Right words can show your concern
One of the most common threats to patient safety in obstetrics is the inability, or hesitation, of staff to clearly state their concern about a patient's status, says Edmund F. Funai, MD, associate professor in the Department of Obstetrics, Gynecology, and Reproductive Sciences at Yale School of Medicine in New Haven, CT. Too often, one clinician is concerned about a patient but does not effectively communicate that concern to others.
Sometimes the problem is that the first staff member or physician is apprehensive about challenging someone else. Other times, the person is trying to express concern but doesn't say it in an effective manner. At Yale, staff and physicians, even the housekeeping staff who work in the obstetrics unit, must undergo four hours of communication training aimed at avoiding those problems.
"We focus on specific techniques that people can use to say they are concerned about a patient, and we teach them how to use specific phrases," Funai says. "They get used to using those phrases, and they get used to hearing them and understanding what they mean."
The hospital uses a system called "CUS" words, derived from the initials of the key words used to escalate communication in a crisis:
- Concern. This is the first level of concern. "Doctor, I'm concerned about Mrs. Smith's tracing."
- Uncomfortable. This expresses a higher level of concern. "Doctor, I'm uncomfortable with Mrs. Smith's tracing."
- Scared. This is the highest level of concern. "Doctor, Mrs. Smith's tracing scares me." At Yale, everyone recognizes that if another team member uses the word "scared," this is a high-priority situation, and you should drop everything you're doing to deal with it immediately.
"These code words perk everyone's ears up," Funai says. "Instead of everyone saying different things and thinking they got their point across, we can use these words and your colleagues know what your level of concern is. If someone says they're scared, that's a slap in the face and gets your attention."
One of the most common threats to patient safety in obstetrics is the inability, or hesitation, of staff to clearly state their concern about a patient's status, says Edmund F. Funai, MD, associate professor in the Department of Obstetrics, Gynecology, and Reproductive Sciences at Yale School of Medicine in New Haven, CT. Too often, one clinician is concerned about a patient but does not effectively communicate that concern to others.You have reached your article limit for the month. Subscribe now to access this article plus other member-only content.
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