Closed-loop communication matters in patient care, reducing errors and helping teamwork with communication and workflow, particularly in situations where there is increased variability. It ensures that the message is properly received by exposing deficiencies that we may have in describing what we heard, which can reflect distraction, confusing terms, or different literacy levels. Using closed-loop communication will not only save you from making errors but also creates an opportunity to teach and empower your medical teams to know why they are doing certain things rather than just following protocols.
Join the conversation with your host Dr. Ryan Stegink as he shares more about closed-looped communication, how you can make a difference in your patient care, and how you experience your critical workflows.
During this episode, you will learn about;
[00:01] Introduction to the show
[01:52] Today’s focus: Workflow optimization
[03:03] Lessons from Dr. Ryan closed-loop communication with his realtor
[04:54] What is closed-loop communication
[06:39] Where you should use closed-loop communication
[09:36] When to use closed-loop communication and why it matters
[11:43] Changing how you engage with others and feel about your job
[12:16] Ending the show and call to action
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- When things really matter, having a shared understanding that is accurate is important.
- Loop communication helps create a shared understanding of a situation and the request being made.
- Loop communication promotes safety and supports wellness
- Providing good care that is more efficient and empowering empowers self, staff, and colleagues to be human beings who have input and feel heard.
Connect With Dr. Ryan Stegink
Above are the episode show notes and below is the transcript. Some episode transcripts have been edited more than others, but they are up in the meantime to help those who would rather read and for searchability on the web. Extensive editing has not been prioritized as I seek to both produce regular content and maintain my own wellness. See the website disclaimer if you have questions, since this is all for your education and entertainment only. Enjoy!
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And now for the rest of today’s episode.
Welcome back to episode 37 of the MedEdWell podcast. Thank you so much for joining me, so glad to have you here to talk about how we can take the next step in our wellness. In this case, we’re in the middle of a six part series on charting and workflow optimization today, we’ll be talking more about some of the workflow optimizations, particularly around communication, closed loop communication, and how that can make a difference for your patients and for how you experience their clinical workflows. I wanted to take a moment to thank you for all your support or sharing these episodes for listening, for engaging, letting me know what you’re appreciated and what you’d like to hear about. So one of the things that really struck me as I was thinking about this is how it’s applicable in so many areas of life. I talked earlier about how the thinking leading to action episode 34 really had a big impact on me.
As I went through the past couple of months, one of the things was my family, and I started looking at purchasing a home. The market’s still very hot right now. And we met with a realtor and he helped us understand what we needed to know about making offers in this market. As we went through the process, we saw a home and we thought about it. We decided whether we were gonna put in an offer. A realtor was really good about having us repeat back exactly what our thoughts were, what our offer was and what the different parts of that looked like. We had to be crystal clear at what he was putting in for us, that we were going to sign reflected what we actually wanted. So in a medical context, this closed loop communication has certain features, certain ways that it gets put into practice, because you think back to being a child and playing the telephone game where you tell a message to somebody else, they whisper it in the ear of someone else.
And it goes from one person to the next, to the next to the next. You don’t know that you’re gonna get the same message back. And typically you don’t. So when things really matter, having a shared understanding that’s accurate is really important. So first today, what is closed loop communication involves saying something, communicating something and repeating it back. These things are now taught as part of the life support trainings with the communication skills section. It’s also like teach back when you’re giving patient education or summarizing the visit says, tell me what you heard or teach me how to, how to use that particular medication or device that we’re prescribing for you. It may take a little bit longer, but it ensures that the message is properly received. Sometimes it exposes certain deficiencies that we may have in how we described it. First time it may reflect that one or both parties in this conversation were distracted or there was something else going on that made it more difficult to really engage or to hear it. Maybe it’s that there’s a different level of health literacy or literacy, or the terms that we’re using are a little bit confusing. I’ve talked before, about how on my developmental peds rotation. I
Used big medical words rather than really breaking it down into words that my family’s understood. So first, what is closed loop communication. And secondly, who should you use it with and what situations now, certainly there are those high risk situations codes giving medications, but there’s also the routine things vaccines, the particular dosage of a medication. Certainly there’s some of the procedural things around entering orders. And that’s part of why entering orders in a computer is required in most situations now, rather than just giving a verbal order. And it’s definitely helped me because sometimes you’re trying to calculate a weight based dose of Tylenol for a febrile patient in clinic. And it’s easy to think one thing, and I just talked to this other patient, the new patient that was just roomed is febrile and trying to give things as opposed to saying, let me put that in the computer and then you can see it, and then you can repeat back, oh, this is actually what it is.
I’ve also encouraged my staff to, to talk back, to engage, to say, did you really mean to give that, that vaccine? Maybe I was looking at their chart and I thought that they were due for this, but no, actually the interval was too short. And so we actually need to wait on that. Or why did you give that extra meningitis shot to that two year old? Well, actually that one’s clinically indicated because they’re traveling to somewhere in the world that has a higher incidence of meningitis and it would be indicated to get that at the current time. So it’s definitely, these questions have definitely saved me or making errors at times. And they’ve also provided opportunities to teach. I want my medical team to be empowered, but also to know why they’re doing certain things. I wanna understand that to have that clinical reasoning, to use our minds in a way that reflects the training that we’ve received, rather than just following protocol, just because that’s what it says.
There might be an opportunity to deviate from that. That makes sense in the moment, but it’s taking that time to say, this is what I’m thinking. This is what I want to do for someone to repeat back. This is what you’re saying. Yes. All right, let’s do it. It helps create a shared understanding of the situation of the request that’s being made. So closed loop communication. When should you use it, but really why does it matter? Well, for one, as we’ve been talking about it matters for patient care or reducing the amount of errors that are made or helping teamwork and communication with workflows, particularly in situations where there is increased variability, where things sometimes are a little bit different, it helps promote safety and helping people feel like, Hey, I can ask these questions rather than just share the doctor. So I have to do it.
No. I want people to be able to engage and to really feel like they’re supported when they want to check that they’re understanding things. But it’s also about supporting wellness because providing good care, that’s more efficient, more empowering that empowers the staff, my colleagues, myself, to be whole human beings who get to have input in these situations to feel heard. It really matters. So I want you to think about the thoughts that you’ve had around communicating with staff, with colleagues, consultants, feelings afterward. You may think of conflict that you’ve had in some of those situations. And the feelings might include being confused, being frustrated, feeling exhausted. Maybe you have something else that you feel when you think about communicating with others in a clinical context, maybe in a personal context, but what do you want to feel after reflecting on these aspects of closed loop communication?
How do you think that might be able to change? What’s one new thought that you want to choose today to get that desired feeling. It might just help your patient outcomes, your patient and patient satisfaction, and just how you engage with others and feel about your job. Thanks so much for joining me here on episode 37 of the MedEdWell podcast. I want to encourage you to subscribe, to share these episodes with another physician to let me know how this has impacted your life and your clinical practice. Again, thanks so much for all that you do. Please comejoin me on the next episode and have a great day.
And now for our important disclaimer:
Dr. Ryan Stegink is a practicing general pediatrician, but the MedEdWell podcast does not reflect the views, opinions, or beliefs of his employer nor affiliated university. Additionally, the MedEdWell podcast is for educational and entertainment purposes only and should NOT be considered advice regarding financial, legal, student loan, medical or any other specific topic. In such a case, you should seek consultation with a certified professional in that particular area. Again thanks for joining us on the MedEdWell podcast, and have a great day!