Communication Map Comparison

Communication Map

With and Without Comparison

The best way to ensure staff use good practices is to make them easy to use as part of the daily routine. By contrast, making good practices hard to do derails them. B&F Consulting’s method provides an infrastructure for staff closest to the residents to routinely share knowledge and problem solve within the immediate circle of daily care and with the rest of the organization. The method first puts in place four foundational organizational practices – consistent assignment, shift huddles, involving CNAs in care planning, and Quality Improvement (QI) closest to the resident. These practices, known as “relational coordination practices” create a forum for regular communication, critical thinking, and problem solving among and with staff closest to the residents.

The relational coordination practices provide a framework for an internal communication network with the resident as the network hub. With consistent assignment as the home base, the network infrastructure supports individualized resident care through enhanced communication: shift huddles, moving QI out of the conference room to staff closest to the resident, and involving CNAs in care planning.

Communication Map Comparison

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The map below represents the progression of the internal communication network as homes engineer consistent assignment, huddles, QI closest to the residents, and CNA involvement in care planning into organizational processes and routines.

Incubator homes found that when staff consistently work with the same residents and co-workers, and huddle regularly to share knowledge and problem-solve together, these work systems engineer communication and teamwork into daily practice as the default, rather than leaving communication and teamwork to chance.


Conversely, without these practices, staff responsible for organizational oversight and support do not have regular easy access to the information from the staff at the point of care. Clinical leaders are then less able to provide timely support to respond to residents’ daily needs. When it takes too long for timely information about residents’ conditions and needs to be shared and acted on, residents may experience avoidable declines.


Developed by Amy Elliot, PhD, Sonya Barsness, MSG and Barbara Frank. Based on B&F Consulting’s method for Engaging Staff in Individualizing Care, incubated in Pioneer Network’s National Learning Collaborative on Using the MDS as the Engine for High Quality Individualized Care. Funded by The Retirement Research Foundation