Emergency Services at Rhode Island Hospital

Project CLEAR!

Project CLEAR! (Communication Leading to Excellence and Ameliorating Risk) is an initiative funded by a grant from Lifespan Risk Services, with contributions from Rhode Island Hospital, University Emergency Medicine Foundation and, most recently, Newport Hospital. CLEAR! was conceived in the spirit of empowering Rhode Island Hospital's emergency department staff to cultivate teamwork and deliver the best possible patient experience.

CLEAR! equips each team member in the hospital's Anderson Emergency Center (attending physicians, residents, physician assistants and nurse practitioners, nurses, technicians and secretaries) with structured tools for effective communication with colleagues and with patients and their families.

The training session itself is a seven-hour day at the hospital's Simulation Center, consisting of three medical care scenarios that include both standardized patients and high-fidelity manikins. Each scenario is followed by a debriefing session where the staff reviews video footage of themselves in action. All CLEAR! attendees participate in at least one simulation. Facilitators lead the debriefing sessions, with everyone encouraged to contribute.

Simulation training sessions began in March 2011. Since then, more than 30 training sessions have taken place, and over 350 staff members, including senior leadership, have taken part in the program.

"CLEAR! was designed to support the pillars of Rhode Island Hospital's mission: Quality of Care, the Patient Experience and Staff Engagement," said Lynn Sweeney, MD, who, along with Adam Rojek, RN, CEN, is a co-principal investigator for Project CLEAR! "The program is re-orienting our staff to the importance of communication. Since the start of CLEAR!, we have been seeing an enriched level of teamwork in the ED, which ultimately improves our patients' experience."

To sustain the impact of CLEAR! over time, program leaders have established a unique collaboration with the Texas Tech College of Mass Communication for guidance with continually reinforcing the teaching points throughout the department.

Future plans for Project CLEAR! include expanding the training to all emergency departments in the Lifespan system.