Which of the following is the most common communication error in patient care

Effective communication is essential in any business but even more so in healthcare. The effects of poor communication in healthcare can have extremely serious consequences. As with other businesses, poor communication decreases profits; but, in healthcare, communication failures can negatively affect patient outcomes. Poor communication results in misdiagnoses and other medical mistakes that can easily lead to avoidable health complications and the death of patients.

In this article we explore some of the main effects of poor communication in healthcare and suggest strategies to adopt to improve communication between staff and for communicating information to patients.

Communication failures most commonly occur during shift changes, when care of a patient is handed over to a different caregiver. When incomplete, inaccurate, or ambiguous information is provided at the changeover it increases the probability of medical mistakes occurring. Poor communication could lead to patients receiving the wrong treatment or procedure, being given incorrect medication, or could result in delays to essential tests and treatments – all of which may negatively affect patient outcomes.

Medical safety experts at CRICO Strategies investigated 23,000 medical malpractice lawsuits and found more than 7,000 of those lawsuits could be attributed to communication failures. Those communication failures resulted in $1.7 billion in malpractice costs and almost 2,000 preventable deaths. A study conducted by the Joint Commission found 80% of serious medical errors were the result of miscommunication between caregivers during patient handovers.

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Effects of Poor Communication Between Physicians and Nurses

The most common communication failures between clinicians involve the miscommunication of important information about a patient’s symptoms or condition and poor documentation of patient information. These issues can lead to incorrect decisions being made about treatment and delays to treatment when the severity of the patient’s condition is not understood.

As an example, the CRICO study identified a case when a nurse had failed to explain to a surgeon that a patient was experiencing abdominal pains following surgery and had a low red blood cell count, which is indicative of internal bleeding. The patient later died from the hemorrhage.

Aside from the risk to patient safety, there are other consequences of poor communication. Patients often experience long delays, often at several stages of their journey in a hospital. Many of the delays are the result of poor communication between staff. These communication issues slow patient throughput, increase hospital stays, and are a key factor in poor patient satisfaction scores and are costly for hospitals.

Communication problems occur for a variety of reasons such as ineffective policies and procedures, language difficulties, poor communication skills, workload pressure, EHR issues, poor documentation, conflicts between staff members, and ineffective communication systems in hospitals. Communication failures can also occur due to the hospital hierarchy, which results in nurses having a power disadvantage which can be a barrier to effective communication.

Effects of Poor Communication Between Clinicians and Patients

Effective communication between clinicians and patients is essential during medical encounters. Clinicians must listen carefully to what patients tell them, verbally and non-verbally, and need to gather information, reassure patients, and communicate important medical advice. Most patients will not have an extensive knowledge of medical matters, so care must be taken to ensure that any information that is communicated has been understood.

Poor communication between clinicians and patients can result in misunderstandings about medications and the miscommunication of follow up instructions, which can result in poor outcomes and readmissions, and could result in a patient coming to harm. Poor communication can also result in inadequate informed consent, which can lead to malpractice lawsuits.

Summary of the Effects of Poor Communication in Healthcare

The main effects of poor communication in healthcare are a reduction in the quality of care, poor patient outcomes, wastage of resources, and high healthcare costs. Communication failures often have a negative effect on patient and staff satisfaction.

Effective communication will:

• Improve quality of care and patient outcomes
• Enhance the patient experience
• Improve patient satisfaction scores
• Reduce the cost of healthcare
• Reduce stress for clinicians and prevent burnout

Improving Communication in Healthcare

There are several strategies that can be adopted to improve communication in hospitals, especially at shift handovers, and ensure more effective communication of information to patients. These include the RELATE model (Reassure, Explain, Listen/answer questions, Take action, Express appreciation), the STICC Protocol (Situation, Task, Intent, Concern, calibrate), and the BATHE Protocol (Background, Affect, Troubles, Handling, Empathy). See Communication Strategies in Healthcare.

These communication strategies are important for improving patient safety, but staff also need to be provided with the communication tools they need. Many hospitals are still reliant on outdated communication technologies such as pagers and faxes, are not using mobile devices, and communication technologies are not integrated with EHRs.

Improve Communication by Updating Outdated Communication Systems

Modern clinical communication and collaboration (CC&C) platforms have greatly improved communication in hospitals. CC&C solutions include HIPAA-compliant text messaging platforms that can be used by all members of the care team to communicate with each other efficiently and effectively. These help to ensure the right information is communicated to the right people at the right time.

The platforms are text message based, but also support audio and video calls and can be used for quick consultations, transferring all important information about patients to new shift owners accurately, and communicating with patients and their families. The platforms integrate with EHRs, allow alerts to be sent instantly from the EHR to clinicians, and since the platforms are accessed via mobile devices, staff are not tied to any one location. Clinicians can receive the information they need at a patient’s bedside.

Hospitals that have adopted these platforms have managed to improve patient safety, reduce medical errors, increase productivity, reduce patient wait times, increase patient throughput, and significantly cut costs.

The Effects of Poor Communication in Healthcare: FAQs

How does poor communication impact HIPAA compliance?

There are many ways in which poor communication can impact HIPAA compliance from the poor communication of HIPAA-compliant policies and procedures to the poor communication of sanctions for non-compliance with the policies and procedures. Communicating patients´ rights is also a key element of HIPAA compliance that covered entities need to get right every time.

How should covered entities communicate patients´ rights?

Covered entities are required to provide each individual with a Notice of Privacy Practices (NPP). The NPP should explain the permissible uses and disclosures of PHI, which uses and disclosures require authorization, and how individuals can access and correct PHI maintained about them and request an accounting of disclosures. The NPP should also explain how individuals can complain if they feel their HIPAA rights are being violated.

How does HIPAA-compliant text messaging improve clinician-patient communication?

Provided the patient has consented to receive communications by text, the text messaging platform can be used to provide written information to the patient rather than verbal information – reducing the chances of misunderstandings and giving the patient the opportunity to ask questions in a non-emotive environment. This level of communication enhances patient understanding of their treatment options and mitigates the risk of inadequate informed consent.

How does HIPAA-compliant text messaging improve handovers?

One of the benefits of HIPAA-compliant text messaging is that there is a permanent record of the information handed over. This eliminates issues with forgetfulness, “he said/she said” disputes, and misunderstandings. With HIPAA-compliant text messaging platforms, the opportunity exists to prepare templates for different types of handovers in the form of a checklist so that every necessary element of the handover is included.

Is there a relationship between HIPAA compliance and patient outcomes?

In January 2022, the JAMA Network published a study which linked patients´ perceptions of privacy protections with their willingness to share personal information. While the report did not claim an increased willingness to share personal information resulted in better patient outcomes, it is easy to make the link that a physician with more complete information available will be able to make better informed treatment decisions, which in turn should result in better patient outcomes.