Tool: CUS
Using the CUS technique provides another tool for advocacy, assertion, and mutual support. Signs with words such as "danger," "warning," and "caution" are common in the medical arena. They catch the viewer’s attention. In verbal communication, "CUS" and other signal phrases have a similar effect. If all team members have a shared mental model and are on the same page, when these words are spoken, all team members will clearly understand the issue and its magnitude.
To use CUS, proceed as follows:
- C: First, state your concern.
- U: Then, state why you are uncomfortable.
- S: If the conflict is not resolved, state that there is a safety issue. Discuss in what way the concern is related to safety. If the safety issue is not acknowledged, a supervisor should be notified.
You can watch an example of the use of CUS. After viewing the video, think about how CUS was used.
TeamSTEPPS: CUS in Labor & Delivery (10 seconds)
- It began in the form of a statement, "I am concerned," and then followed up with additional patient vitals.
- The nurse stated she was uncomfortable with the late decelerations.
- She then said she was concerned that the patient's safety was at risk.
CUS is also a recommended tool to express concerns regarding the need for a medical interpreter when conversations involve patients with limited English proficiency. A video-based example of using CUS for this purpose is available below.
TeamSTEPPS: LEP Safety: Success (6:09)
