Vol. 33, No. 1     Winter 2010
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Photo of a simulated infant patient from the Institute for Simulation and Interprofessional Studies (ISIS)

Pharmacy, MEDEX and fourth-year nursing and medical students at the UW soon will benefit from a pilot project in communications, funded in part by the Hearst Foundation. “We want [students] to know that no one discipline takes care of the patient,” says Associate Dean Brenda Zierler, School of Nursing. “It’s really a team approach.” Above: a photo of a simulated infant patient from the Institute for Simulation and Interprofessional Studies (ISIS), where the
pilot project will be held.

Fostering Teamwork Among Doctors and Nurses: The William Randolph Hearst Foundation

If you’ve ever stayed in or visited a hospital, you’ve probably witnessed the “patient relay” — that moment when nurses, doctors and other healthcare personnel pass the “baton” of information from one person or team to the next. Health-care professionals do this all the time, updating each other on a patient’s progress, medication change or transfer. They also share vital information during medical procedures, like surgery, or at the end of a shift or workday.

Information-sharing is essential to good care. It’s also tricky, says Brenda K. Zierler, associate dean of technology innovations in education and research, Department of Biobehavioral Nursing and Health Systems, University of Washington. “According to the Institute of Medicine, communication is the leading cause of [medical] errors in the country…communication, or the lack thereof, was identified as a patient-safety problem,” she says.

With help from the William Randolph Hearst Foundation, and with a grant made by the Josiah Macy, Jr. Foundation, Zierler, her UW Medicine colleague Brian K. Ross, M.D. ’83, Res. ’87, professor of anesthesiology, and others are developing a pilot program to enhance patient safety by improving interprofessional communications.

This program will be conducted at a site devoted to enhanced patient safety — the University’s Institute for Simulation and Interprofessional Studies. ISIS contains sophisticated equipment that allows trainees to practice skills and procedural competencies, from suturing to full-blown surgery, before ever treating a real patient.

“We not only train simple to very complex skills, but we also train health-care teams, medical physicians or internists, anesthesiologists, surgeons and family practice physicians, in teams with their nurses, pharmacists and social workers, all of them working together to deliver high-quality care to patients,” says Ross, ISIS’s director.

To improve the ways doctors and nurses communicate, says Zierler, the pilot will bring together fourth-year medical and nursing students, as well as people studying to be pharmacists and physician assistants, in ISIS’s simulated operating room. The students share competencies, says Zierler; they know how to interview a patient and how to diagnose. This strong, common clinical foundation will allow them to focus on communication: respect, presenting and absorbing information, working as a team.

Catherine Pyke, program officer at the Hearst Foundation, says her board liked the UW’s approach of training professionals together in simulated scenarios, as well as the UW’s reputation. “Our board members were honored to work with a university whose Schools of Nursing and Medicine are among the best in the nation,” she says.

With Hearst’s support, says Zierler, students and faculty are developing an assessment tool that will evaluate the effectiveness of the pilot project; at the same time, students and faculty are developing clinical scenarios for the operating room, complete with “trigger points” for good communication. When they’re finished, a different group of students will begin the pilot course. A module to bring faculty up to speed in interprofessional communication also is in the works.

“I don’t think that healthcare professionals should all be the same because we’re not the same; we all bring different perspectives,” says Zierler. “But when we do the same thing, let’s train together so that people can understand what the other discipline knows, value and respect the differences, and find out how they can work together as a team to provide safe, quality care.”

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