DISCover a New Way of Caring

University Hospitals Rainbow Babies & Children’s Hospital, Cleveland, Ohio

Nov 06, 2024

CSI Summary

Available only to registered AACN.org users.

CSI Presentation

Available only to registered AACN.org users.

CSI Toolkit

Available only to users with a paid AACN membership.

Added to Collection

Project Topic:

Increasing skilled communication

Hospital, City and State:

University Hospitals Rainbow Babies & Children’s Hospital, Cleveland, Ohio

Unit:

  • Pediatric Cardiac Stepdown Unit (CSDU)
  • Pediatric Cardiac Intensive Care Unit (PCICU)

CSI Participants:

  • Craig Erickson, BSN, RN, CPN
  • Grace Jackson, BSN, RN
  • Megan Varley, BSN, RN

Project Goals/Objectives:

  1. 95% of nurses will attend communication skills training
  2. 95% of staff will be able to state their behavioral tendency and list its major characteristics
  3. Increase Skilled Communication score on the Healthy Work Environment Assessment Tool (HWEAT) from 4.21 to 4.7
  4. Decrease nursing turnover 5%

Project Outcomes:

  1. 95% of nurses attended communication skills training
  2. 95% of staff were able to state their personal behavioral tendency and list its major characteristics
  3. Skilled Communication HWEAT score decreased from 4.21 to 3.21
  4. Nursing turnover increased

Project Overview:

The Heart Center at Rainbow Babies & Children’s Hospital is a growing program that includes two inpatient areas, a Cardiac Step-Down Unit (CSDU) and a recently opened Pediatric Cardiac Intensive Care Unit (PCICU). The majority of nurses working in these units began their nursing career within the last three years. Learning to work in a new environment with a new team of medical professionals can be challenging. Understanding your own communication style, how that differs from those around you, and how to modify your style to better communicate with others can help improve understanding, lead to greater empathy, and decrease errors associated with miscommunication.

Using the AACN HWEAT survey, our team assessed the health of our work environment and determined that we had an opportunity to improve our HWEAT Skilled Communication score. To help our team better understand their own behavioral tendencies and how to communicate with those who have a different tendency, we acquired the help of an outside organization with proven experience in helping teams communicate. We introduced our initiative “DISCover a New Way of Caring” to all the nurses in our area using email, text, announcements during morning huddle and shared governance meetings. We created a logo and decals given as a reminder to participants. Each nurse in our area was given the opportunity to complete a DISC assessment and then participate in an interactive half-day course with their coworkers. Through instruction and group work participants were helped to understand the results of their assessment, the key features of each behavioral tendency, and how to modify their communication style to better meet the needs of those with whom they communicate. Follow-up resources including review sheets, online videos and rotating slides on unit monitors were used to help reinforce the concepts learned in the group class.

Overall, our goal was to improve our nurses’ awareness of their own behavioral tendencies as well as the tendencies of others and then use that knowledge to communicate in a way that those receiving their message would better understand. The interactive class had a 95% participation rate and was well received by staff. However, at the end of our project, our aggregate HWEAT score decreased from 4.44 to 3.43, and our HWEAT score in Skilled Communication decreased from 4.21 to 3.21.

During our project our unit experienced several changes including the restructuring of our hospital system, the loss of the Heart Center nurse manager and the CSDU assistant nurse manager, and the relocation of the CSDU into a space shared with the PCICU. We believe the significant amount of change we all experienced contributed to the decrease in our scores and increase in nursing turnover but now provides us with the opportunity to use what we learned about behavioral tendency and communication to continue to improve the health of our work environment.

Permission to Reuse Materials
The materials associated with this AACN Clinical Scene Investigator (CSI) Academy project are the property of the participating hospital noted above, not AACN. Requests to use content contained in the CSI team’s summary, presentation or toolkit should be directed to the hospital. We suggest reaching out to the hospital’s Communications, Marketing or Nursing Education department for assistance.

Disclaimer
The AACN CSI Academy program supports change projects based on quality improvement methods. Although CSI teams seek to ensure linkage between their project and clinical/fiscal outcomes, data cannot be solely attributed to the project and are estimations of impact.