Tool: the CUS technique

Summary

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.

Content

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. 

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.