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Communication Breakdown: The Cause of Many Malpractice Lawsuits

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Inadequate communication is a major contributor to medical malpractice incidents in the United States. According to a recent report by CRICO Strategies, approximately 30 percent of all medical malpractice claims are associated with some form of miscommunication. While some communication failures in medical care result in relatively insignificant consequences, others cause long term or permanent damage. Sadly, these errors can even cost victims their lives. The report reveals that 1,744 victims lost their lives to medical errors that were linked to communication failures in the five year period studied (2009-2013).

Communication breakdowns can occur in any care delivery setting, but the risk varies with the type of service being provided, the individuals involved, and the setting itself.

  • The 2015 report reveals that out of the 7,149 malpractice cases analyzed, 57 percent reflect communication errors between two or more care providers. About 55 percent involve miscommunication between health care providers and patients, and 12 percent of cases are associated with communication breakdowns in both categories.
  • According to the CRICO study, about 48 percent of communication breakdowns that were linked to malpractice occurred in ambulatory settings. Another 44 percent happened in inpatient hospital settings, and the remaining 8 percent occurred in emergency departments.
  • In about 38 percent of malpractice cases in general medicine, miscommunication was a factor.
  • Approximately 34 percent of obstetrics malpractice cases involve an error in communication.
  • In nursing malpractice cases, about 32 percent are associated with a breakdown in communication.
  • Around 26 percent of all surgery malpractice cases involve a failure in communication.

Factors that Impact Miscommunication Risk in Medical Care

It is concerning that something as vital as effective communication occurs so regularly in the medical field. To better understand breakdowns in communication between health care providers as well as those between health professionals and patients, an evaluation of the factors surrounding medical malpractice cases involving miscommunication is necessary.

WORKLOAD IMPACTS THE RISK FOR MISCOMMUNICATION

Health care worker shortages often cause health professionals to work extremely long hours, frequently change shifts, and provide care for a very large number of patients on a regular basis. As a result, physicians and staff members sometimes become very rushed, extremely fatigued, and even forgetful. In some situations, the pressures of managing such a heavy workload can lead to communication errors in medical settings.

ELECTRONIC HEALTH RECORDS (EHRS) CAN LEAD TO MEDICAL ERRORS

Although electronic health records are intended to improve communication between health care providers, studies reveal that they can actually have the opposite effect. In many cases, providers depend on EHRs to deliver important information instead of communicating directly between each other. And if specific information is not entered correctly, not marked as important, or simply overlooked, the consequences can be permanently damaging or even deadly. According to the CRICO report, about 12 percent of communication failures evaluated involved poor documentation and another 7 percent were associated with care providers not reading the patient's medical record.

MEDICAL MISTAKES DURING PATIENT TRANSFERS/ HAND-OFFS

Defective communication during patient transfers can lead to significant delays in patient care, improper or missed diagnosis, medication errors, and other consequences that can result in severe patient harm and even fatality. According to an estimate by the Joint Commission- that accredits hospitals and other health care organizations and sets safety standards, about 80 percent of serious medical mistakes are linked to miscommunication between health care providers while transferring patients. To help improve communication among providers during patient hand-offs, a program called I-PASS is currently being studied and its use is well underway in many health care settings throughout the United States and Canada. The effects of this award-winning intervention are very promising. A recent study revealed that the use of the I-PASS Handoff Bundle was associated with a 30 percent reduction in medical errors.

COMMUNICATION SHORTCUTS CAN RESULT IN MALPRACTICE

In many cases, physicians and other health care providers fail to offer clear and concise definitions and instructions to patients, caregivers and other health care professionals, or they fail to thoroughly explain all of the factors surrounding diagnosis, treatment or prognosis. They simply assume that the other person will understand. These communication shortcuts can lead to medical errors as well as inadequate informed consent.

When Breakdowns in Communication Cause Malpractice

Although many hospitals and other health care facilities are taking steps to improve communication, medical errors due to miscommunication still occur all to often. When a victim suffers harm due to inadequate communication in a medical setting, he or she may be entitled to receive financial compensation to help pay for damages. According to the CRICO report, malpractice cases that are associated with communication breakdowns close with a payment more frequently than other types of malpractice cases, and they typically end with higher payments. Between 2009 and 2013, 49 percent of cases with provider-to-provider miscommunication closed with an average indemnity of $484,000.

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