By focusing on enhancing horizontal communication at Parrish Medical Center, Titusville, Fla., researchers have found that this type of interaction results in clear, dedicated nursing practices.1-4

Root cause analysis

Researchers conducted a root cause analysis that led to the identification of several horizontal communication issues. Communication of patient assignments to other departments was ranked as the highest priority to be addressed. Although every nurse carried a cordless phone, the ancillary departments found they had to make several phone calls before finally reaching the nurse caring for a given patient.

Developing the solution

Investigators decided they would explore a system-based solution consisting of online patient assignments accessible to all staff throughout the organization. The team's requirements for the system were that it be readily accessible to all staff that needed to view the assignment, be easy to use for unit staff to enter and update, and use an existing computer program. After testing several programs, it was decided to use the word processing function that was associated with the staff's internal e-mail system.

One year after implementation, a survey was sent out to all clinical departments using the online assignment sheet. Participating staff reported that the system saved time, energy, promoted teamwork throughout the hospital, and reduced the potential for errors. Overall, 95% of the respondents reported using the online assignment program daily. The importance of updating assignments has been reinforced with the nursing units, and other departments have been identified for inclusion in this online posting of assignments to further improve communication between key patient care departments.

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