Fixing communication breakdown in hospitals to improve patient outcomes

Senior woman visited by home care specialist

Communication breakdown contributes to over 450,000 people per year suffering from an avoidable critical incident, according to researchers.


Consequently, an International Consortium of Communication in Health Care (IC4CH), which includes the Australian National University (ANU), are driving research on healthcare communication and training to improve patient safety outcomes.

Professor Diana Slade from the ANU Institute for Communication in Health Care said in Australia an estimated 500,000 people are harmed by the hospitals they seek help from each year.

“When these incidents are investigated over 90% are found to have a communication failure component,” Professor Slade said. “That’s at least 450,000 patients.

“These incidents can be misunderstandings between patients and clinicians, such as lack of clarity around a diagnosis or treatment options not being clearly understood or illegible patient records. Or it can be omissions or failures to clarify ambiguities and confusions in the handover process or in emergency departments.

“Hundreds of patients we have interviewed say they don’t feel heard, they often don’t understand what is being said to them and all too frequently they are not even part of the conversation about what’s happening to them at all.

“In fact the problem around the world is getting worse. Never has communication about health been more important, from the news in the media to the bedside.”

It is estimated there are over 50 million shift handovers per year in Australian hospitals, including nursing, medical and allied health.

The new global consortium will use research to help drive healthcare communication methods and training. The groups’ research includes listening in to and observing emergency departments in real time.

“Our research takes place as events are unfolding,” Professor Slade said.

“The recordings are transcribed verbatim, de-identified and analysed to see where the potential risk points are and how these misalignments can accumulate across a patient’s journey and contribute to a series of adverse events. We now have over two million words of authentic hospital interactions, which we believe is one of the largest databases of hospital interactions in the world.

“Our goal is to translate cutting-edge communication knowledge into best practice and training for safe and compassionate healthcare. In many ways the message is the medicine. So we need to make sure we get the messages right.”

IC4CH members include ANU, University College London, Lancaster University, Nanyang Technological University, the University of Hong Kong and the Queensland University of Technology. Harvard University will join later this year.

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