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Updated: Jun 15, 2026

Using Visual and Narrative Methods to Achieve Fair Process in Clinical Care

Using Visual and Narrative Methods to Achieve Fair Process in Clinical Care

Published on: February 16, 2011

PURE conversations: enhancing communication and teamwork.

Larry Veltman¹, Kristine Larison

¹Department of Obstetrics and Gynecology, Providence St. Vincent Medical Center, Portland, USA.

Journal of Healthcare Risk Management : the Journal of the American Society for Healthcare Risk Management

|March 5, 2010

Summary

Structured communication, like SBAR, aims to improve healthcare safety. PURE (Purposeful/prepared/productive, Unambiguous, Respectful, Effective) conversations foster the necessary cultural shift for effective team communication in obstetrics.

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Area of Science:

Healthcare communication
Medical safety
Obstetrics

Background:

Communication failures are a major cause of adverse events in obstetrics.
Structured communication tools, such as SBAR (Situation, Background, Assessment, Recommendation), are increasingly adopted in healthcare.
Effective implementation of structured communication often necessitates a cultural shift among healthcare professionals.

Purpose of the Study:

To introduce the PURE (Purposeful/prepared/productive, Unambiguous, Respectful, Effective) conversation framework.
To facilitate a cultural shift supporting structured communication in perinatal teams.
To describe a multidisciplinary workshop designed to enhance structured communication effectiveness.

Main Methods:

Development of a multidisciplinary workshop using clinical scenarios.
Incorporation of the PURE conversation concept into workshop activities.
Focus on the mental processes and contextual factors influencing real-time communication.

Main Results:

The workshop aims to improve the adoption and effectiveness of structured communication strategies.
PURE conversations emphasize the cognitive and relational aspects of professional interactions.
The approach targets the perinatal team for enhanced patient safety.

Conclusions:

PURE conversations offer a complementary approach to structured communication tools like SBAR.
Facilitating a cultural shift is crucial for successful implementation of communication protocols.
This workshop model provides a practical method for improving perinatal team communication and patient outcomes.