Communication is an essential and constant exchange of information between the patient and health professional with full understanding occurring on both camps (The Joint Commission, 2010, p. 1). It is one of the major activities done by healthcare staff across diverse settings (Redfern, Brown, & Vincent, 2009). Research shows that communication breakdown is one, if not the leading cause, of medical errors (Kohn L., 1999). For instance, out of 258 malpractice claims which led to patient harm, nearly 25 % was due to failures in communication (Greenberg, Regenbogen, & Studdert, 2007). 61 % of 176 incident reports to the Australian Incident Monitoring Study in Intensive Care resulted from communication breakdown (Beckmann, Gillies, Berenholtz, Wu, & Pronovost, 2004). According to the World Health Organization, lack of communication and coordination is the number one global research priority area in developed countries (Bates, Larizgoitia, Prasopa-Plaizier, & Jha, 2009).
A high-risk area for communication breakdown is the Emergency Department (ED), which can be highly intense and complex due to factors such as crowding and time constraints. For example, Redfern & colleagues (2009) discovered that there were 21 communication steps occurring when a patient is admitted in the ED, with each step identified to be a risk for at least one failure. The nursing documentation phase was revealed to be the most error-prone, which in addition to the other steps, resulted in loss of information and waste of time (Redfern, et al., 2009).
With these in mind, there has been a growing urgency to establish a patient safety culture. According to Sammer & colleagues (2010), a patient safety culture is encouraged when the healthcare setting seeks to ensure and maintain a safe environment for its patients (Sammer, et al., 2010). Essentially, a safety culture where both healthcare professionals and patients communicate effectively is of paramount importance to prevent harm, reduce mortality, minimise cultural and linguistic gaps while promoting satisfaction and evidence-based practice (Institute for Healthcare Improvement, 2008). Currently, many approaches have been developed for its promotion, with some gearing towards practices that prevent system errors instead of relying on human knowledge or memory and which minimise risks and hazards similar to aviation (Doucette, 2006; Pronovost et al., 2009), nuclear and military industries (Clarke, Lerner, & Marella, 2007).
Nevertheless, few fully describe how ineffective communication can result in compromising patient safety due to several challenging and dynamic factors, with little known about interventions that can prevent communication breakdown. This essay proposes to discuss that communication, integrated with teamwork and coordination, can positively and negatively affect the patient safety culture. The writer will focus on the ED setting and will discuss the different methods used to address this critical...