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Vermont hospitals begin new programs to increase patient safety

Patient Safety Monitor Alert, January 21, 2005

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Residents and graduate nursing students at Fletcher Allen Health Care in Burlington, VT, are learning to improve communication with the goal of increasing patient safety, according to The Barre Montpelier Times Argus.

The hospital is developing a four-week course to instill a culture of safety in new doctors and nurse practitioners, according to Anna Noonan, vice president for quality and operational effectiveness.

"We're trying to get them to view the world through the lens of the patient and eliminate potential risks and harm," she said. "It's a way of looking at care procedures to identify where the steps are in the process that may result in patient safety concerns, and then using engineering principles to eliminate the risk."

The hospital received funding for the program through a federal grant awarded to only 11 institutions in the country to develop a training program to teach healthcare providers to think about safety early on.

"I fundamentally believe if you want clinicians to behave differently, you need to educate them differently," said Noonan.

Another Vermont hospital is beginning a four-month training in a verbal communications system, which was initially designed for use by the Navy on nuclear submarines.

"Every time there's a handoff...there is a 25-fold increase in the chance of something going wrong," said Robert Pezzulich, MD, chief medical safety officer at Central Vermont Medical Center in Berlin. "It's kind of like the U.S. women's track team dropping the baton in a relay."

The situation, briefing, assessment, and recommendation (SBAR) program helps doctors exchange information among themselves and helps medical professionals highlight important information.

"It teaches how to give rapid, accurate, and complete information," said Pezzulich.

Physicians and nurses each have different communication styles, said Alex Heinz, director of quality improvement. "Nurses like to tell the story about the patient and their feelings, where doctors like to cut to the chase."

"In every single event we have involving some sort of unintended outcome...we find communication issues were underlying it all," she said.

To read The Barre Montpelier Times Argus article, click here.

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