Decreasing STAT Team Activations

Project Topic:

Improving nurse-to-nurse communication in an outpatient endoscopy unit

Hospital, City and State:

The Kirklin Clinic of UAB Hospital, Birmingham, Alabama

Unit:

• Endoscopy

CSI Participants:

• Lily Beth Ayers BSN, RN
• Megan Cox ADN, RN
• Arianne Crow BSN, RN
• Rachel Morris ADN, RN-II, AMB-BC
• Nurse Manager: Paige Culp BSN, RN, AMB-BC
• Coach: Joey Travis DNP, CRNP FNP-C

Project Goals/Objectives:

1. Decrease the amount of avoidable STAT team activations
2. Increase Healthy Work Environment Assessment Tool (HWEAT) communication score from 2.99 to 3.4

Project Outcomes:

1. Decreased STAT team activations from 16 to 6, 62% reduction
2. Improvement with zero ED admissions potentially caused by nurse communication errors
3. 88.77% compliance achieved by April 2026
4. Increased all HWEAT aggregate scores and all standard scores
5. HWEAT Skilled communication increased from 2.99 to 3.34
6. Potential annual fiscal impact of $81,706

Project Overview:

The project team developed a form to follow each patient through every operative phase. The “HIPO” form, includes sections for patient history, pre-op interventions, procedural interventions and patient outcomes. The project was launched on September 5, 2025, with a kickoff party with the endoscopy unit’s nursing staff.

The original HIPO form included check boxes for each section:

History: seizures, hypertension, diabetes, end-stage renal disease, and atrial fibrillation; Interventions: pregnancy test, electrocardiogram, medications given pre-op, ISTAT, and other;

Procedure: Biopsy, polyps, clips, ink, dilation, and other
Outcomes: when to restart blood thinners, next colonoscopy, and initiation of new medications.

The HIPO form was updated in November 2025 to remove the hypertension diagnosis and add cerebrovascular events as well as an “N/A” column if none of the boxes apply. The project team conducted daily manual audits to determine staff compliance using the HIPO form. In April of 2026 the endoscopy unit achieved an average rate of 85 % compliant with HIPO forms and implemented a post-intervention HWEAT survey which showed the units skilled communication score increased from 2.99 to 3.34. The project also showed a 67% reduction in STAT team activations overall, as well as a 100% reduction in STAT team activations that could potentially be related to communication gaps.