Who Is Talking? Who is Listening? - Improving Communication Among Hospital Nurses and Clinicians

Joint Commission Resources in Oak Brook Ill., oversaw development and testing of an online course and support materials to improve communication among hospital nurses, physicians and other clinicians involved in team-oriented patient care. The project ran from 2006 to 2008.

Open and effective communication among health care team members is known to be a key factor in a safe and healthy work environment, job satisfaction and nurse retention.

The grantee—the nonprofit, knowledge transfer and publications arm of the Joint Commission—contracted with Instructional Innovations, LLC, in Phoenix, to create the online course and convened a panel of outside experts to guide course content.

A second firm, Learning Studio, Inc., of Naperville, Ill., served as project manager for the pilot test of the course at 17 hospitals recruited for the project. The project team conducted in-person training for lead staff of the participating hospitals and developed a written training guide.

Key Results

  • The project produced an online course, Enhancing Clinician Communication— Improving Patient Safety, that uses video footage to demonstrate common health care situations and the communication skills required to deal with them. The depicted scenarios include interactions between nurses and physicians and other health care professionals.

    The project team also developed a DVD version of the course with a companion train-the-trainer text. Not initially planned, the DVD was a response to the inability of several of the test hospitals to access the online material.

    Joint Commission Resources originally intended to distribute the completed curriculum. However, the need for modifications to increase the course’s utility prevented dissemination beyond the pilot hospitals, the grantee reported at the project’s conclusion.

    Nevertheless, the online course was available for viewing with permission at a password-protected site maintained by Instructional Innovations, and the DVD version was available from Joint Commission Resources.
  • In 2008, approximately 1,550 clinicians across the 17 hospitals took a beta version of the course, although not all participants completed all components. One of the hospitals—John H. Stroger Jr. Hospital in Chicago—accounted for about threequarters of the test-takers.

    A survey of the participants showed:
    • Most (79%) were nurses and only 4 percent were physicians. The rest were technicians (4%) and clerical or administrative staff (13%).
    • A significant number felt their hospital units lacked adequate communication, cooperation and teamwork.
    • Physicians taking the survey perceived higher levels of shared decision-making, cooperation and open physician-nurse dialogue than did nurses.