March 11, 2015
Improve Communication, Slash Error Rates

It might seem logically intuitive that better communication between clinicians and healthcare organizations would lead to better patient outcomes — such as higher quality of care and lower error rates. Although determination of a causal connection has historically been slow, research in this area has picked up and is beginning to show just how strong the link is.

For example, one study found that the keys to lowering error rates and improving outcomes include (1) the ability of each clinician to ask more complex questions about patients, giving them full attention; (2) sharing of information across “activity systems involved in the knots of activity”; and (3) ensuring that the information is able to be easily relayed, so that it doesn’t become altered or confused.

On the backs of this and similar types of findings, the Joint Commission even created a 2011 National Patient Safety Goal calling for communication that is timely, accurate, completely unambiguous, and understood by the recipient, and saying poor communication of patient information was “the most frequent root cause of sentinel events.” The Agency for Healthcare Research and Quality have also reported, to Congress, no less, that communication problems are the most common root cause of medical errors, and that miscommunications arise between providers and organizations, often due to insufficient documentation that is not easily and quickly shared among them.

As a result, healthcare institutions have begun to develop and institute improved communication systems to meet these criteria — and, in turn, research into these communication systems has been able to quantify that longed-for causation. In a new study, published in the December New England Journal of Medicine, researchers conducted a prospective intervention study of a handoff-improvement programs in 9 hospitals, measuring rates of medical errors, preventable adverse events, miscommunications and workflow. The results were astonishing: Over 10,740 patient admissions, the medical-error rate decreased by 23% after implementation, compared to before implementation, and rates of preventable adverse events decreased by 30%. Workflow remained stable.

“Miscommunications and handoff errors are two of the most significant causes of medical errors in hospitals in the U.S.,” said the researchers in a press release. “We recognized that it would take a great deal of work to make the handoff program a sustainable system. Because we know that miscommunications so commonly lead to serious medical errors, and because the frequency of handoffs in the hospital is increasing, there is no question that high-quality handoff improvement programs need to be a top priority for hospitals.”

The lack of a complete patient information record that can be easily communicated between clinicians and healthcare organizations can be easily solved by using scribes. With complete patient and care information recorded in real time, it is easier to share and, more importantly, know information is relevant and complete. A clinician may conduct as many as 150,000 patient interviews during a typical career, according to the Institute for Healthcare Communication, so information is rapid-fire, and scribes can help clinicians get the most out of these interviews to prevent errors down the chain of care.