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Group Exercise

*Groups of 3- RN, MD, Observer


*Each Person is given a sheet describing a
problem, requiring RN/MD communication to
solve.
*Find solution(s) to the problem that are:
*Appropriate
*Mutually agreeable
*Timely
*Observer looks for Quality of Solution and
Communication using checklist
2004 Kaiser Foundation Health Plan, Inc.
Kaiser Foundation Health Plan, Inc. is the owner and holds the copyright of the material(s) and must be acknowledged in all print and electronic media as
the original developer and copyright holder of the material(s).
P.Preston San Francisco Medical Center

RNs View of Life


55 YO Man with HTN, admitted for GI
Bleed- received 2 units, last crit 31
VS: BP 90/50, Pulse 120
Looking pale, sweaty
Feels confused and weak, some problem
with heavy chest
2004 Kaiser Foundation Health Plan, Inc.
Kaiser Foundation Health Plan, Inc. is the owner and holds the copyright of the material(s) and must be acknowledged in all print and electronic media as
the original developer and copyright holder of the material(s).
P.Preston San Francisco Medical Center

Physicians View of Life


Working a 24 hour call, busy service, late
PM
Currently working on an ED patient:
Diabetic with productive cough, fever, chills
65 YO, H/O angina
HR 127, BP 78/40

2004 Kaiser Foundation Health Plan, Inc.


Kaiser Foundation Health Plan, Inc. is the owner and holds the copyright of the material(s) and must be acknowledged in all print and electronic media as
the original developer and copyright holder of the material(s).
P.Preston San Francisco Medical Center

Observer Checksheet
Got the persons attention
Made eye contact, faced the person
Used persons name
Expressed Concern
Stated the problem (clear, concise)
Proposed action
Re-asserted as necessary
Reached decision
Escalated if necessary

GET PERSONS
ATTENTION
REACH
DECISION *

PROPOSE
ACTION

EXPRESS
CONCERN

STATE
PROBLEM

2004 Kaiser Foundation Health Plan, Inc.


Kaiser Foundation Health Plan, Inc. is the owner and holds the copyright of the material(s) and must be acknowledged in all print and electronic media as
the original developer and copyright holder of the material(s).
P.Preston San Francisco Medical Center

Example SBAR briefing


Situation: Dr. Jones, I have a 55 Y/O Man who looks pale,
sweaty and is complaining of chest pressure

Background: He has a history of HTN, admitted for GI Bleedreceived 2 units, last crit two hours ago was 31 his vital signs
are: BP 90/50, Pulse 120

Assessment: I think hes got an active bleed and we cant rule


out an MI but we dont have a troponin or a recent H&H

Recommendation: Id like to get an EKG and labs and I need for


you to evaluate him in right away.
2004 Kaiser Foundation Health Plan, Inc.
Kaiser Foundation Health Plan, Inc. is the owner and holds the copyright of the material(s) and must be acknowledged in all print and electronic media as
the original developer and copyright holder of the material(s).
P.Preston San Francisco Medical Center