The Importance of Closing the Loop and How to do it

Closing the loop is a frequently used term in the healthcare industry referring to a well functioning and coordinated healthcare delivery system. Closing the loop is an essential communication model to minimize medical errors and encourage team collaboration. This business practice is modeled in other industries outside of healthcare. In the most simplistic form, when thinking about an open loop, anything can get in and anything can get out. Whereas, a closed loop, the direction and flow is controlled leading to less variability. This model requires bidirectional communication and information sharing. Closed loop communication leads to effective interpersonal relationships between colleagues with an emphasis on teamwork, and  communication, leading to key improvements in patient safety.

Closed loop communication is a unique model originating from military radio transmissions. These transmissions involved verbal communication with the goal of ensuring accurate comprehension and understanding of important information. Closed loop communication was essential in military practices; the radio being used to pass messages long distances meant that the person on the receiving end was not visible. There needed to be an error proof method to confirm the accurate and intended receival of the message. This was created to ensure the transmittal and receival of key information in an environment where communication is frequently confusing and urgent. Every conversation must open and close the loop. This communication begins when an individual sends a message, the receiver then interprets the message and confirms the receival, and concludes with the sender of the message verifying the message has been received and correctly interpreted, resulting in a closed loop. 

In the healthcare industry, miscommunication is the root cause of a significant amount of medical errors. This high pressure environment requires a strict standard of communication. According to the Control Risk Insurance Company, miscommunication is the cause of up to 30% of successful lawsuits where a patient is incapacitated or killed. Handoff periods between healthcare personnel are extremely vulnerable to errors in verbal communication. In addition, the sharing of information between healthcare providers and families represents an instance where careful and specific communication is necessary. Misunderstandings, interruptions, and hesitations involving verbal communication can easily occur especially when recalling medical terminology, such as generic versus brand name drugs for example. 

goShadow’s Employee Rounding tool analyzes the everyday experiences of various units in a healthcare system. goShadow designs a curriculum with unit teams that include action-oriented questions to better understand successes, barriers, and how to support employees, patients, and teams. Subsequent improvement projects and solutions are harvested and presented in the employees’ voices. Digital data collection, analysis and aggregation, and coaching are the tools utilized to co-create solutions to the most significant pain points. Employee Rounding at UPMC Magee-Womens Hospital Med-Surg Units took place from March to December of 2020 aggregating 707 employee responses collected by unit leadership. Clarity of information, provider communication, coordination of care, and frequency of communication were expressed as bringing joy and satisfaction when done well but also a significant pain point to employees when done poorly. goShadow supports organizations in identifying best practices in communication and areas for improvement to close the gaps in the healthcare system. 

Employee Rounding provides an opportunity for all organizations to increase job satisfaction by actively listening and responding to the first-hand feedback of employees. Collecting data every month shows incremental improvements creating sustainable change. 

Get started today closing the gaps in organizational and unit level communication with goShadow’s Employee Rounding tools, customized action oriented questions, data collection, and reporting; to learn more visit


Closed loop communication training in ... - (n.d.). Retrieved April 29, 2022, from

Sarah E. Peyre, E. D. (n.d.). Closed Loop Communication: Operating Room Team training. CRICO. Retrieved April 29, 2022, from,before%20it%20came%20to%20healthcare

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April 29, 2022