Stroke Training and Awareness Resources (STARs)

Communication within teams

The importance of good communication within teams

In this section we want you to look at your own communication; how and where it can be improved. Learning from when things go wrong, being open to discussion of difficult cases and learning from outcomes. There needs to be a culture of no blame in order to allow people to have open and honest discussions with colleagues. Often there are no easy answers for patients with complex needs. They should be reviewed on a case-by-case basis. Staff can learn from each other and should not hesitate to ask for advice.

When we surveyed staff learning needs, we were were struck by the complexity of some of the cases and how difficult end-of-life situations are for patients, families and healthcare professionals. This module will not provide all the answers, but by addressing some of the common themes, we hope to provide healthcare professionals with a starting point for discussions within your own team.

The following tips may help:

  • Use a heading. This should be clear so that staff can find information about the crux of the meeting quickly
  • Note who was at the meeting (staff and family members). Is there a welfare power of attorney?
  • Current situation regarding the patient. Include the physical/medical status and psychological/emotional status of the patient
  • Are the family fully aware that the person may be dying?
  • For each patient there should be a clear plan of care which is explicit about what treatments should be given and which should not be; and whether decisions are still to be made for example ‘decision about NG feeding will be made following a family meeting’ or whether the team is adopting a ‘waiting and seeing’ approach and will discuss again at the next meeting
  • A list of action points can be useful if those who will take responsibility are agreed and named
  • This plan should be documented and easily accessible to all members of the team, including the on-call team
  • Clear handovers between different teams are essential. This applies in a range of circumstances e.g. consultants going on leave handing over to colleagues, routine handovers to night teams, nursing handovers
  • Communication with the primary care team and nursing home is essential if you are discharging a patient to die at home or in their nursing home. For those being discharged and who are not expected to die imminently, it’s important to communicate any decisions about DNACPR (e.g. in the discharge summary)
  • Any decisions should be signed and dated in medical or nursing notes. Sometimes a decision may be changed at a later date for example someone could be for antibiotics to treat infection or CPR but after a period of time the family have discussed not aggressively treating infections or resuscitating and the new decision has to be recorded
  • Record when family and/or the patient have been informed

Page last reviewed: 17 Apr 2020