Transparent Communication Through the Glass Door of the ICU: Improving Caregivers’ Shared Mental Model
CCCF ePoster library. Zavalkoff S. Nov 7, 2018; 233390; 42 Disclosure(s): none
Dr. Samara Zavalkoff
Dr. Samara Zavalkoff
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To ensure effective and coordinated care, clear communication between numerous caregivers is essential. In our Pediatric Intensive Care Unit (PICU), only 55% of healthcare workers (HCW) agreed they had a full understanding of the plan for their patient. Multiple patient information sources, numerous caregivers and a lack of standardized handover contribute to the root cause of this problem.  The aim of this observational study was to implement and assess the impact of the glass door team communication tool on HCWs reported understanding of their patients’ care plans.



We conducted a retrospective pre-post observational study of a communication intervention in the PICU. We designed a communication template for the outside of the glass door of the patient’s room, through multiple PDSA (Plan, Do, Study, Act) cycles, outlining patient’s goals, plans and tests. We defined a clear process for the template's use including the medical team updating it in morning and evening rounds and items being checked off throughout the day by any team member. After three months of >95% compliance, surveyed PICU HCWs rated their level of agreement with the statement “I have a full understanding of the plan for my patient” using a retrospective pre/post survey. HCWs also reported their perceived benefits and barriers of the tool. Family experience metrics regarding privacy were tracked.



Of 94 health care team respondents, 84% agreed they had a full understanding of the care plan, based on their current perspective, in comparison to 59% based on the perspective they held six months ago (p<0.001). Top reported benefits were: improved communication, improved job performance and improved collaboration with consultants. Barriers reported were inconsistent application and confidentiality. As a balancing measure, family experience data regarding privacy remained stable.



Implementation of the glass door team communication tool, easily visible on the door of the patient’s room, was associated with an improvement in PICU HCWs perceived knowledge of their patient’s plan. Next steps would be to qualitatively evaluate the team’s and family’s impressions of the tool and to implement it in the PICU’s step down unit.


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