Module 3

Assumptions

Fatigue
Distractions
HIPAA

COMMUNICATION
(DRAFT)

SUBSECTIONS
•
•
•
•

Importance of
Communication
Communication Definition,
Standards, and Challenges
Communication Challenges
Information Exchange
Strategies and Tools (e.g.,
SBAR, Check-Back, CallOut, and Handoff)

TIME: 45 minutes

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Communication

INSTRUCTOR OUTLINE: COMMUNICATION
Instructor Note: In this module, you will present information
about communication. It is important to convey the importance of
communication and how effective information exchange strategies
can improve resident safety.
The Communication module includes the content provided in the
outline below. More content is available than can be covered in
the time provided; therefore, optional content and activities are
noted. It is strongly recommended that instruction not focus solely
on lecture, but also includes exercises, videos, and other
activities. As such, instructors should use the information below to
plan how the module will be taught within the time available.
Content
1. Introduction
2. Importance of
Communication
3. Communication Failures

Page #

Approx. Time

5- 6

3 mins

7

2 mins

8- 9

3 mins*

4. Communication:
Definition, Standards,
Challenges

10 - 15

10 mins

5. Information Exchange
Strategies

16 - 27

2 mins

7. Applying TeamSTEPPS
Exercise

29

5 mins

MATERIALS:
• Flipchart or
Whiteboard
(Optional)
• Markers
(Optional)

• Call-Out
Subacute Video
(Call-Out_
Subacute.mpg)

30 mins

28

45 minutes

• SBAR LTC
Video
(SBAR_LTC.mpg)

(Challenges
Examples*)

6. Tools and Strategies
Summary

Slide
MODULE
TIME:

• Check-Back LTC
Video (CheckBack_LTC.mpg)
• Handoff
Subacute Video
(Handoff_
Subacute.mpg)

*Although all instructional content and activities are recommended to
ensure that participants achieve the learning objectives, these
activities may be considered “optional” if time is constrained.

• I PASS the
BATON LTC
Video
(I_PASS_the_
BATON_LTC.mpg)
• TeamSTEPPS
Implementation
Worksheet

Continued…
TeamSTEPPS for Long-Term Care | Communication

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Communication

INSTRUCTOR OUTLINE: COMMUNICATION
(Continued)

Slide
Additional Resources: Below are sources of additional
information and videos you may want to use to customize this
module to your participants.
•

TeamSTEPPS for Long-Term Care DVD: The
TeamSTEPPS for Long-Term Care DVD includes Specialty
Scenarios and additional videos that can be used to
customize your instruction.

•

TeamSTEPPS 2.0: Includes videos specific to the use of the
communication tools and strategies in multiple hospital settings.
• http://www.ahrq.gov/professionals/education/curriculumtools/teamstepps/instructor/index.htm l

•

TeamSTEPPS for Office-Based Care Version: Includes
videos specific to the use of the communication tools and
strategies in the primary care setting.
• http://www.ahrq.gov/professionals/education/curriculumtools/teamstepps/primarycare/index.html

•

TeamSTEPPS Rapid Response Systems Module (RRS):
Includes videos specific to the use of the communication
tools and strategies by Rapid Response Teams.
• http://www.ahrq.gov/professionals/education/curriculumtools/teamstepps/rrs/index.html

•

DoD Patient Safety Program SBAR Toolkit:
• http://www.health.mil/Military-Health-Topics/Access-Cost-Qualityand-Safety/Quality-And-Safety-of-Healthcare/PatientSafety/Patient-Safety-Products-And-Services/Toolkits/SBARToolkit

•

Comprehensive Unit-Based Safety Program (CUSP)
“Implement Teamwork and Communication” Module:
Includes information on some of the communication tools
and strategies taught in TeamSTEPPS.
• http://www.ahrq.gov/professionals/education/curriculumtools/cusptoolkit/index.html

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Communication

OBJECTIVES
SAY:
Following this module, you will be able to:
•

Describe how communication affects team processes and
outcomes;

•

Define effective communication;

•

Identify communication challenges; and

•

Identify TeamSTEPPS tools and strategies that can improve a
team’s communication.

TeamSTEPPS for Long-Term Care | Communication

Slide

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Communication

TEAMSTEPPS TEAMWORK SKILLS
SAY:
So far, we have covered the following in the TeamSTEPPS
framework:
•

Slide

Team Structure, which facilitates teamwork by identifying the
individuals among which information must be communicated,
a leader must be clearly designated, and mutual support must
occur.

In this module, we will cover Communication. Communication is the
lifeline of a well-functioning team and serves as a coordinating
mechanism for teamwork. Effective communication skills are vital for
resident safety and interplay directly with the other components of the
TeamSTEPPS framework. Further, communication is the mode by
which most of the TeamSTEPPS tools and strategies are executed.
Therefore, this module serves as the basis for the leading teams,
situation monitoring, and mutual support modules that will follow.
This module will discuss the standards of effective communication
and will present information exchange strategies and specific tools
to enhance communication among team members.

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IMPORTANCE OF COMMUNICATION

Communication

SAY:
The continued importance of effective communication in care
teams cannot be understated. According to sentinel event data
compiled by the Joint Commission between 1995 and 2005,
ineffective communication was identified as the root cause of 66
percent of reported errors. More recent Joint Commission data
from 2010 to 2013 show that ineffective communication has
remained among the top three root causes of sentinel events. As
these data illustrate, failure to communicate effectively as a team
significantly increases the risk of error.

Slide

Additional information about sentinel events and root causes can
be found on the Joint Commission website:
http://www.jointcommission.org/sentinel_event.aspx

TeamSTEPPS for Long-Term Care | Communication

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Communication
Slide

(OPTIONAL) COMMUNICATION FAILURES
Instructor Note: Create a slide showing your organizational
data related to the top causal factors for inadequate information
sharing using local, state, regional, or other benchmark data as
appropriate. Discuss findings with the group regarding root cause
analyses from events that occur in your nursing home or are noted
on your slide.
Examples of contributing factors can be found at:
http://www.jointcommission.org/sentinel_event.aspx
ASK:
•

Can you describe an example in which a communication
breakdown was the major contributing factor of an error in care?

Instructor Note: The following examples can be read aloud
for discussion, using the questions listed below each example.
Example 1:
•

Jack, a newly admitted resident to the subacute unit, is at the
nursing home for rehabilitation following hospitalization for an
acute episode of congestive heart failure. The dietitian orders
a low salt diet and speaks with Jack and his wife about the
importance of eating low sodium foods and not adding salt to
any foods. They agree and say they have been following those
recommendations as given by their doctor. Jack says that he
misses foods such as ham, but is thankful he can still eat
bacon.

ASK:
•
•

What might the dietician have said to cause confusion?
What information should be included and communicated to the
resident so he is fully informed of potential outcomes?

Example 2:
•

Christine, a resident who takes warfarin, is noted to have a
bloody nose, bleeding gums, and a large bruise on her arm.
The nurse reports these findings to her physician. The
physician orders a CBC and INR and assumes the nurse
understands his intent to have these labs drawn stat. The
nurse orders the labs to be drawn on the next lab day, 2 days
from now.

ASK:
•

How could the physician more effectively communicate to the
nurse what is needed?

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(OPTIONAL) COMMUNICATION FAILURES
(Continued)

Communication
Slide

SAY:
Lack of communication among department staff can lead to failure
to:
• Share information with the team;
• Request information from others;
• Direct information to specific team members; and
• Include residents and their families in communication
involving their care.
Examples of missed communication opportunities include:
• Unavailable or underutilized status board;
• Inconsistencies in the utilization of automated systems;
• Poor documentation—not timed, nonspecific, illegible, and
incomplete; and
• Failure to seek input from the resident.
In this module, we will discuss approaches to promote effective
communication.

TeamSTEPPS for Long-Term Care | Communication

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Communication

COMMUNICATION IS…
SAY:

Slide

Communication is defined as the transfer or exchange of
information from a sender to a receiver. More specifically,
communication is a process whereby information is clearly and
accurately conveyed to another person using a method that is
known and recognized by all involved. It includes the ability to
ask questions, seek clarification, and acknowledge the message
was received and understood. One critical result of effective
communication is a shared understanding, between the sender
and receiver(s) of the information conveyed.
Two considerations in communication are whom you are
communicating with and how you are communicating information.
•

Whom you are communicating with, or the audience, will
influence how information is conveyed. For example, an
information exchange with a nurse aide may differ from an
exchange with a physician.

•

In terms of how you communicate, there are two modes
of communication: verbal and nonverbal.

We will cover standards of effective communication shortly.
These relate primarily to verbal communication.
Nonverbal communication can take several forms. Written
communication is common in health care. This form of nonverbal
communication should adhere to many of the same standards we
will discuss shortly. In addition, one should be mindful of
standards associated with written communication, such as the
Joint Commission’s “Do Not Use” list of abbreviations.
More information about the “Do Not Use” List of Abbreviations can
be found on the Joint Commission website:
http://www.jointcommission.org/facts_about_do_not_use_list/

Continued…

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COMMUNICATION IS… (Continued)

Communication

SAY:
Another form of nonverbal communication is body language. The
way you make eye contact and the way you hold your body during
a conversation are signals that can be picked up by the person
with whom you are communicating. Body language plays a
significant role in communication. In a face-to-face communication,
words account for 7 percent of the meaning, tone of voice
accounts for 38 percent of the meaning, and body language
accounts for the remaining 55 percent. Although powerful, this
mode of communication does not provide an acceptable mode to
verify or validate (acknowledge) information.
A third form of nonverbal communication is visual cues. For
example, the use of color coding for assignments, charts, scrubs,
orders, and so on can help team members identify the information
they need quickly.
To avoid making assumptions that can lead to error, you should
verify in writing or orally any nonverbal communication, such as
body language or visual cues, to ensure resident safety. The
simple rule is, “When in doubt, check it out, offer information, or
ask a question.”
ASK:
•

Can you provide examples from your work setting when
nonverbal communication produced a breakdown in
teamwork?

•

Did you know the actual intent of the person?

Instructor Note: If responses to the questions above do
not provide sufficient examples, the one below may be read
aloud to participants.
Example:
•

The nonverbal cues a doctor gives when looking at an ECG
would quickly tell the nurse the severity of the situation and
might lead to proactive action. Likewise, the nonverbal cues
from the nurse’s face might communicate the urgency of the
situation and need for interruption to a doctor who is with a
resident’s family members.

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Communication

STANDARDS OF EFFECTIVE
COMMUNICATION
SAY:
When sharing information with the team, which can include other
providers, residents, or family members, communication must
meet four standards to be effective.
Effective communication is:

Slide

•

Complete
– Communicate all relevant information while avoiding unnecessary
details that may lead to confusion
– Leave enough time for questions, and answer questions
completely

•

Clear
– Use information that is plainly understood (lay terminology with
residents and their families)
– Use common or standard terminology when communicating with
members of the team

•

Brief
– Be concise

•

Timely
– Be dependable about offering and requesting information
– Avoid delays in relaying information that could compromise a
resident’s situation
– Note times of observations and interventions in the
resident’s record
– Update residents and families frequently
– Verify authenticity, which requires checking that the information
received was the intended message of the sender
– Validate or acknowledge information

Example:
A well-written discharge prescription is:
•

Complete—It includes medication, dosage, frequency, and caregiver
instructions

•

Clear—It is clearly written and legible

•

Brief—It contains only the necessary information

•

Timely—It is written before discharge

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Communication

BRIEF, CLEAR, AND TIMELY
SAY:
Provide information that is brief, yet as complete as possible. Do
not overexplain the situation; be concise.
Be clear—Plainly understood.
Timely—Looks like it may be a little too late for these penguins!

Slide

MATERIALS:
Instructor Note: (Time Permitting) Ask the question below
before proceeding to the next slide, which will list communication
challenges. You may wish to create a list of answers to the
question on a flipchart and then compare those to the challenges
listed on the next slide.

•

Flipchart or
Whiteboard
(Optional)

•

Markers
(Optional)

ASK:
•

What could affect communication among team members?

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Communication

COMMUNICATION CHALLENGES
SAY:
Challenges may include:

Slide

•

Language barriers—Non-English speaking residents/staff
pose particular challenges*

•

Distractions—Emergencies can take your attention away
from the current task at hand

•

Physical proximity

•

Personalities—Sometimes it is difficult to communicate
with particular individuals

•

Workload—During heavy workload times, all of the
necessary details may not be communicated, or they may be
communicated but not verified

•

Varying communication styles—Health care workers have
historically been trained with different communication
styles

•

Conflict—Disagreements may disrupt the flow of
information between communicating individuals

•

Lack of verification of information—Verify and
acknowledge information exchanged

•

Shift change—Transitions in care are the most significant
time when communication breakdowns occur

ASK:
•

Have you experienced a situation involving a breakdown
of communication?

•

What are some examples?

*A TeamSTEPPS Limited English Proficiency Module is available
at http://www.ahrq.gov/professionals/education/curriculumtools/teamstepps/lep/index.html.

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(OPTIONAL) COMMUNICATION
CHALLENGES EXAMPLES
Instructor Note: The following examples can be read aloud
to the class and used to facilitate discussion about communication
challenges.

Communication
Slide

SAY:
Let’s spend a few minutes reviewing an example or two of
scenarios in which communication challenges are present.
Example 1:
A resident is experiencing a new problem with her eye. This
problem requires two different types of drops to be instilled into
the eyes, with a waiting period in between to prevent the
medication from overflowing. The nurse administers the first
medication. When the nurse later returns to administer the
second medication, the resident balks, telling the nurse that she
already has had her drops.
DISCUSSION:
•

How would you communicate the treatment protocol to
the resident?

•

How would you ensure that the resident understands
the importance of the method of medication delivery?

Example 2:
An 89-year-old resident and her daughter inform the social
worker that they want to change the resident’s advance
directive, as they no longer want aggressive medical treatments
taken. The social worker places a DNR note in the chart, but
does not notify the nurse on duty or prepare a revised advance
directive.
DISCUSSION:
•

Where might miscommunication occur in this situation?

•

What are the possible outcomes?

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Communication

INFORMATION EXCHANGE STRATEGIES
SAY:

Slide

A number of tools and strategies to potentially reduce errors
associated with miscommunication or lack of information are
listed. The following four strategies are simple to integrate into
daily practice and have been shown to improve team
performance:
•

Situation−Background−Assessment–Recommendation (SBAR)

•

Call-Outs

•

Check-Backs

•

Handoffs

Of these strategies, handoffs in particular can take many forms. In
this course, we will describe the I PASS the BATON handoff tool
in the most detail; however, it is only one tool among many that
have been created to standardize the handoff process. Examples
of additional handoff resources will also be presented.

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Communication

SBAR PROVIDES…
SAY:
The SBAR technique provides a standardized framework for
members of the health care team to communicate about a
resident’s condition. You may also refer to this as the ISBAR,
where “I” stands for “Introductions.”
In phrasing a conversation with another member of the team,
consider the following:
•
•
•
•

Slide

Situation—What is happening with the resident?
Background—What is the clinical background?
Assessment—What do I think the problem is?
Recommendation—What would I recommend?
ASK:

•

Have you used SBAR in your nursing home? If so, how was
it used? What was the result of its use?

•

What were the challenges to implement the use of SBAR and
how were these challenges overcome?

SAY:
Although SBAR is typically used as a communication tool between
care team staff, it can also be modified for use by the resident to
communicate with the care team. For example, your facility could
provide residents with a version of SBAR to enable them to share
information about their own situation, background, assessment,
and recommendations, or to ask the care team about their care.
Additional information about partnering with residents and
families can be found at the Department of Defense (DoD)
website:
http://www.health.mil/Military-Health-Topics/Access-CostQuality-and-Safety/Quality-And-Safety-of-Healthcare/PatientSafety/Patient-Safety-Products-And-Services/TEAM-UP

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Communication

SBAR VIDEO EXAMPLE
SAY:
Let’s review how to properly use the SBAR technique. In this
video, a resident’s condition has worsened, resulting in a call to
the attending physician. Watch the video to see the transfer of
information using the SBAR technique.

Slide
DO:
Play the video by clicking the director icon on the slide.
VIDEO TIME:
1:10 minutes

DISCUSSION:
•

How did the SBAR technique improve communication
between the nurse and physician?
– The nurse identified herself and the reason she was calling

MATERIALS:
• SBAR LTC Video
(SBAR_LTC.mpg)

– The physician was quickly made aware of Mrs. Smith’s
deteriorating situation
– The nurse provided the background about the resident’s
condition, behavior, and current vitals
– The recent assessment of the resident has led the nurse to
call the physician with her concerns
– The recommendation was initiated by the nurse for
additional testing and lab work
 Some find recommendation difficult as they attempt not to
diagnose but give broader indirect suggestions that may
not provide clear or concise resident information

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EXERCISE: SBAR

Communication

SAY:
Take the next few minutes to create an SBAR example based on
your specific role.

Instructor Note: You may want to write the following on a
flipchart to remind participants of the SBAR acronym:
•

Situation:

•

Background:

•

Assessment:

•

Recommendation:

Slide

TIME:
10 Minutes

MATERIALS:
DO:
After a few minutes, ask for a few volunteers to share their
examples. You may want to write out some of the examples
shared by participants.

• Flipchart or
Whiteboard
(Optional)
• Markers
(Optional)

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Communication

CALL-OUT IS…
SAY:

Slide

A call-out is a tactic used to communicate critical information
during an emergent event. Critical information called out in these
situations helps the team anticipate and prepare for vital next
steps in resident care. It also benefits a recorder when present
during a code or emergent event. One important aspect of a callout is directing the information to a specific individual.
ASK:

VIDEO TIME:
00:30 seconds

•

What information would you want called out?
Example:
Vital signs for a resident with hemodynamic instability

MATERIALS:

DO:

• Call-Out Subacute
Video (Call-Out_
Subacute.mpg)

Play the video by clicking the director icon on the slide.
DISCUSSION:
•

How did the call-outs of the vital signs assist in the care of Mr.
Larkin?
– The nurse manager could focus on her assessment and
prepare for his transfer to the emergency department.
– Mr. Larkin’s vital signs were accurately recorded into his
medical record.
– The team (including Mr. Larkin) could hear Mr. Larkin’s
vitals in real time, keeping them informed of the changing
situation and preparing them for any other needed
interventions.

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TeamSTEPPS for Long-Term Care | Communication

CHECK-BACK IS…

Communication

SAY:
A check-back is a closed-loop communication strategy used to
verify and validate information exchanged. This strategy involves
the sender initiating a message, the receiver accepting the
message and confirming what was communicated, and the sender
verifying that the message was received.
Here is an example of the use of a check-back:
•

A nurse is accepting a telephone order from a physician: “Give
amoxicillin 875 mg every 12 hours for 7 days.” The nurse
verifies and validates the order by recording it directly into the
chart and reading it back to the physician, “Okay, that was
amoxicillin 875 mg every 12 hours for 7 days?” The physician
closes the loop by saying, “Correct.”

Slide

VIDEO TIME:
00:36 seconds

MATERIALS:
A check-back is an effective tool for all members of the team,
including residents and their family members. For example,
residents and families can use the check-back to verify the
receipt of care instructions or confirm understanding of symptoms
to monitor.

• Check-Back
LTC Video
(CheckBack_LTC.mpg

Now let’s watch a short example.
DO:
Play the video by clicking the director icon on the slide.
DISCUSSION:
•

Who was the sender? Who was the receiver?
– The physician was the sender
– The nurse was the receiver

•

How did the sender and receiver “close the loop”?
– The physician acknowledged that the nurse correctly recorded
his orders

•

What communication errors were avoided?
– The nurse did not rely on memory to record orders
– Medication dose and instruction errors are avoided

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Communication

HANDOFF IS…
SAY:

Slide

When a team member is temporarily or permanently relieved of
duty, there is a risk that necessary information about the resident
might not be communicated. The handoff strategy is designed to
enhance information exchange at critical times such as transitions
in care. More important, it maintains continuity of care despite
changing caregivers.
According to the Joint Commission: “The primary objective of a
handoff is to provide accurate information about a
patient’s/client's/resident's care, treatment and services, current
condition, and any recent or anticipated changes. The information
communicated during a handoff must be accurate to meet safety
goals.”
The Joint Commission National Patient Safety Goals (NPSG 2E)
mandate implementing the use of handoffs within each institution.
In addition, a standardized approach to handoff communications,
including an opportunity to ask and respond to questions, is
required.
For more information about Joint Commission handoff solutions,
visit their website:
http://www.jointcommission.org/

ASK:
•

When do you typically use handoffs?

•

What do you think makes an effective handoff?

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Communication

HANDOFF CONSISTS OF…
SAY:
A proper handoff includes the following:
•

•

•

Transfer of responsibility and accountability—When
handing off, it is your responsibility to know that the person
who must accept responsibility is aware of assuming
responsibility. Similarly, you are accountable until both parties
are aware of the transfer of responsibility.
Clarity of information—When uncertainty exists, it is your
responsibility to clear up all ambiguity of responsibility before
the transfer is completed.
Verbal communication of information—You cannot
assume that the person obtaining responsibility will read or
understand written or nonverbal communications.

•

Acknowledgment by receiver—Until it is acknowledged
that the handoff is understood and accepted, you cannot
relinquish your responsibility.

•

Opportunity to review—Handoffs are a good time to
review and have a new pair of eyes evaluate the situation
for both safety and quality.

Slide
VIDEO TIME:
0:23 seconds

MATERIALS:
• Handoff_
Subacute Video
(Handoff_
Subacute.mpg)

In addition, handoffs include the transfer of knowledge and
information about:
•

The degree of certainty and uncertainty regarding a resident,
such as whether a diagnosis has been confirmed;

•

The resident’s response to treatment;

•

Recent changes in condition and circumstances; and

•

The plan of care, including contingencies.

It is important to highlight that both authority and responsibility are
transferred in a handoff. As identified in root cause analyses of
sentinel events and poor outcomes, lack of clarity about who is
responsible for care and decisionmaking has often been a major
contributor to medical error.
Let’s watch an example of a handoff.
DO:
Play the video by clicking the director icon on the slide.
DISCUSSION: Go to next page >

Continued…

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Communication

HANDOFF CONSISTS OF… (Continued)

Slide

DISCUSSION:
•

What went well in the handoff in this video?
– Continuity of care was maintained
– Presenting symptoms and current assessment were
communicated
– Actions taken so far were reviewed
– The face to face handoff allowed the sender to see the nonverbal
communication from the receiver that confirmed the message had
been received

•

Was there anything about the handoff that could have
been improved?
– Verbal communication that the message had been properly
received would have further confirmed that the receiver had the
needed information and did not have any questions

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Communication

I PASS THE BATON
SAY:
Your nursing home should determine a standard protocol for
delivering handoffs and make it known to everyone. “I PASS the
BATON" is a TeamSTEPPS tool that provides one option for
conducting a structured handoff.
I

Introduction—Introduce yourself and your role/job (include
resident)

P

Patient/Resident—Name, identifiers, age, sex, location

A

Assessment—Presenting chief complaint, vital signs,
symptoms, and diagnosis

S

Situation—Current status/circumstances, including code status,
level of uncertainty, recent changes, response to treatment

S

Safety Concerns—Critical lab values/reports, socioeconomic
factors, allergies, alerts (falls, isolation, etc.)

Slide

VIDEO TIME:
1:26 minutes

THE
B

Background—Comorbidities, previous episodes, current
medications, family history

A

Actions—What actions were taken or are required? Provide
brief rationale

T

Timing—Level of urgency and explicit timing and
prioritization of actions

O

Ownership—W ho is responsible (nurse/doctor/team)? Include
resident/family responsibilities

N

Next—What will happen next? Anticipated changes? What is
the plan? Are there contingency plans?

MATERIALS:
• I PASS the
BATON LTC
Video
(I_PASS_the_
BATON_LTC.
mpg)

DO:
Play the video by clicking the director icon on the slide.
DISCUSSION: Go to next page >

Continued…
TeamSTEPPS for Long-Term Care | Communication

VERSION FOR REVIEW ONLY; NOT FOR DISTRIBUTION

B-3-25

Communication
Slide

I PASS THE BATON (Continued)
DISCUSSION:
• How was I PASS the BATON used in this nurse to
nurse example?
– Nurse shift change report focused on an unstable resident
– Incoming nurse is given a comprehensive update covering the
period since she last saw the resident

B-3-26VERSION FOR REVIEW ONLY; NOT FOR DISTRIBUTION
TeamSTEPPS for Long-Term Care | Communication

ADDITIONAL HANDOFF TOOLS AND
RESOURCES

Communication

SAY:
Numerous tools and resources are available to facilitate effective
handoffs. Each nursing home should adopt the tool that best
meets its needs. In addition to I PASS the BATON, other handoff
tools and resources include:
•

I PASS:

Slide

• Stands for - Illness severity; Patient Summary; Action list for
the new team; Situation awareness and contingency plans;
and Synthesis and “read back” of the information.
• http://www.ipasshandoffstudy.com/
•

HAND-IT:
• Stands for the Handoff Intervention Tool.
• http://www.ncbi.nlm.nih.gov /pmc/articles /PMC354051 1/

•

Patient Hand-Off Tool Kit:
• This resource includes 10 examples of handoff tools.
• https://www2.aorn.org/guidelines/clinical-resources/toolkits/patient-hand-off-tool-kit

•

Safer Sign Out Form:
• This tool was developed to standardize the sign-out process.
• http://safersignout.com/resources/
ASK:
•

Can you describe an example of the handoff method used in
your facility?

•

Is the same handoff method used in every situation, or do
they vary?

TeamSTEPPS for Long-Term Care | CommunicationVERSION FOR REVIEW ONLY; NOT FOR DISTRIBUTION B-3-27

Communication

TOOLS AND STRATEGIES SUMMARY
SAY:
Communication skills interact directly with leadership, situation
monitoring, and mutual support:
•

Team leaders require effective communication skills to convey
clear information, provide awareness of roles and
responsibilities, and provide feedback.

•

Team members monitor situations by communicating any
changes to keep the team informed and the resident protected.

•

Communication facilitates a culture of mutual support when
team members request or offer assistance and verbally
advocate for the resident.

•

Communication tools that can enhance teamwork include the
SBAR, call-out, check-back, and handoff. These tools facilitate
effective and efficient communication within and across teams.
Good communication facilitates the development of shared
mental models, adaptability, mutual trust, and resident safety.

Slide

B-3-28 VERSION FOR REVIEW ONLY; NOT FOR DISTRIBUTION
TeamSTEPPS for Long-Term Care | Communication

EXERCISE: APPLYING TEAMSTEPPS

Communication

SAY:
Instructor Note: This slide is intended for the Master
Training course only. The previous slide should be the last one
shown to staff participants at your nursing home.
SAY:
Slide

Now return to your TeamSTEPPS Implementation Worksheet.
Think about the teamwork issue you previously identified. Then,
review and answer the questions for Module 3.
Think about:
•
•

Whether your teamwork issue relates to problems with
communication; and
Whether any of the tools and strategies covered in this
module could be used to address your issue.

MATERIALS:
•

TeamSTEPPS
Implementation
Worksheet

DO:
Ask a few individuals to report on their communication issue
and which TeamSTEPPS tools or strategies they will consider
implementing to address the issue.

TeamSTEPPS for Long-Term Care | Communication VERSION FOR REVIEW ONLY; NOT FOR DISTRIBUTION

B-3-29