Communicationfailure is the leading cause of medical errors such as gaps in health care,incomplete or missing information, medication errors. Effective Communicationmainly supports the foundation of patient care. Effective Hand-off reportingduring shift change is an important component of safe and effective care. Ineffectivehandoff communication is a critical threat to patient safety.
The problems thatresult from ineffective handoffs are delayed or wrong treatment, decline in thequality of care, patient safety outcome is declined. The factors that interferewith effective handoffs are stressful work environment, leadership and managementconcerns, multitasking and ineffective teamwork. Poor teamwork andcommunication between medical and nonmedical health personnel’s increases patientsafety incidents. The SBAR tool alone will not improve patient safety outcomesbut an educational intervention that provides information on effectivecommunication techniques and styles, good teamwork strategies will have apositive effect on work environment, resulting in improved communication,teamwork, patient satisfaction, patient safety outcomes. Leadership is also responsiblefor ineffective handoff reporting if the management fails in developingstrategies to reduce communication failure which is mainly due to poor teamenvironment, no proper planning, lack of practice, knowledge, skills and confidencewithin the health care team members, inadequate staffing and overworked nursesor other health care team members.
It is also important for the hospitaladministrative team to invest time in the development of a standardized anddefined reporting tool like SBAR to facilitate effective handoff procedures. Theimplementation of written handover policy is an essential step towards reducingmedical errors which in return decreases the financial costs to the system dueto medico-legal claims. Nurse leader also plays an essential role inimplementing processes that helps to clearly define the transfer ofresponsibility from one health care member to another, standardize thecommunication process with the use of SBAR tool and allow for an interactiveexchange of information in order to facilitate positive patient outcomesthroughout the healthcare continuum. Nurses can assume a leadership role byworking with other disciplines to review current processes and doing an initialinventory of existing transition of care communication processes. Afterdetermining what transition of care processes exist currently, processes can beanalysed by comparing the information that needs to be provided during eachtransition of care with the information that is actually being provided.
If theappropriate information is already being shared and both senders and receiversare satisfied with the quality and quantity of information provided, theorganization may already have an effective standardized method forcommunication during transitions of care and processes do not need to be revised.Nurse leaders can advocate at the policy level for implementing creative SHAREsolutions for hand-off communications. Nurse Leaders can continue to identifybarriers to safe and effective hand-offs and use targeted strategies likeeffective communication styles and techniques, SBAR tool to solve theseproblems in delivering safe, quality care. By taking leadership, it is the dutyof the health care team leader to ensure that health-care organizationsimplement systems which ensure at the time of hospital discharge that thepatient and the next health-care provider are given key information regardingdischarge diagnoses, treatment plans, medications, and test results. Initiativestowards incorporation of training on effective hand-over communication into theeducational curricula and continuing professional development for health-careprofessionals.
The team leader must also encourage communication betweenorganizations that are providing care to the same patient in parallel (forexample, traditional and non-traditional providers). By taking leadership thehealth care provider can engage the patients and family member in decisionsabout their care. The health care provider should also provide patients withinformation about medical condition and treatment care plan in a way that thepatient can understand.