Improving Communication Between Nurses and Resident Physicians: A 3-Year Quality Improvement Project

Area of Science:

• Healthcare Quality Improvement
• Patient Safety Research
• Surgical Communication

Background:

• Communication breakdowns between nurses and residents are significant predictors of medical errors.
• A 2013 survey identified nurse-resident communication as a critical patient safety concern on a general surgery unit.
• The Comprehensive Unit-based Safety Program initiated a quality improvement project to address this issue.

Purpose of the Study:

• To improve nurse-resident communication within a general surgery unit.
• To assess the impact of targeted interventions on communication and collaboration.
• To provide a framework for other institutions seeking to enhance interprofessional communication.

Main Methods:

• A multidisciplinary team conducted a root-cause analysis of communication issues.
• Implemented structured face-to-face discharge rounds and a notebook system for nonurgent messages.
• Assessed perceived communication and collaboration using validated surveys pre-intervention, at 9 months, and 2.5 years post-intervention.

Main Results:

• Interventions were associated with significant improvements in perceived communication and team function.
• Survey scores increased from baseline: residents from 57% to 74% (9 months) and 72% (2.5 years); nurses from 63% to 80% (9 months) and 77% (2.5 years).
• Sustained improvements in communication and collaboration were observed 2.5 years after the intervention.

Conclusions:

• Structured interventions, including enhanced rounds and message transfer systems, effectively improved nurse-resident communication.
• The quality improvement initiative demonstrated a positive and lasting impact on team function and patient safety perception.
• This model offers a transferable strategy for improving critical communication pathways in healthcare settings.