Author Archive
Thursday, October 2nd, 2014
156
Student’s Guide – Everyone is a Monitor
Overview:
This story is about the impacts of adverse drug events (ADEs). Proper communication protocols between physicians and nursing home staff are essential to prevent patient ADEs.
Primary Learning Outcomes
After completing this lesson, the student will be able to:
- Describe evidence-based practices to improve medication safety, and the challenges in ensuring medication safety.
- Identify steps to improve medication safety, including empowering patients to be aware of the medications they are taking.
QSEN Pre-Licensure Competencies
The following QSEN competencies are addressed in this lesson:
- Evidence-Based Practice (EBP): Integrate best current evidence with clinical expertise and patient/family preferences and values for delivery of optimal health care.
- Safety: Minimizes risk of harm to patients and providers through both system effectiveness and individual performance.
Story Directions:
As you listen to and read the story, think about the things that you think the team members did well, and the things you think could lead to errors. Also, consider the questions below as you listen.
Reflection Questions:
- What evidence-based practices for medication safety were not followed in this story?
- What are some ways this team could ensure better medication safety for their patients?
Posted in Pro ED Guides, Student Guides | No Comments »
Thursday, October 2nd, 2014
155
Student’s Guide – No Shortcuts to Risk Reduction
Overview:
This story is about surgical site infections (SSIs). According to the CDC, SSIs are the second most common healthcare-acquired infection. Following evidence-based perioperative practices such as using precautions to prevent contamination of sterile equipment can prevent the risk of SSI.
Primary Learning Outcomes
After completing this lesson, you will be able to:
- List evidence-based perioperative practices that prevent SSIs.
- Demonstrate awareness of techniques to resolve conflict when team members take shortcuts in perioperative practices.
- Describe a strategy to improve SSI preventative practices, such as implementation of the WHO SSI checklist.
QSEN Pre-Licensure Competencies
The following QSEN competencies are addressed in this lesson:
- Patient-Centered Care: Recognize the patient or designee as the source of control and full partner in providing compassionate and coordinated care based on respect for patient’s preferences, values, and needs.
- Safety: Minimizes risk of harm to patients and providers through both system effectiveness and individual performance.
QSEN Teamwork & Collaboration Enrichment
TeamSTEPPS® Best Practice: CUS
Team Strategies to Enhance Performance and Patient Safety (TeamSTEPPS) is an evidence-based set of teamwork tools, aimed at optimizing patient outcomes by improving communication and teamwork skills among health care professionals.
CUS: The CUS technique provides a framework for conflict resolution, advocacy, and mutual support. Signal words, such as “danger,” “warning,” and “caution” are common in the medical arena. They catch the reader’s attention. “CUS” and several other signal phrases have a similar effect in verbal communication. When they are spoken, all team members will understand clearly not only the issue, but also the magnitude of the issue.
CUS Technique:
- First, state your Concern.
- Then state why you are Uncomfortable.
- If the conflict is not resolved, state that there is a Safety issue.
Story Directions:
As you listen to and read the story, think about the things that you think the team members did well, and the things you think could lead to errors. Also, consider the questions below as you listen.
Reflection Questions:
- What evidence-based perioperative practices were ignored in this story? Why are they important to follow?
- What barriers did Celeste face in addressing the breaks in evidence-based practice that she witnessed? What does this say about the norms of the unit?
- How could the use of the CUS Technique have helped Celeste address her concerns?
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Thursday, October 2nd, 2014
154
Student’s Guide – Patients are People Too
Overview:
This story illustrates how knowing about being patient-centered, and actually doing it, are two different things, and that staff must be intentional and self-aware about engaging the patient.
Primary Learning Outcomes
After completing this lesson, you will be able to:
- Identify the core components of patient-centered behavior.
- Describe the importance of planning for all care providers to demonstrate patient-centered behaviors in all interactions with patients and family members.
QSEN Pre-Licensure Competencies
The following QSEN competencies are addressed in this lesson:
- Patient-Centered Care: Recognize the patient or designee as the source of control and full partner in providing compassionate and coordinated care based on respect for patient’s preferences, values, and needs.
Story Directions:
As you listen to and read the story, think about the things that you think the team members did well, and the things you think could lead to errors. Also, consider the questions below as you listen.
Reflection Questions:
- What important elements of patient-centered care did Tiana and Javier miss in this story?
- Why is it important to view events from the patient’s perspective when evaluating the efficacy of patient-centered care?
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Thursday, October 2nd, 2014
153
Student’s Guide – No One Sits Until Everyone Sits
Overview:
This story is about mutual support and task assistance, and how offering assistance to other team members when your workload permits promotes safety, mutual trust, efficiency, productivity, and service excellence.
Primary Learning Outcomes
After completing this lesson, you will be able to:
- Describe the importance of adopting task sharing norms across team members to effectively manage workload.
- Identify high threat practices or protocols requiring increased shared vigilance.
- Generate team norms for engaging non-supportive team members to provide consistent mutual support.
QSEN Pre-Licensure Competencies
The following QSEN competencies are addressed in this lesson:
- Teamwork and Collaboration: Function effectively within nursing and inter-professional teams, fostering open communication, mutual respect, and shared decision-making to achieve quality patient care.
- Patient-Centered Care: Recognize the patient or designee as the source of control and full partner in providing compassionate and coordinated care based on respect for patient’s preferences, values, and needs.
QSEN Teamwork & Collaboration Enrichment
TeamSTEPPS® Best Practice: Task Assistance
Team Strategies to Enhance Performance and Patient Safety (TeamSTEPPS) is an evidence-based set of teamwork tools, aimed at optimizing patient outcomes by improving communication and teamwork skills among health care professionals.
Task Assistance is guided by situation monitoring because situation awareness allows team members to effectively identify the need for assistance by others on the team. To a certain degree, some of us have been conditioned to avoid asking for help because of the fear of suggesting lack of knowledge or confidence. Many people refuse to seek assistance when overwhelmed by tasks. In support of patient safety, however, task assistance is expected. One of the most important concepts to remember with regard to Task Assistance is that assistance should be actively given and offered whenever there is a concern for patient safety related to workload. Task assistance may involve asking for assistance when overwhelmed or unsure; helping team members to perform their tasks, shifting workload by redistributing tasks to other team members, delaying/rerouting work so the overburdened member can recover, and/or filling in for overburdened team members when necessary.
Story Directions:
As you listen to and read the story, think about the things that you think the team members did well, and the things you think could lead to errors. Also, consider the questions below as you listen.
Reflection Questions:
- What does this story illustrate about the importance of task assistance across the unit and hospital?
- What high threat practices and protocols were occurring in this story?
- What team norms did Jane establish for engaging non-supportive team members to provide consistent mutual support across the unit? Why was this important?
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Thursday, October 2nd, 2014
152
Student’s Guide – Let’s Huddle Up Here
Overview:
This story illustrates the importance of the TeamSTEPPS® “huddle” tool to keep everyone on the same page and allow for brief problem-solving before continuing the treatment plan as a patient’s condition changes.
Primary Learning Outcomes
After completing this lesson, the student will be able to:
- Identify the types of situations where huddles could be advantageous in coordinating patient care.
- Explain how and when huddles should be conducted.
- Describe how to adopt huddles as a normal problem-solving event for improved patient care.
QSEN Pre-Licensure Competencies
The following QSEN competencies are addressed in this lesson:
- Patient-Centered Care: Recognize the patient or designee as the source of control and full partner in providing compassionate and coordinated care based on respect for patient’s preferences, values, and needs.
- Teamwork and Collaboration: Function effectively within nursing and inter-professional teams, fostering open communication, mutual respect, and shared decision-making to achieve quality patient care.
QSEN Teamwork & Collaboration Enrichment
TeamSTEPPS® Best Practice: Huddles
Team Strategies to Enhance Performance and Patient Safety (TeamSTEPPS) is an evidence-based set of teamwork tools, aimed at optimizing patient outcomes by improving communication and teamwork skills among health care professionals.
Huddles: A huddle is a tool for reinforcing the plans already in place for the treatment of patients and for assessing the need to change plans. It can also help develop a shared understanding between team members of the plan of care and provides team leaders with the opportunity to informally monitor patient and unit-level situations. Huddles are particularly useful because information and patient status change over time, requiring ongoing monitoring and updating of the team. It may just be a matter of a sudden increase in the activity level of an individual or the team needing to reevaluate workload status. Workload distribution may have to be adjusted as a result. Information updates within the team should occur as often as necessary, and can take the form of a huddle at the status board or can occur between individual team members whenever new information needs to be shared.
Story Directions:
As you listen to and read the story, think about the things that you think the team members did well, and the things you think could lead to errors. Also, consider the questions below as you listen.
Reflection Questions:
- How would a huddle have been useful in this story?
- How could the use of huddles help a team better coordinate patient care?
- What were the barriers to using huddles in this story? How could they have been overcome?
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Thursday, October 2nd, 2014
151
Student’s Guide – CUS-sing for Safety’s Sake
Overview:
This story is about CUS, a TeamSTEPPS® tool that helps care providers find the right words to express their concerns when they become aware of something they think will compromise patient safety.
Primary Learning Outcomes
After completing this lesson, the student will be able to:
- Describe situations where the TeamSTEPPS® CUS tool would be appropriate to use to advocate for patient safety.
- Generate a plan for and practice using the TeamSTEPPS® CUS tool among providers and staff where there are unexpressed concerns about patient safety.
QSEN Pre-Licensure Competencies
The following QSEN competencies are addressed in this lesson:
- Evidence-Based Practice (EBP): Integrate best current evidence with clinical expertise and patient/family preferences and values for delivery of optimal health care.
- Teamwork and Collaboration: Function effectively within nursing and inter-professional teams, fostering open communication, mutual respect, and shared decision-making to achieve quality patient care.
QSEN Teamwork & Collaboration Enrichment
TeamSTEPPS® Best Practice: CUS Technique
Team Strategies to Enhance Performance and Patient Safety (TeamSTEPPS) is an evidence-based set of teamwork tools, aimed at optimizing patient outcomes by improving communication and teamwork skills among health care professionals.
The CUS technique provides a framework for conflict resolution, advocacy, and mutual support. Signal words, such as “danger,” “warning,” and “caution” are common in the medical arena. They catch the reader’s attention. “CUS” and several other signal phrases have a similar effect in verbal communication. When they are spoken, all team members will understand clearly not only the issue, but also the magnitude of the issue.
CUS Technique:
- First, state your Concern.
- Then state why you are Uncomfortable.
- If the conflict is not resolved, state that there is a Safety issue.
Story Directions:
As you listen to and read the story, think about the things that you think the team members did well, and the things you think could lead to errors. Also, consider the questions below as you listen.
Reflection Questions:
- Why was the use of CUS so important in this story? What might have happened if it had not been employed?
- Why is it important to express your concerns, regardless of hierarchy?
- What barriers did Marylou have to overcome in order to successfully use the CUS strategy?
Posted in Pro ED Guides, Student Guides | No Comments »
Thursday, October 2nd, 2014
150
Instructor’s Guide – See You Soon
Overview:
This story illustrates the likelihood of readmission in the absence of a coordinated care plan for the patient. Readmissions are often caused by preventable complications that occur during a transition from one care setting to another and may reflect poor coordination of care.
Primary Learning Outcomes
After completing this lesson, the student will be able to:
- List components of a coordinated discharge plan.
- Describe how to modify discharge processes to enhance communication between the hospital and discharge settings.
- Explain the importance of creating opportunities to involve patients and their families in discharge planning.
QSEN Pre-Licensure Competencies
The following QSEN competencies are addressed in this lesson:
- Patient-Centered Care: Recognize the patient or designee as the source of control and full partner in providing compassionate and coordinated care based on respect for patient’s preferences, values, and needs.
- Teamwork and Collaboration: Function effectively within nursing and inter-professional teams, fostering open communication, mutual respect, and shared decision-making to achieve quality patient care.
Reflection Questions:
Students will answer reflection questions upon completing the story. These questions are aligned with the QSEN competencies and are designed to help the student reflect on both the content of the story and the QSEN competencies addressed by the story.
*Following each question are some potential answers
- What components of a coordinated discharge plan are missing from this story?
A: It is unclear if the patient understood the discharge instructions. She repeated some of the words the nurse said, but it does not appear as if the patient had a good understanding of the discharge instructions.
- How could Andrea have modified her discharge process to enhance communication between the hospital and Mei Li and her family?
A: She could have waited until the family was present to provide the discharge information. She also could have provided information in a manner that was more understandable for Mei Li.
- What could Andrea have done to ensure that Anna was included in the discharge planning process?
A: She could have waited to provide the discharge information until Anna was present. She also could have provided a check off sheet with important information for the family.
Discussion Questions:
Use discussion questions for face to face or online discussion boards to get students to further reflect on the content of the story together.
*Following each question are some potential answers
- What can we learn from this story?
A: That patients want to learn more about their disease process and how to care for themselves, but it may be difficult for them. Sometimes health care providers provide a great deal of information to the patient, but the patient does not understand the information. Therefore, it is not helpful for the patient.
- What can you do to ensure patients and their caregivers actively participate in discharge planning?
A: One way is to ask the patient if they would like someone specific with them when the information is provided. Another way is to ask questions that require more than a “yes” or “no” response. Providing valuable information at the time of discharge is an important part of providing quality care for the patient.
Suggested Classroom Mastery Activities:
These activities can be tailored for individuals or groups in a face to face or online setting.
- List the components of a coordinated discharge plan. Be sure to include who should be involved and why. Discuss your components with others and compare.
- Write out a discharge plan for Mei Li that better meets her needs.
Measuring Student Mastery:
| Learning Outcome |
Level 1 |
Level 2 |
Level 3 |
| List components of a coordinated discharge plan. |
Student struggles to list components of a coordinated discharge plan. |
Student can list components of a coordinated discharge plan, but needs further practice. |
Student can accurately list components of a coordinated discharge plan. |
| Describe how to modify discharge processes to enhance communication between the hospital and discharge settings. |
Student struggles to describe how to modify discharge processes to enhance communication between the hospital and discharge settings. |
Student can describe how to modify discharge processes to enhance communication between the hospital and discharge settings, but needs further practice. |
Student can accurately describe how to modify discharge processes to enhance communication between the hospital and discharge settings. |
| Explain the importance of creating opportunities to involve patients and their families in discharge planning. |
Student struggles to explain the importance of creating opportunities to involve patients and their families in discharge planning. |
Student can explain the importance of creating opportunities to involve patients and their families in discharge planning, but needs further practice. |
Student can accurately explain the importance of creating opportunities to involve patients and their families in discharge planning. |
Additional Story-Specific Resources:
For additional information on improving team communication, please consult the following articles and resources in Further Reading:
Story-Specific Best Practices and Proven Tools:
In addition to the ideas generated by students and mentioned in the activities, there are established best practices that may be appropriate to introduce or reference during this lesson to support communication. Some best practices to consider for improving team communication include:
- Handoff
- Check-Backs
- Collaboration
- Bedside Handoffs
- SBAR
- Advocacy and Assertion
- I PASS the BATON
- Debriefs
- “Speak Up”
- 3Ws – Who I am, What I am Doing, and Why I Care
- Patient Rounding
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Thursday, October 2nd, 2014
149
Instructor’s Guide – Room for Improvement
Overview:
This story addresses patient falls. According to reports by the IHI, Robert Wood Johnson Foundation, and several studies, falls are three times more likely in hospitals and nursing homes than in the community. It is every team member’s responsibility to help prevent falls.
Primary Learning Outcomes
After completing this lesson, the student will be able to:
- Describe strategies to assess patients at risk for fall or at risk for injury from falls.
- Explain evidence-based fall prevention best practices.
QSEN Pre-Licensure Competencies
The following QSEN competencies are addressed in this lesson:
- Evidence-Based Practice (EBP): Integrate best current evidence with clinical expertise and patient/family preferences and values for delivery of optimal health care.
- Safety: Minimizes risk of harm to patients and providers through both system effectiveness and individual performance.
Reflection Questions:
Students will answer reflection questions upon completing the story. These questions are aligned with the QSEN competencies and are designed to help the student reflect on both the content of the story and the QSEN competencies addressed by the story.
*Following each question are some potential answers
- What evidence-based practices could be used to prevent falls and reduce harm from falls?
A: One way is to investigate what the most common falls are, and work to reduce common falls in a hospital. The IHI, along with other resources, have a variety of resources to help identify common falls.
- What could have been done in this story to prevent Mrs. Shreaver’s fall?
A: One way is to attach a bed alarm to the patient. This can either be something that is attached to the patient or the bed and it makes a loud noise when the patient gets out of the bed.
Discussion Questions:
Use discussion questions for face to face or online discussion boards to get students to further reflect on the content of the story together.
*Following each question are some potential answers
- What can we learn from this story?
A: We have learned that no one was intentionally trying to hurt the patient, however harm still occurred. It is important to have every member of the team aware of any patient that may be at risk for fall or injury.
- How can I monitor patients in order to reduce the risk of falls and injury?
A: One way is to keep those patients at risk for falls closer to the nurse’s station. Another way is to attach a bed alarm to the patient. Another way to reduce harm is to ensure all team members are aware of those at risk for falls and to check on those patients more often.
Suggested Classroom Mastery Activities:
These activities can be tailored for individuals or groups in a face to face or online setting.
- Create a guide for medical staff to remind them of evidence-based practices for preventing falls.
- Make a list of best practices for preventing falls to share with your classmates. Create a top ten list of the best ideas.
Measuring Student Mastery:
| Learning Outcome |
Level 1 |
Level 2 |
Level 3 |
| Describe strategies to assess patients at risk for fall or at risk for injury from falls. |
Student struggles to describe strategies to assess patients at risk for fall or at risk for injury from falls. |
Student can describe strategies to assess patients at risk for fall or at risk for injury from falls, but needs further practice. |
Student can accurately describe strategies to assess patients at risk for fall or at risk for injury from falls. |
| Explain evidence-based fall prevention best practices. |
Student struggles to explain evidence-based fall prevention best practices. |
Student can explain evidence-based fall prevention best practices, but needs further practice. |
Student can accurately explain evidence-based fall prevention best practices. |
Additional Story-Specific Resources:
For additional information on improving team communication, please consult the following articles and resources in Further Reading:
Story-Specific Best Practices and Proven Tools:
In addition to the ideas generated by students and mentioned in the activities, there are established best practices that may be appropriate to introduce or reference during this lesson to support communication. Some best practices to consider for improving team communication include:
- Feedback
- Check-Backs
- Collaboration
- Handoff
- “Speak Up”
- SBAR
- I’M SAFE
- AskMe3
- Advocacy and Assertion
- Patient Rounding
- 3Ws – Who I am, What I am Doing, and Why I Care
Posted in Pro ED Guides, Teacher Guides | No Comments »
Thursday, October 2nd, 2014
148
Instructor’s Guide – One Big Team
Overview:
This story demonstrates the benefits of a care team functioning as a unified whole where everyone assumes responsibility for every job getting done when it comes to the patient’s safety and satisfaction.
Primary Learning Outcomes
After completing this lesson, the student will be able to:
- Identify and summarize the problems that are caused by an “it’s not my job” attitude.
- Generate guidelines for how to respond to patients’ requests when the request is outside the staff member’s particular functional responsibilities.
- Describe the importance of the distribution of guidelines to every unit in the hospital.
QSEN Pre-Licensure Competencies
The following QSEN competencies are addressed in this lesson:
- Teamwork and Collaboration: Function effectively within nursing and inter-professional teams, fostering open communication, mutual respect, and shared decision-making to achieve quality patient care.
- Patient-Centered Care: Recognize the patient or designee as the source of control and full partner in providing compassionate and coordinated care based on respect for patient’s preferences, values, and needs.
Reflection Questions:
Students will answer reflection questions upon completing the story. These questions are aligned with the QSEN competencies and are designed to help the student reflect on both the content of the story and the QSEN competencies addressed by the story.
*Following each question are some potential answers
- How did the “it’s not my job” attitude of the staff in the story affect Kathy’s care?
A: Kathy may have felt less confident in the skills of the staff when they continued to focus on their other work and not on her question. Kathy was no longer the center of care, but rather the tasks that everyone needed to complete became the focus of care.
- How could guidelines that help staff members respond to patient requests outside of their responsibilities have helped Kathy?
A: Guidelines to help staff with requests outside of their responsibilities would have helped Kathy to feel more included in the care provided. It would have also allowed other members of the health care team to assist in the situation. Sometimes other healthcare members are not given the opportunity to help out, even if they wanted to.
- Why is it important that all staff members are on the same page regarding policies about patient-centered care?
A: It is very easy for health care providers to get “caught up” in their own work and forget about the needs of the patient. If all staff members are on the same page it is easier to reach the goal of quality patient care.
Discussion Questions:
Use discussion questions for face to face or online discussion boards to get students to further reflect on the content of the story together.
*Following each question are some potential answers
- What can we learn from this story?
A: She wanted to comply with the diet order set out by her doctor, but she was unsure if the meal tray she had received was correct. She was asking a rather simple question, however no one that she spoke to was able to assist her.
- What can I do to encourage everyone in every function to look at ourselves and behave as one, well-functioning team?
A: One way is to facilitate open communication between all team members. The responsibility in this scenario was left to the primary nurse, however it could have been handled by another nurse. Also, the other team members could have done a better job of keeping Kathy the focus of the care and not the numerous tasks they were trying to accomplish.
Suggested Classroom Mastery Activities:
These activities can be tailored for individuals or groups in a face to face or online setting.
- Generate guidelines for how to respond to patients’ requests when the request is outside the staff member’s particular functional responsibilities.
- Describe how you might distribute your guidelines for patient-centered care to all units and staff in the hospital?
Measuring Student Mastery:
| Learning Outcome |
Level 1 |
Level 2 |
Level 3 |
| Identify and summarize the problems that are caused by an “it’s not my job” attitude. |
Student struggles to identify and summarize the problems that are caused by an “it’s not my job” attitude. |
Student can identify and summarize the problems that are caused by an “it’s not my job” attitude, but needs further practice. |
Student can accurately identify and summarize the problems that are caused by an “it’s not my job” attitude. |
| Generate guidelines for how to respond to patients’ requests when the request is outside the staff member’s particular functional responsibilities. |
Student struggles to generate guidelines for how to respond to patients’ requests when the request is outside the staff member’s particular functional responsibilities. |
Student can generate guidelines for how to respond to patients’ requests when the request is outside the staff member’s particular functional responsibilities, but needs further practice. |
Student can accurately generate guidelines for how to respond to patients’ requests when the request is outside the staff member’s particular functional responsibilities. |
| Describe the importance of the distribution of guidelines to every unit in the hospital. |
Student struggles to describe the importance of the distribution of guidelines to every unit in the hospital. |
Student can describe the importance of the distribution of guidelines to every unit in the hospital, but needs further practice. |
Student can accurately describe the importance of the distribution of guidelines to every unit in the hospital. |
Additional Story-Specific Resources:
For additional information on improving team communication, please consult the following articles and resources in Further Reading:
Story-Specific Best Practices and Proven Tools:
In addition to the ideas generated by students and mentioned in the activities, there are established best practices that may be appropriate to introduce or reference during this lesson to support communication. Some best practices to consider for improving team communication include:
- Huddles
- Check-Backs
- Collaboration
- 4 Step Process
- Cross Monitoring
- 3Ws – Who I am, What I am Doing, and Why I Care
- Task Assistance
- AskMe3
- “Speak Up”
Posted in Pro ED Guides, Teacher Guides | No Comments »
Thursday, October 2nd, 2014
147
Instructor’s Guide – Can You Suggest A Solution?
Overview:
This story is about how you can put the emphasis on respectful problem-solving and building buy-in and responsibility-taking when disruptive or unprofessional behavior affects patients by slowing their care, thereby increasing the risk of error or omission.
Primary Learning Outcomes
After completing this lesson, the student will be able to:
- Summarize the tools and techniques used in an engagement approach to resolving unprofessional conduct issues.
- Evaluate the appropriateness of an engagement approach versus a disciplinary approach for any given example of unprofessional conduct.
- Plan for an engagement-approach discussion with a peer or subordinate who is exhibiting unprofessional conduct.
QSEN Pre-Licensure Competencies
The following QSEN competencies are addressed in this lesson:
- Teamwork and Collaboration: Function effectively within nursing and inter-professional teams, fostering open communication, mutual respect, and shared decision-making to achieve quality patient care.
Reflection Questions:
Students will answer reflection questions upon completing the story. These questions are aligned with the QSEN competencies and are designed to help the student reflect on both the content of the story and the QSEN competencies addressed by the story.
*Following each question are some potential answers
- What tools and techniques were used in this story to resolve unprofessional conduct issues?
A: An engagement approach was used in this situation. Bob was treated with respect when he was spoken to by Kim. She let him know what was expected of him, but did not make him feel that he was not part of the team.
- Do you think Kim would have had a different reaction from Bob if she had taken a disciplinary approach to the problem? Why?
A: Yes, Bob would have most likely become defensive and angry if she would have used a disciplinary approach. It is important that Bob feels he has respect and is part of the decision-making process.
- What do you think Kim did well in this story to begin building the kind of teamwork she wants to see in her unit?
A: She kept the patient the focus of the conversation and not the other staff. She made patient safety the priority and did not focus on the dispute between the two staff members.
Discussion Questions:
Use discussion questions for face to face or online discussion boards to get students to further reflect on the content of the story together.
*Following each question are some potential answers
- What can we learn from this story?
A: We have learned that patients are always listening, even if we don’t think they are. They are very aware of the attitudes and actions made by the health care team members.
- What can I do to engage colleagues and subordinates in discussions to resolve unprofessional conduct issues?
A: One was is to keep the patient the focus of the discussion. Patient-centered care means that health care professionals need to keep the patient the focus of care. Another way is to use shared-decision making. When staff feel they are a part of the solution they are more likely to join in the change process.
Suggested Classroom Mastery Activities:
These activities can be tailored for individuals or groups in a face to face or online setting.
- Create and write a script for an engagement-approach discussion with a peer or subordinate who is exhibiting unprofessional conduct.
- Develop a presentation to help your colleagues access tools and techniques that would allow them to use the engagement approach for dealing with conflict with subordinates or peers.
Measuring Student Mastery:
| Learning Outcome |
Level 1 |
Level 2 |
Level 3 |
| Summarize the tools and techniques used in an engagement approach to resolving unprofessional conduct issues. |
Student struggles to summarize the tools and techniques used in an engagement approach to resolving unprofessional conduct issues. |
Student can summarize the tools and techniques used in an engagement approach to resolving unprofessional conduct issues, but needs further practice. |
Student can summarize accurately the tools and techniques used in an engagement approach to resolving unprofessional conduct issues. |
| Evaluate the appropriateness of an engagement approach versus a disciplinary approach for any given example of unprofessional conduct.
| Student struggles to evaluate the appropriateness of an engagement approach versus a disciplinary approach for any given example of unprofessional conduct. |
Student can evaluate the appropriateness of an engagement approach versus a disciplinary approach for any given example of unprofessional conduct, but needs further practice. |
Student can evaluate accurately the appropriateness of an engagement approach versus a disciplinary approach for any given example of unprofessional conduct. |
| Plan for an engagement-approach discussion with a peer or subordinate who is exhibiting unprofessional conduct. |
Student struggles to plan for an engagement-approach discussion with a peer or subordinate who is exhibiting unprofessional conduct. |
Student can plan for an engagement-approach discussion with a peer or subordinate who is exhibiting unprofessional conduct, but needs further practice. |
Student can plan accurately for an engagement-approach discussion with a peer or subordinate who is exhibiting unprofessional conduct. |
Additional Story-Specific Resources:
For additional information on improving team communication, please consult the following articles and resources in Further Reading:
Story-Specific Best Practices and Proven Tools:
In addition to the ideas generated by students and mentioned in the activities, there are established best practices that may be appropriate to introduce or reference during this lesson to support communication. Some best practices to consider for improving team communication include:
- Advocacy and Assertion
- Collaboration
- Cross Monitoring
- CUS
- DESC Script
- Feedback
- I’M SAFE
- STEP
- Task Assistance
- Two-Challenge Rule
- 4 Step Process
- PEARLA
Posted in Pro ED Guides, Teacher Guides | No Comments »
