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Improved Communication Benefits Surgical ICUs

Improved Communication Benefits Surgical ICUs

In complex environments like surgical ICUs, integrated team performance and effective communication skills are vital to positive patient outcomes. These skills are critical because breakdowns in communication have reportedly been responsible for nearly 85% of sentinel events that lead to increased length of stay in the hospital, higher morbidity, and more litigious actions. Patients most susceptible to negative outcomes as a result of communication errors are those who are acutely ill in the surgical ICU. Improving communication among healthcare teams enhances the quality of care and has the potential to reduce the likelihood of negative patient outcomes. Identifying Communication Barriers In surgical ICUs, it’s important to ensure that the knowledge and experience of attending surgeons are appropriately utilized by the residents and fellows executing the care. Anytime there is a communication breakdown or a barrier that prevents essential information flow, there is a risk of accentuating negative patient outcomes either directly or indirectly. In the January 2010 Journal of the American College of Surgeons, my colleagues and I initiated a prospective observational trial to evaluate communication between surgical ICU residents and fellows following the occurrence of hypotension, new arrhythmias, desaturation, and tachypnea. Our study found that a third of these critical events were never reported to an upper level physician, and a quarter of these events resulted in negative short-term outcomes.   There are many reasons why these events may not be properly communicated to senior surgeons, including overconfidence, complacency, and/or fear of appearing to be incompetent. Much of this behavior is attributed to the traditional evaluation of medical students where individual performance is rewarded. However, it’s clear that efforts...
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