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When Failure to Communicate Becomes Deadly

Closeup of a doctor holding a stethscope

Several studies have shown communication failure to be a leading cause of preventable deaths in the medical arena.

Alarming Findings on Communication Failure

A study from the 1990s found miscommunication to contribute to between 44,000 and 98,000 deaths in American hospitals annually. In a more recent report, CRICO Strategies analyzed about one-third of the paid medical malpractice claims in the United States. Communication failures occurred in 30% of the cases and resulted in 1,744 deaths.

In the 2020 CNA/NSO report of the claims encountered by nurses, communication failure allegations had the highest average total incurred ($324,260) of the closed claims with paid indemnities above $10,000.

Causes of Communication Failure

Research findings have spurred efforts to establish the factors that contribute to poor communication in hospitals.

Handoff Errors

When a doctor’s or nurse’s shift ends, a patient must be handed off to the new health care provider. According to the Joint Commission on Accreditation of Healthcare Organizations or JCAHO, ineffective communication during handoffs contributes to 80% of serious errors. In a case reported in Today’s Hospitalist magazine, a 37-year-old woman died after crucial information was not communicated at the time of handoff.

Interpersonal Dynamics

Communication problems also arise from interpersonal dynamics among hospital staff members. Medical facilities tend to be hierarchical, with doctors in charge despite spending less time with patients than nurses. Nurses are not accustomed to speaking up or asking questions. Studies have shown the hierarchical set-up to contribute to communication problems and medical errors.

In one case, a nurse noticed a drop in a patient’s red blood cell count after surgery. She did not convey these potential symptoms of internal bleeding to the surgeon. This patient died later of an internal hemorrhage.

Poor Physician-to-Physician Communication

One important study found that primary care providers do not thoroughly communicate patients’ information or needs with specialists. Conversely, many consultants and specialists neglect to notify primary care physicians of their findings. The study implies the likelihood of communication problems developing increases with the number of physicians involved in caring for a patient.

In one case, a primary care provider failed to mention the lab results indicating congestive heart failure when referring a patient to a lung doctor. The patient died nine days later.

Hierarchical structures, workplace dynamics, and shortcomings of physician-to-physician communications plague the healthcare industry. Unfortunately, it is the patients that often pay the price of the resulting communication problems.

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