Telephone 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.
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.
Miscommunication 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
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:
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.
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.
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.
Poor 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.
Staff 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.
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