Improving telephone communication with patients

Physician on telephone with patientTelephone communications with physicians, pharmacists, medical staff, and patients can result in miscommunication and lead to treatment and prescription errors. Anna Reisman, MD, and Karen Brown, MD, point out in their Journal of General Internal Medicine article that telephone communication may be error-prone because of technical issues and an absence of visual cues.

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Can we improve the accuracy of orders given to radiologists?

radiologist with head scanCase study

A 49-year-old male patient arrived at the ER with a chief complaint of dizziness and vertigo with nausea and vomiting. The treating physician ordered a noncontrast head CT scan, indicating a history of “headache” for the radiologist to review.

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Ensuring effective handoffs

Verbal handoff of patient chartMiscommunication contributes to as much as 80 percent of medical errors, much of it occurring when care is transferred from one health care provider to another.1 In fact, in a 2006 survey of residents at Massachusetts General Hospital, 58.3 percent revealed that at least one patient was harmed in the course of their most recent rotation because of a problem with the handoffs. Even more troubling, 12.3 percent said that major harm occurred.2
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Breaking bad news to patients

Physician delivering bad news to an anxious patient



It can be hard to find the right words when breaking bad news to patients. Whether you’re telling a patient he has high cholesterol, pneumonia, or a positive test for cancer, the discussion can be tense and difficult. Here are some ways to help a patient deal with the stress of bad news:

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Working with patients for medication safety

Physician holding a handful of medication

Health care providers know that patient safety is a process that works best when patients and providers work together. In fact, a provider’s communication and engagement with patients remains a cornerstone of high-quality, safe care.

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EHR case studies: The case of the unfinalized document

Physician examining computer recordsWhat happened during patient care?

A patient presented to her primary care physician for reoccurring chest pain, and the physician referred her for a stress test. The test report was suggestive of ischemia and recommended a thallium test to confirm coronary artery disease. The patient completed the thallium test in March, and an abnormal myocardial ischemia was identified.

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EHR case studies: The case of the orphan files

IMG_1246blogWhat happened at the practice?

A patient presented to the hospital with cough, fever, aches, and irregular breathing. After a chest X-ray, pneumonia was ruled out. The radiologist’s final report indicated an incidental finding of an increased density near the mediastinum, suggesting follow-up.

The patient name was listed as “Hanssen” in the hospital’s EHR—but as “Hansen” in the clinic’s EHR. Though the hospital had electronically submitted the discharge summary, including the radiologist’s recommendation for follow-up, the patient’s clinic EHR was not updated.

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Responding to a Patient’s Complaint

MHE_093CWebPoor communication can damage a patient’s confidence in the interest, competence, and attitude of a health care team. Patients and their families may feel strongly that they have been wronged. They may complain about poor clinical care, a billing issue, a health care employee’s display of rude behavior, someone’s inability to communicate pertinent information, a breach of confidentiality, a delay in service, or lost or damaged property.

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How bilingual staff members can improve patient care

iStock_000012870360XSmallWebStaff members who are bilingual are sometimes asked to interpret for a patient when the hospital interpreter or approved contract interpreter is not available. Following are general guidelines for bilingual staff members to consider when working with patients.

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EHR case studies: The case of the data that was copied and pasted

iStock_000011067094MediumblogWhat happened in the patient record?

A longtime patient presented at a specialty clinic for routine evaluation and monitoring. A tech initiated the documentation for the encounter by copying a problem/diagnosis list from another patient’s chart but not updating the information in the current patient’s chart. The provider did not confirm the information with the patient.  Continue reading