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Vishal Vyas Foundation Year 1 Doctor Barnet and Chase Farm Hospitals NHS Trust Academic Foundation Year 1 Representative for London Deanery.

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Presentation on theme: "Vishal Vyas Foundation Year 1 Doctor Barnet and Chase Farm Hospitals NHS Trust Academic Foundation Year 1 Representative for London Deanery."— Presentation transcript:

1 Vishal Vyas Foundation Year 1 Doctor Barnet and Chase Farm Hospitals NHS Trust Academic Foundation Year 1 Representative for London Deanery

2 Background Methods Results Conclusions Limitations Literature Acknowledgements

3 Inter-professional telephone communication during on- call shifts felt to be of a highly variable quality. For a significant proportion of received telephone calls, FY1 doctors felt they had an inadequate handover. Poor written/verbal communication – one of the most common sources of serious error. No data available to quantify/validate the quality of communication at Barnet and Chase Farm Hospitals NHS Trust. SBAR is the official handover tool used by the Trust.

4 Structured method of communication between health professionals. Simple and effective; well-established in military, aviation and acute medical settings. Ensures critical information that required urgent attention/action communicated. Effective escalation and improved safety. 4 steps: Situation, Background, Assessment, Recommendation.

5 Reduces barriers to communication between different health care professionals/ levels of staff. Takes the uncertainty out of communication through a shared mental model. Easy to remember

6 Nurse-doctor, doctor-doctor, between other allied health professionals etc. Change of shift e.g. handover meeting Escalating a concern Telephone handover/referral Urgent or non-urgent Inpatient or outpatient

7 Prospectively designed data collection sheet, trained FY1 doctors asked to rate calls received by healthcare professionals. Communication across Trust and across medical/ surgical wards. Data collected on the caller e.g. doctor/nurse, grade, location of caller. FY1 doctors rated the quality of calls: Likert scale of 1-10 how useful were the calls in helping them to prioritize tasks

8 Health Professional Number of calls Doctor34 Nurse31 Total65 Doctor Grade Number of calls FY112 SHO13 SpR8 Consultant1 Total34 Nurse Grade Number of calls Staff Nurse 25 Sister/Ch arge Nurse 5 Senior Sister/Sen ior Charge Nurse 1 Total31

9

10 p=

11 * * = p=<0.0001

12 *

13 *

14 Majority of calls used SBAR (72%) with the overall communication being rated at 8/10. Overall, calls using SBAR were rated as significantly better than those did not use SBAR (median 9 vs. 4, p=<0.0001) Calls using SBAR consistently significantly better across doctors and nurses and throughout the various grades. A sizeable proportion of staff nurses did not use SBAR (44%) with the median rating of communication significantly lower (4) compared to when SBAR (7) was used (p=<0.0001).

15 Small sample size (n=65 telephone calls) Only FY1 on-call observers to receive calls Single Trust sample – difficult to extrapolate data to other trusts Lack of data on quality of care/patient outcomes Need for formal education programme

16 SBAR improved nurse-doctor communication leading to better documentation and fewer unexpected deaths 1 SBAR improved call impact in telephone from junior doctors and reduced the time taken to present the referral 2 1 De Meester K, Verspuy M, Monsieurs KG, Van Bogaert P. SBAR improves nurse-physician communication and reduces unexpected death: A pre and post intervention study. Resuscitation 2013 March Cunningham NJ, Weiland TJ, van Dijk L, Paddle P, Shilkofski N, Cunningham NY. Telephone referrals by junior doctors: a randomised controlled trial assessing the impact of SBAR in a simulated setting. Postgrad Med J Nov;88!0145):619-26

17 All staff at Barnet and Chase Farm Hospitals NHS Trust particularly FY1 colleagues for their assistance in kindly rating calls and collecting data Dr James Dooley


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