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Navigating Communication Challenges in Clinical Practice: A New Approach to Team Education
Christine M Rachwal1, Thorsten Langer2, Bethany P Trainor2
1Christine M. Rachwal is a CICU nurse practice specialist in the cardiovascular and critical care programs, Boston Children's Hospital, Boston, Massachusetts. She is also faculty associate and leadership circle member for the Institute for Professionalism and Ethical Practice, Boston Children's Hospital. Thorsten Langer is an attending physician in the Department of Neuropediatrics and Muscle Disorders, Faculty of Medicine, University of Freiburg, Freiburg, Germany, and an international faculty associate for the Institute for Professionalism and Ethical Practice. Bethany P. Trainor is the manager of the clinical research navigation program at the Institutional Centers for Clinical and Translational Research, Boston Children's Hospital. Mary Anne Bell is a clinical staff nurse I in the cardiovascular and critical care programs, Boston Children's Hospital. David M. Browning is senior scholar emeritus for the Institute for Professionalism and Ethical Practice. Elaine C. Meyer is the founding director of the Institute for Professionalism and Ethical Practice and associate professor in psychology, Department of Psychiatry, Harvard Medical School, Boston, Massachusetts. christine.rachwal@childrens.harvard.edu.
Background:
Cultivating a healthy work environment and upholding patient safety are important priorities in health care. Challenges in workplace communication are common and affect staff well-being and patient outcomes. Previous interventions have focused on organizational issues and work-life balance.
Objective:
To assess the feasibility of monthly interdisciplinary educational rounds that support clinicians' ability to navigate workplace clinical and communication challenges while promoting interprofessional teamwork and self-care.
Methods:
The Program to Enhance Relational and Communication Skills rounds are an educational initiative within a large pediatric tertiary care hospital. Participation is voluntary and offered to inter-professional clinicians from 4 critical care units, cardiac catheterization unit, and intermediate care unit. Topics of monthly hour-long sessions are developed collaboratively. Feasibility is assessed by ongoing documentation of attendance. Postintervention questionnaires are used to evaluate the program's value.
Results:
Between April 2010 and December 2016, a total of 1156 clinicians participated (median, 18 per seminar): 653 nurses (56%), 103 social workers (9%), 102 child life specialists (9%), 32 psychologists (3%), 40 chaplains (3%), 18 physicians (2%), 18 ethicists (2%), and 190 others (16%), including medical interpreters, nursing students, and administrative staff. Ninety-two percent of participants rated their participation as "quite valuable" or "very valuable." Programs of highest interest included child assent, bereavement, social media, and workplace bullying. Evolution into actual clinical practice change remains a challenge for the future.
Conclusion:
Our approach to communication and workplace challenges is relevant, user-friendly, and feasible. Difficult topics are addressed in real time, with clinicians learning interprofessionally.
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