There Are Stars Amongst Us! Using Video to Change Culture

Purpose for the program: Communication is well known to be one of the most frequent contributing factors to safety events. Our organization developed a Chain of Communication to assist the division for appropriate structure for communication. The physicians reported that the nurses did not always include the attending physician in their notification of concerns regarding the plan of care. Also, the physicians were unclear on appropriate notification for their concerns regarding nursing care. Throughout this process the attendings were not always informed by nursing of their concerns or nursing was not clear of the plan of care. This led to frustration and an unsafe environment.

Proposed change:  A group of physician, nurses, and leaders developed the Chain of Communication. The algorithm provided a clear guide for appropriate communication. However, the actual implementation was not as easy. There were many personalities and scenarios that lead to some ambiguity. There was concern that the message could be interpreted differently depending upon the delivery. The executive leadership recommended filming videos to use as teaching tools.

Implementation, outcomes and evaluation: The video was written by bedside nurses, this contributed to buy in during the rollout. The physicians were selected by leadership that was well respected by their peers to help gain their attention. An unexpected outcome was the filming helped to bridge relationships between the physician and nurses involved in the film. The Chain of Communication and showing of the videos were presented by the leadership of the departments. The message was consistent regardless of the unit. Overall, the message was well received and generated great discussion to improve the communication. The relationship with the physicians improved, knowing that they were being communicated to directly. The use of videos was great way to help express the opinions of the leadership to a large number of staff.  The staff enjoyed seeing their peers and physicians “act” on film, which kept them engaged in the topic.

Implications for nursing practice: The development of clear Chain of Communication is imperative for all nurses to have available to prevent unclear channels of communication and authority. The use of videos is a fun and interactive way to delivery a consistent message.

Keywords: communication, video education, safe culture