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Irene McGhee

Title: Improving Interprofessional Team Performance with "I START-END"TM - a Unique Communication Tool

Biography

Biography: Irene McGhee

Abstract

The complexity of healthcare today means a patient is cared for by many healthcare professionals. Reliable transitions of care are the mainstay of such a system – unfortunately data shows that miscommunication during handovers are common (80% in one study) and can result in patient harm. 

A communication tool/framework, “I START-END” was developed, to facilitate effective communication and collaboration among healthcare providers, during handovers and other episodic care encounters (AD HOC) –settings where a group of healthcare workers, usually with no prior relationship to each other, meet episodically to co-manage a patient’s care. 

I START-END promotes engagement and dialogue so providers can “get on the same page”, and connect more effectively for improved seamless care of patients.

Speaking up behavior, closed loop communication, shared mental maps, doing readbacks & debriefings, as well as anticipating and planning for next, are the key activities promoted by the 

I START-END communication tool. 

This tool was studied in a simulator study. Before and after questionnaires showed 90% of residents stated the I START-END tool was OFTEN or ALWAYS helpful in the AD HOC setting. It facilitated communication and speaking up, and made them more aware of what else was happening with the patient and to anticipate additional resources needed.

Residents stated that they would continue to use the tool in their practice and felt it could be applied to many other clinical settings.

To prevent fragmentation of care, resilient communication strategies, such as I START END, are essential for successful inter-professional practice of the future.