Newswise — Navigating the challenges of workplace communication can be especially difficult in critical care, with its high-stakes and high-stress environment.

An educational initiative at Boston Children’s Hospital offers specialized content on timely topics and sensitive subjects to help clinicians from six units in the hospital’s critical care cardiovascular service face those challenges confidently and effectively.

The monthly interdisciplinary educational rounds focus on team dynamics and relationship challenges, instead of the more common interventions that aim to improve clinicians’ personal well-being, help develop individual resilience or address structural aspects of the work environment.

The hospital’s Institute for Professionalism and Ethical Practice developed the rounds in 2010 as an extension of the daylong workshops offered through its well-established Program to Enhance Relational and Communication Skills (PERCS). The PERCS rounds allow participants to explore highly sensitive topics that are otherwise difficult to address in traditional settings.

Navigating Communication Challenges in Clinical Practice: A New Approach to Team Education” provides an overview of the PERCS rounds, as well as recommendations for institutions considering a similar educational approach. The article is published in December’s Critical Care Nurse (CCN).

Co-author Christine Rachwal, MSN, RN, CCRN, is a Cardiac Intensive Care Unit nurse practice specialist in the cardiovascular and critical care program at Boston Children’s. She is also a faculty associate and leadership circle member of the Institute.

“The PERCS rounds offer an approach to transform challenging issues that arise in the clinical setting into hourlong, bite-sized educational activities that facilitate safe, interactive learning,” she said. “Similar educational programs are rare in practice and virtually nonexistent in nursing programs.”

More than 1,100 clinicians participated in the monthly sessions from April 2010 through December 2016. More than half were nurses; other attendees included social workers, child life specialists, psychologists, chaplains, physicians and ethicists. Medical interpreters, nursing students and administrative staff also attended these sessions.

The median attendance was 18 people per session, with some topics attracting especially high participation. Programs of highest interest included child assent, bereavement and workplace bullying. Sessions related to the use of social media and video in healthcare were standing room only, with requests for follow-up sessions.

Evaluations provide feedback on each session, offer suggestions for future topics and identify take-home points that participants plan to use in their own practice. All of the participants responded yes when asked if they would recommend the program to their peers, and more than 90 percent of participants rated the program “quite valuable” or “very valuable.”

As the American Association of Critical-Care Nurses’ bimonthly clinical practice journal for high-acuity and critical care nurses, CCN is a trusted source of information related to the bedside care of critically and acutely ill patients.

Access the article abstract and full-text PDF by visiting the CCN website at


About Critical Care Nurse: Critical Care Nurse (CCN), a bimonthly clinical practice journal published by the American Association of Critical-Care Nurses, provides current, relevant and useful information about the bedside care of critically and acutely ill patients. The award-winning journal also offers columns on traditional and emerging issues across the spectrum of critical care, keeping critical care nurses informed on topics that affect their practice in high-acuity, progressive and critical care settings. CCN enjoys a circulation of more than 120,000 and can be accessed at

About the American Association of Critical-Care Nurses: Founded in 1969 and based in Aliso Viejo, California, the American Association of Critical-Care Nurses (AACN) is the largest specialty nursing organization in the world. AACN represents the interests of more than half a million acute and critical care nurses and includes more than 200 chapters in the United States. The organization’s vision is to create a healthcare system driven by the needs of patients and their families in which acute and critical care nurses make their optimal contribution.

American Association of Critical-Care Nurses, 101 Columbia, Aliso Viejo, CA 92656-4109; 949-362-2000;;;



Journal Link: Critical Care Nurse, December 2018