PURE conversations: enhancing communication and teamwork.

Communications failures have been identified as a significant cause of adverse outcomes in obstetrics. Following the lead of some high reliability organizations, healthcare has introduced structured communication such as SBAR as a way to make sure communications between professionals are direct, complete and effective. The authors have observed, however, that structured communication in healthcare often requires a cultural change in the way that professionals relate to each other; PURE conversations (Purposeful/prepared/productive, Unambiguous, Respectful and Effective) can facilitate this cultural shift. PURE conversations stress the mental processes necessary to conduct and monitor structured communications in real time by taking into account the context and relationships that exist among professionals. This article describes the elements of a multidisciplinary workshop based on clinical scenarios incorporating the PURE concept to improve the effectiveness and adoption of structured communication by the perinatal team.