{"id":3931,"date":"2016-06-27T07:00:40","date_gmt":"2016-06-27T07:00:40","guid":{"rendered":"https:\/\/www.thesullivangroup.com\/RSQSolutions\/?p=3931"},"modified":"2016-10-19T20:28:32","modified_gmt":"2016-10-19T20:28:32","slug":"breakdowns-in-communication-a-significant-cause-of-risk-and-malpractice-litigation","status":"publish","type":"post","link":"https:\/\/test.thesullivangroup.com\/RSQSolutions\/breakdowns-in-communication-a-significant-cause-of-risk-and-malpractice-litigation\/","title":{"rendered":"Communication Breakdowns in Healthcare: A Significant Cause of Risk and Malpractice Litigation"},"content":{"rendered":"\u201cIt\u2019s all about communication!\u201d The world of medicine has changed by leaps and bounds over recent decades. Computers have become part of our daily lives, and technological advances have significantly improved our ability to diagnose and treat diseases that were once thought incurable. Despite this incredible progress, healthcare providers continue to commit far too many medical errors. And unfortunately, many of these mistakes are simply caused by \u201cpoor communication.\u201d\nMalpractice litigation is often caused by communication failures. A 2015 report by CRICO, a division of The Risk Management Foundation of the Harvard Medical Institutions, Inc., found that: \u201cCommunication failures were linked to 1,744 deaths in five years \u2026 and communication was a factor in 30% of 23,658 cases \ufb01led from 2009-2013.\u201d These communication failures occurred throughout the healthcare system. According to the CRICO study, 48% of the communication breakdowns happened in ambulatory settings, 44% in hospital inpatient environments, and 8% in emergency departments.\nEvaluation of these malpractice cases revealed that frequent communication breakdowns included:\n\nMiscommunication of the patient\u2019s condition (26%)\nInadequate informed consent (13%)\nPoor documentation (12%)\nUnsympathetic response to patient complaints (11%)\nFailure to read the medical record (7%)\n\n\nIn addition, breakdowns related to inadequate patient education regarding medications were noted in 5% of cases.\nResults of the CRICO report provide significant take-home messages:\n\nMalpractice litigation cases involving breakdowns in communication more frequently resulted in financial payments to plaintiffs than other types of cases.\nPayouts to plaintiffs were higher for cases involving communication errors than for other types of cases.\nCases caused by errors in provider-provider communication more frequently resulted in plaintiff payouts than for cases involving provider-patient communication breakdowns.\nPayouts to plaintiffs were higher for cases involving provider-provider communication mistakes than for cases caused by provider-patient communication errors.\n\nThe authors of the CRICO study suggested three ways to improve communication and potentially avoid litigation:\n\nThe first is to have and display \u201cempathy\u201d for the patient\u2019s situation. Providers must consider emotional aspects when delivering diagnoses, treatment plans, and complex scientific subjects. Keep in mind that compassion plays a major role in efficient communication.\nThe second suggestion made for improving communication is to create an \u201cEffective Consent Process.\u201d Some organizations are creating legal, yet \u201cpatient friendly\u201d consent forms. As part of the consent process, providers should discuss expectations, outcomes, the effect of obesity or smoking, the possible use of blood products, the presence of sales representatives in the operating room, the use of anesthesia, and the use of photography. All conversations need to be clearly documented in the medical record.\nThe third recommendation is to develop a family\/friend \u201cin-room tablet communication portal\u201d for Intensive Care Units. The portal could provide information on the patient\u2019s care, procedures, and medical devices being used. The tablet would allow the posting of questions to be answered by providers.\n\nData from The Joint Commission consistently reveals that poor communication is a leading cause of medical mistakes that result in patient harm. In fact, during the years 2014 and 2015, communication was the third most frequent \u201croot cause\u201d of all sentinel events reviewed.\nAny discussion concerning the need to improve communication in healthcare settings would be incomplete without including the role of federal healthcare reform legislation. The Patient Protection and Affordable Care Act (ACA) established the Value-Based Purchasing Program (VBP), which reimburses providers based on performance regarding specific domains of patient care. In particular, the \u201cPatient Experience of Care Domain\u201d evaluates and compares hospitals on the topic of patient satisfaction.\nA random number of patients discharged from hospitals are asked to complete the Hospital Consumer Assessment of Healthcare Providers and Systems Survey, better known simply as HCAHPS. The survey asks specific questions, many of which are related to the patient\u2019s satisfaction concerning communication with providers. For example, some of the questions are concerned with: communication with doctors, communication with nurses, responsiveness of staff, providing communication about medications, and preparing the patient with adequate discharge information.\nMedical errors continue to plague our healthcare system. Many of these mistakes cause significant patient harm and often result in malpractice litigation. Communication breakdowns rather than a lack of provider skill and or medical training are responsible for far too many adverse events. For these unfortunate cases, it is truly \u201call about communication!\u201d\nInterested in learning more for CME?\nCheck out our Course: Communication Strategies to Improve Patient Safety in High-Risk Situations\nReferences\n\nCRICO Strategies. \u201cMalpractice Risks in Communication Failures.\u201d 2015 Annual Benchmarking Report. https:\/\/www.rmf.harvard.edu\/~\/media\/0A5FF3ED1C8B40CFAF178BB965488FA9.ashx.\nThe Joint Commission. \u201cSentinel Event Data &#8211; Root Causes by Event Type.\u201d http:\/\/www.jointcommission.org\/assets\/1\/18\/Root_Causes_by_Event_Type_2004-2015.pdf.\nCenters for Medicare and Medicaid Services. https:\/\/www.cms.gov\/Medicare\/Quality-Initiatives-Patient-Assessment-instruments\/HospitalQualityInits\/HospitalHCAHPS.htm.\nThe Lake Superior Quality Innovation Network. \u201cUnderstanding Value-Based Purchasing.\u201d CMS Quality Improvement Organization Program.\u00a0http:\/\/www.stratishealth.org\/documents\/FY2017-VBP-fact-sheet.pdf\n\nIf you liked this post, you might also like:\n\n","protected":false},"excerpt":{"rendered":"<p>\u201cIt\u2019s all about communication!\u201d The world of medicine has changed by leaps and bounds over recent decades. Computers have become part of our daily lives, and technological advances have significantly improved our ability to diagnose and treat diseases that were once thought incurable. Despite this incredible progress, healthcare providers continue to commit far too many medical errors. And unfortunately, many of these mistakes are simply caused by \u201cpoor communication.\u201d<\/p>\n","protected":false},"author":3,"featured_media":4811,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"om_disable_all_campaigns":false,"footnotes":""},"categories":[41,20,22,25,42],"tags":[],"acf":[],"_links":{"self":[{"href":"https:\/\/test.thesullivangroup.com\/RSQSolutions\/wp-json\/wp\/v2\/posts\/3931"}],"collection":[{"href":"https:\/\/test.thesullivangroup.com\/RSQSolutions\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/test.thesullivangroup.com\/RSQSolutions\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/test.thesullivangroup.com\/RSQSolutions\/wp-json\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/test.thesullivangroup.com\/RSQSolutions\/wp-json\/wp\/v2\/comments?post=3931"}],"version-history":[{"count":11,"href":"https:\/\/test.thesullivangroup.com\/RSQSolutions\/wp-json\/wp\/v2\/posts\/3931\/revisions"}],"predecessor-version":[{"id":3977,"href":"https:\/\/test.thesullivangroup.com\/RSQSolutions\/wp-json\/wp\/v2\/posts\/3931\/revisions\/3977"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/test.thesullivangroup.com\/RSQSolutions\/wp-json\/wp\/v2\/media\/4811"}],"wp:attachment":[{"href":"https:\/\/test.thesullivangroup.com\/RSQSolutions\/wp-json\/wp\/v2\/media?parent=3931"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/test.thesullivangroup.com\/RSQSolutions\/wp-json\/wp\/v2\/categories?post=3931"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/test.thesullivangroup.com\/RSQSolutions\/wp-json\/wp\/v2\/tags?post=3931"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}