality of being incompetent or incapable of performing a function, as the failure of the cardiac valves to close properly. 2. , poor teamwork (product, software, tool) Teamwork - A SASD tool from Sterling Software, formerly CADRE Technologies, which supports the Shlaer/Mellor Object-Oriented method and the Yourdon-DeMarco, Hatley-Pirbhai, Constantine and Buhr notations. , disrespect and micromanagement This is about the management style. For the computer game strategy, see Micromanagement (computer gaming). In business management, micromanagement is a management style where a manager closely observes or controls the work of their employees, generally used as a pejorative term. ) that are frequently encountered, yet rarely addressed. The study was co-sponsored by the American Association American Association refers to one of the following professional baseball leagues:
AACN American Association of Critical-Care Nurses AACN American Association of Colleges of Nursing AACN Advanced Automatic Crash Notification (General Motors) ) and VitalSmarts, a company specializing in leadership training and organizational performance Organizational performance comprises the actual output or results of an organization as measured against its intended outputs (or goals and objectives). Specialists in many fields are concerned with organizational performance including strategic planners, operations, . To drive the cultural transformation needed to improve communication in hospitals, AACN unveiled a set of national standards to promote skilled communication and collaboration among nurses and other caregivers. The AACN standards and VitalSmarts' recommendations emphasize the urgent need for hospitals to implement initiatives, especially communication training and education, to ensure that healthcare professionals deliver safe, high quality care to their patients. AACN and VitalSmarts combined their resources to better understand communication problems in hospitals through the survey Silence Kills: The Seven Crucial Conversations for Healthcare. Among the study's key findings: * 84% of physicians and 62% of nurses and other clinical-care providers have seen coworkers taking shortcuts See Win Shortcuts. that could be dangerous to patients * 88% of physicians and 48% of nurses and other providers work with people who show poor clinical judgment * 92% of physicians and 65% of nurses said they work with some people who have trouble following directions * 81% of physicians and 53% of nurses and other clinical care providers questioned the competency COMPETENCY, evidence. The legal fitness or ability of a witness to be heard on the trial of a cause. This term is also applied to written or other evidence which may be legally given on such trial, as, depositions, letters, account-books, and the like. 2. of some of the nurses or clinical care providers they work with * 68% of physicians and 34% of nurses expressed the same concern about the competency of physicians they work with * 53% of nurses and clinical care providers reported colleagues who were reluctant to help, refused to help or were impatient im·pa·tient adj. 1. Unable to wait patiently or tolerate delay; restless. 2. Unable to endure irritation or opposition; intolerant: impatient of criticism. 3. * 77% of nurses and clinical care providers work with colleagues who they perceive as condescending, insulting in·sult v. in·sult·ed, in·sult·ing, in·sults v.tr. 1. a. To treat with gross insensitivity, insolence, or contemptuous rudeness. See Synonyms at offend. b. , or rude rude - [WPI] 1. Badly written or functionally poor, e.g. a program that is very difficult to use because of gratuitously poor design decisions. Opposite: cuspy. 2. Anything that manipulates a shared resource without regard for its other users in such a way as to cause a * 52% of nurses and clinical care providers reported working with someone who abused their authority through bullying Bullying Chowne, Parson Stoyle terrorizes parish; kidnaps children. [Br. Lit.: The Maid of Sker, Walsh Modern, 94–95] Claypole, Noah bully; becomes thief in Fagin’s gang. [Br. Lit. or threatening. "People frequently see these problems, but too often they fail to talk about them," says Joseph Grenny, president of VitalSmarts. "Healthcare professionals who embrace the findings of this study and start talking candidly can·did adj. 1. Free from prejudice; impartial. 2. Characterized by openness and sincerity of expression; unreservedly straightforward: In private, I gave them my candid opinion. and safely about these seven problems will find that outcomes can improve dramatically." Physicians, nurses, and other healthcare providers who were confident and able to confront individuals who display problematic behaviors were also examined in this study. Fewer than 10 percent of physicians, nurses and other clinical staff directly confront their colleagues about their concerns and one in five physicians said they have seen harm come to patients as a result. The study found that people who were confident in their ability to address problem-causing behaviors were able to achieve positive outcomes for patients, for the hospital, and for themselves. For example, nurses who stated their concerns about incompetence "observed better patient outcomes, were more satisfied with their workplace, exhibited more discretionary effort beyond the minimum required, and intended to stay in their unit or hospital". The AACN has stated that work and care environments must be safe, healing and humane humane pertaining to the avoidance of infliction of pain, discomfort and harassment; used especially with regard to animals. humane considerations , respectful re·spect·ful adj. Showing or marked by proper respect. re·spect  ful·ly adv. of the rights, responsibilities, needs
and contributions of patients, their families, nurses and all health
professionals. With the help of an expert panel, a new set of standards
was created that identifies six aspects that are necessary for a healthy
work environment. These are:
* skilled communication * true collaboration * effective decision-making * appropriate staffing * meaningful recognition * authentic leadership To be most effective, all these standards must be maintained consistently and simultaneously. As labor assistants/birth doulas entering the hospital, where open communication is difficult even for the physicians and nurses on staff, you face an extra challenge. Bearing in mind the AACN standards necessary for a healthy work environment may help you and your clients to have a more positive experience. It may also help create a more positive experience for the nurses and physicians attending them as well. Developing excellent nonconfrontational communication skills is very important. The AACN Standards for Establishing and Sustaining Healthy Work Environments lists many resources that may be helpful to sharpen sharp·en tr. & intr.v. sharp·ened, sharp·en·ing, sharp·ens To make or become sharp or sharper. sharp your communication skills. Having a spirit of collaboration versus an "us against them" attitude can go a long way to set the tone. Talking with your clients prenatally about decision-making is the best time to help them begin to have an effective decision-making process. Letting them know that it is their responsibility to get the information they need to feel comfortable to make decisions and giving them some vocabulary to talk with healthcare providers, can be very helpful. Since nurses have many responsibilities and shift changes, it is often your continuity of care that can bridge many transitions. Recognize that physicians and nurses are in healthcare because they want to help people. They are making an important contribution to your clients' care. Acknowledging ways they have been helpful to your client may help them to be able to see the valuable role you play on the careprovider team. For copies of the Silence Kills study report and the AACN Standards for Establishing and Sustaining Healthy Work Environments, visit their website at http://www.rxforbettercare.org. Critical Elements of Skilled Communication * Critical communication skills include self-awareness, inquiry/dialogue, conflict management, negotiation, advocacy and listening. * Skilled communicators focus on finding solutions and achieving desirable outcomes. * Skilled communicators seek to protect and advance collaborative relationships among colleagues. * Skilled communicators invite and hear all relevant perspectives. Skilled communicators call upon goodwill and mutual respect to build consensus and arrive at common understanding. * Skilled communicators demonstrate congruence con·gru·ence n. 1. a. Agreement, harmony, conformity, or correspondence. b. An instance of this: "What an extraordinary congruence of genius and era" between words and actions. Excerpted from the AACN Standards for Establishing and Sustaining Healthy Work Environments |
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