In closed-loop communication, the person receiving instruction or information repeats it back to make sure the message is understood correctly, and the sender confirms to “close the loop.” It does not require more time, and in fact, it is likely to save time. But ultimately, it's an important tool that protects our patients from communication errors that can lead to serious consequences.
What is Closed-Loop Communication?
See It In Action
Use closed-loop communication frequently.
Closed-loop communication is not just for chaotic or emergent situations. Consider using it when providing any request in your daily practice to ensure everyone has a shared mental model.
As Heather begins her shift, the day shift nurse tells her which vital signs to monitor for a high-risk patient recovering from a total hip replacement. Heather responds: “OK, got it,” and the day nurse leaves.
Did Heather close the loop?
While assisting with a routine procedure, Jaxon notices that the surgeon’s call-out instructions were not directed at anyone, so he doesn't take any action.
Did Jaxon close the loop?
Can you help Dr. Evans close the loop?
Close the loop to confirm instructions.
When calling out specific instructions for a patient’s care—for example, making sure the patient gets out of bed at least four times a day—closing the loop will ensure these instructions are followed so ineffective communication won't interfere with the patient’s recovery.
Close the loop with patients and family members.
When meeting with or providing care to patients and their families, ask them to close the loop or provide an opportunity for a check-back so they can repeat back what they heard from the care team.
Close the loop when ordering or administering medication.
Not closing the loop could result in administering the wrong dose or type of medication, which could lead to an adverse outcome for the patient.
Close the loop when ordering tests.
It's always important to use closed-loop communication when ordering any tests or procedures for a patient. For example, if an order for an ABG test is ignored or misinterpreted, this could delay diagnosis and critical care.