Introduction

Recommendations
- Management for anger and stress.
- The staff should be aware of difference of others and respect their values.
- Communication process should be clear and to the point.
- Continuous Education:
1. Sessions.
2. Posters and brochures.
3. Surveys.
- The staff should use ice breaking skills for developing trust relationship,
and they should be appreciative of others.
- The supervisors should always be accessible to all staff and members for
any help.

Conclusion
- Collaboration between staff.
- Coordination of communication.
- A policy for communication should be formatted, and to follow up on it.
- (instructions are not clear) so During communication process, there should
be:
1. Subject is known.
2. Eye-eye contact.
3. Effective listening.
4. Positive attitude.
5. Flexibility.
This problem is found almost everywhere in hospitals between employees
and it should be addressed before it affects the care of the patients.
Thank You ! .. Any Questions??
Fish Bone:
Casual Diagrams created by Kaoru Ishikawa in 1968.
Definition:
A troubleshooting tool that can be used to visually diagram the causes and
effects of a problem.
In this fish bone, we will be presenting the problem of improper
communication between nurses and doctors

instructions are not clear

instructors are not following the order

given too many tasks concurrently to one staff

unspecific information

relevant resources are not readly available

Cause and Effect

The strength of the fish bone diagram is that it allows you to focus on
specific cause categories, which may help you to better focus your line of
enquiry.

The fishbone diagram, also known as the Ishikawa diagram, is another tool to
provide you with a visual representation of your 5-why analysis.

Event

Delayed antibiotic therapy following admission through the emergency department

Implemented Changes
 Creation of two standardized report tools, one for physicians and one for nurses, each of which
generates directly from the electronic medical record a list of each patient’s medications, facilitating
clinicians’ assessment of treatment adequacy

Addition to nursing report of the critical step of reviewing patient diagnoses and related therapy and
notifying the physician of any apparent discrepancies

Event

Missed order for therapy following discharge from the hospital , on a Sunday evening

Implemented Changes

Institution of case management coverage on a 24-hour-a-day 7-day-a-week basis