I’ve been researching, teaching, and writing about the importance of communication skills and emotional intelligence for over 20 years. This is roughly the same amount of time that The Joint Commission has been tracking catastrophic mistakes we make which are known as Sentinel Events. They track and publish a detailed report on the types and causes of these tragic events including the most recent 2023 Annual Report.
What is most striking is how communication is and has been one of if not the leading root cause year after year! And root causes of Sentinel Events that show up consistently in the data include teamwork, leadership, and human factors. We can appreciate how the quality of interactions influences our ability to provide safe care by examining two examples.
Image by Gerd Altmann from Pixabay
- A nurse overhears a colleague gossiping about her and interrupts: “I’d appreciate it if you have concerns about my work that you discuss them with me directly and professionally.” The gossiping nurse apologizes and later offers to help the nurse. The help enabled the nurse to get pain medication to her post-op patient quickly and the patient felt cared for. Patient experience scores increase.
- A doctor yells at a nurse on Tuesday. Saturday night the nurse hesitates to call her about a subtle change in a patient’s condition. Since it’s close to the end of the shift, she tells the oncoming nurse. This nurse makes it a priority to check the patient, but the telemetry alarm beats him to it. The patient does not survive.
These examples show how the quality of simple interactions influences critical outcomes like patient safety and patient experience. Like the ‘Butterfly Effect, in both these situations, the outcomes are obvious, yet the roots involving the quality of interactions are elusive. Combining this train of thought with the data suggests that our solutions to date are not getting at the underlying issues aimed to improve these root causes.
Reducing the incidence of sentinel events will require us to dive deeper into the social and emotional learning that influences individual, team, and organizational behavior. This includes understanding the need for professionals to develop skills and competencies that influence the quality of our interactions. These include; self-awareness, confidence, adaptability, flexibility, perspective-taking, and the ability to give and receive constructive feedback, set limits, respect others’ limits, ask for help, and delegate tasks.
Developing these skills is no small task as people have different levels of growing edges, resources such as time and money are limited, experiential learning opportunities are essential, and effective teaching methods are limited. The good news is that Medical Improv can be used to teach all of these skills and competencies while reducing stress and promoting positive relationships and cultures. More about that in future posts. For now, the important take-home is that the quality of healthcare interactions matters!
