JCAHO's patient safety goals: Taking a look at effective communication

Nurse Leader Insider, January 3, 2003

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The second of the Joint Commission on Accreditation of Health Care Organizations' (JCAHO) six patient safety goals-communication among caregivers-has its most significant application in relation to your medical staff's day-to-day activities. It's your job to educate nurses about what they must do to help your organization avoid a Type I during your next JCAHO survey. Read on to see what our experts had to say about complying with this particular goal.

Communication is key

There is no question that communication is one of the most important processes in a hospital, asserts Hugh Greeley, chair of The Greeley Company based in Marblehead, MA. "Nearly everything done to or for a patient requires precise communication," he says. "A patient may come in contact with over 30 caregivers during a hospital stay. Each provider must know a great deal about the patient and must be able to communicate [that information to] other caregivers effectively." The JCAHO recommends that you take the following steps for complying with this goal:

Verify verbal and telephone orders

Your organization must adopt a process that specifies who at the hospital can give verbal orders and who can take them, says Richard Kaine, MD, director of consulting services at Quality Management Resources in Hoschton, GA. Providers should document the verbal order, including verification of who gave the order, who took it, and that it was read back.

Although reading back orders seems like a simple process, Greeley warns that members of your medical staff will require significant ongoing training and coaching before they consistently follow procedure.

Christina W. Giles, CMSC, MS, president of MS Solutions in Pepperell, MA, recommends that organizations include a simple checksheet in each chart where practitioners who take verbal orders can document their names, note that they repeated the verbal order back to the physician who made the order, and indicate the time the order was received.

"These sheets could then be removed [from the chart] and tallied monthly," Giles says. "If people are made to document the activity, I would think it would encourage them to try to change their behavior to incorporate the new step in the process." Reading back orders is essential when working with "sound-alike" medications-a common communication challenge, according to experts.

Adapted from: Medical Staff Briefing,

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