Care Escalation: Teaching Residents How to Effectively Communicate Patient Care Concerns

Introduction Care escalation for patients at risk of deterioration requires that care team members are able to effectively communicate patient care concerns to more senior team members. However, multiple factors inhibit residents from escalating their concerns, which contributes to treatment delays...

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Autores principales:	Jillian Mayer Cotter, Sonja Ziniel, Justin Lockwood, Jennifer Reese
Formato:	article
Lenguaje:	EN
Publicado:	Association of American Medical Colleges 2019
Materias:	Escalation Residency Education Patient Safety Program Evaluation Communication Skills Medicine (General) R5-920 Education L
Acceso en línea:	https://doaj.org/article/0b46600d5b794117b78f3c3757c63ca3
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spelling	oai:doaj.org-article:0b46600d5b794117b78f3c3757c63ca32021-11-22T13:57:18ZCare Escalation: Teaching Residents How to Effectively Communicate Patient Care Concerns10.15766/mep_2374-8265.108332374-8265https://doaj.org/article/0b46600d5b794117b78f3c3757c63ca32019-08-01T00:00:00Zhttp://www.mededportal.org/doi/10.15766/mep_2374-8265.10833https://doaj.org/toc/2374-8265Introduction Care escalation for patients at risk of deterioration requires that care team members are able to effectively communicate patient care concerns to more senior team members. However, multiple factors inhibit residents from escalating their concerns, which contributes to treatment delays and sentinel events. Methods We developed and implemented an annual 1- and 2-hour escalation curriculum for senior pediatric residents from the University of Colorado. The curriculum consisted of case presentations (one for the 1-hour or two for the 2-hour session), lecture, large-group discussion, and small-group activities. Faculty and fellows facilitated small groups, in which barriers to care escalation and specific tools for effective escalation were discussed. We administered precurriculum surveys for resident self-reflection and postcurriculum surveys for curriculum evaluation. Results The curriculum was delivered to 179 residents over 3 years (2016–2018). Surveys were administered during the first 2 years, and 87% of participants completed pre- and postcurriculum surveys. Of all respondents, 88% believed that the curriculum helped them recognize care escalation barriers, and 85% believed that they learned skills for effective escalation. Resident comfort in asking for attending physician help improved from 52% to 95% (p < .001). Analysis of postsurvey open-ended responses indicated that residents valued listening to faculty share their personal experiences of escalating care. Discussion The development and implementation of a curriculum to improve resident comfort and perceived ability to escalate patient care concerns are feasible and effective. Further work is needed to evaluate the impact of this curriculum in the clinical setting.Jillian Mayer CotterSonja ZinielJustin LockwoodJennifer ReeseAssociation of American Medical CollegesarticleEscalationResidency EducationPatient SafetyProgram EvaluationCommunication SkillsMedicine (General)R5-920EducationLENMedEdPORTAL, Vol 15 (2019)
institution	DOAJ
collection	DOAJ
language	EN
topic	Escalation Residency Education Patient Safety Program Evaluation Communication Skills Medicine (General) R5-920 Education L
spellingShingle	Escalation Residency Education Patient Safety Program Evaluation Communication Skills Medicine (General) R5-920 Education L Jillian Mayer Cotter Sonja Ziniel Justin Lockwood Jennifer Reese Care Escalation: Teaching Residents How to Effectively Communicate Patient Care Concerns
description	Introduction Care escalation for patients at risk of deterioration requires that care team members are able to effectively communicate patient care concerns to more senior team members. However, multiple factors inhibit residents from escalating their concerns, which contributes to treatment delays and sentinel events. Methods We developed and implemented an annual 1- and 2-hour escalation curriculum for senior pediatric residents from the University of Colorado. The curriculum consisted of case presentations (one for the 1-hour or two for the 2-hour session), lecture, large-group discussion, and small-group activities. Faculty and fellows facilitated small groups, in which barriers to care escalation and specific tools for effective escalation were discussed. We administered precurriculum surveys for resident self-reflection and postcurriculum surveys for curriculum evaluation. Results The curriculum was delivered to 179 residents over 3 years (2016–2018). Surveys were administered during the first 2 years, and 87% of participants completed pre- and postcurriculum surveys. Of all respondents, 88% believed that the curriculum helped them recognize care escalation barriers, and 85% believed that they learned skills for effective escalation. Resident comfort in asking for attending physician help improved from 52% to 95% (p < .001). Analysis of postsurvey open-ended responses indicated that residents valued listening to faculty share their personal experiences of escalating care. Discussion The development and implementation of a curriculum to improve resident comfort and perceived ability to escalate patient care concerns are feasible and effective. Further work is needed to evaluate the impact of this curriculum in the clinical setting.
format	article
author	Jillian Mayer Cotter Sonja Ziniel Justin Lockwood Jennifer Reese
author_facet	Jillian Mayer Cotter Sonja Ziniel Justin Lockwood Jennifer Reese
author_sort	Jillian Mayer Cotter
title	Care Escalation: Teaching Residents How to Effectively Communicate Patient Care Concerns
title_short	Care Escalation: Teaching Residents How to Effectively Communicate Patient Care Concerns
title_full	Care Escalation: Teaching Residents How to Effectively Communicate Patient Care Concerns
title_fullStr	Care Escalation: Teaching Residents How to Effectively Communicate Patient Care Concerns
title_full_unstemmed	Care Escalation: Teaching Residents How to Effectively Communicate Patient Care Concerns
title_sort	care escalation: teaching residents how to effectively communicate patient care concerns
publisher	Association of American Medical Colleges
publishDate	2019
url	https://doaj.org/article/0b46600d5b794117b78f3c3757c63ca3
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Care Escalation: Teaching Residents How to Effectively Communicate Patient Care Concerns

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