Nav: Home

Preventing medical communication errors

December 19, 2016

Structured tools can reduce "end-of-round time compression" during multidisciplinary morning rounds in the hospital, according to a new study.

Previous studies on multidisciplinary rounds, or MDRs, have demonstrated that the daily meeting of doctors, nurses, and other clinicians-used to coordinate patient care across disciplines and shifts-has positive effects on patient care and outcomes. But those studies have also shown that clinical staff spend less time discussing patients at the end of rounds compared to those presented at the beginning of rounds. In addition, data from the U.S. Agency for Healthcare Research and Quality show that approximately 70 percent of deaths caused by medical errors are related to communication breakdowns during handoffs.

To see if structured rounding tools might lessen these communications problems, University of Illinois at Chicago researchers tracked MDRs in a medical intensive care unit for two months to study two different paper-based communication rounding tools.

Their results are reported in JMIR Human Factors, a spin-off of the Journal of Medical Internet Research.

The goal was to test structured rounding tools and "evaluate if they improved equality in time allocation across patients and quality of patient care team communication," said Joanna Abraham, assistant professor of biomedical and health information sciences in the UIC College of Applied Health Sciences.

"We audio-recorded rounding for a total of 82 patient cases and observed the sessions," Abraham said. The patients were presented using one of two rounding tools -- either one called SOAP, for Subjective, Objective, Assessment and Plan, or HAND-IT, a systems-oriented Handoff Intervention Tool.

Both were used to gather patient information before rounds and to support communication during rounds.

The researchers calculated the time spent discussing each patient and coded the recordings for communication breakdowns during rounds, which were defined as any failure in information transfer between the outgoing team to the on-coming team. Breakdowns were classified as missing or incomplete information; incorrect or conflicting information; or irrelevant or ambiguous information.

Results showed that time allocation per patient improved with use of either tool when compared to no tool, and that the difference between the two tools was not significant. Abraham and her colleagues also found that communication breakdowns increased with the amount of time spent discussing each patient--on average there were 1.04 additional breakdowns per every 120 seconds in discussion.

"This study shows that the use of structured rounding tools mitigates disproportionate time allocation and communication breakdowns during rounds," Abraham said. "With the more structured HAND-IT tool, these effects were almost completely eliminated.

"Our results help to demonstrate the benefits of using structured rounding tools for reducing communication errors and improving patient care quality and safety. Although our results are preliminary, they present a strong case for further research into rounding communication," she said.
Co-authors on the paper include Thomas Kannampallil of UIC, Vimla Patel of the New York Academy of Medicine, Dr. Bela Patel of the University of Texas Health Science Center, and Dr. Khalid Almoosa of Memorial Hermann Katy Hospital.

This research was supported in part by a Grant No. 220020152 from the James S McDonnell Foundation and by Grant No. 1 T32 HS017586-02 from the Keck Center AHRQ Training Program in Patient Safety and Quality on the Gulf Coast Consortia.

University of Illinois at Chicago

Related Patient Care Articles:

Pharmacists provide patient value in team-based care
As part of an innovative model being used at UNT Health Science Center, Dr.
When the cardiology patient ends up in the oncology care ward
If you end up needing to go to the hospital, often times you're hoping to get a bed without having to wait hours, but a new study shows you may want to wait a little longer, so that you are placed in the best ward for your needs.
Could artificial intelligence improve patient care in the NHS?
The adoption of artificial intelligence in the diagnosis and prognosis of disease could help to extend people's lives whilst providing significant savings for the NHS.
Enhanced research reporting method to improve patient care
Patients could benefit from improved care and outcomes thanks to new research guidance developed as part of a University of Stirling-led study.
Mandate patient access to primary care medical records
Canada's provincial governments should mandate patient access to their electronic medical records, argue authors of a commentary in CMAJ (Canadian Medical Association Journal).
Dental checklist of bad practice has patient care at its heart
Dental experts have drawn up a definitive list of never events -- scenarios that patients should never face -- in a bid to ensure excellent patient care worldwide.
Transforming patient health care and well-being through lighting
The world of health care is changing rapidly and there is increased interest in the role that light and lighting can play in improving health outcomes for patients and providing healthy work environments for staff, according to many researchers.
New research on why GPs quit patient care
The research aimed to identify factors influencing GPs' decisions about whether or not to remain in direct patient care, and what might help to retain them in the role.
At-home vision monitoring app may improve patient care
Patients with age-related macular degeneration or diabetic retinopathy who used a mobile application to test their vision at home got comparable results to in-office vision testing, according to research presented today at AAO 2017, the 121st Annual Meeting of the American Academy of Ophthalmology.
Using machine learning to improve patient care
In a new pair of papers, researchers from MIT's Computer Science and Artificial Intelligence Laboratory (CSAIL) explore ways for computers to help doctors make better medical decisions.
More Patient Care News and Patient Care Current Events

Best Science Podcasts 2019

We have hand picked the best science podcasts for 2019. Sit back and enjoy new science podcasts updated daily from your favorite science news services and scientists.
Now Playing: TED Radio Hour

Rethinking Anger
Anger is universal and complex: it can be quiet, festering, justified, vengeful, and destructive. This hour, TED speakers explore the many sides of anger, why we need it, and who's allowed to feel it. Guests include psychologists Ryan Martin and Russell Kolts, writer Soraya Chemaly, former talk radio host Lisa Fritsch, and business professor Dan Moshavi.
Now Playing: Science for the People

#538 Nobels and Astrophysics
This week we start with this year's physics Nobel Prize awarded to Jim Peebles, Michel Mayor, and Didier Queloz and finish with a discussion of the Nobel Prizes as a way to award and highlight important science. Are they still relevant? When science breakthroughs are built on the backs of hundreds -- and sometimes thousands -- of people's hard work, how do you pick just three to highlight? Join host Rachelle Saunders and astrophysicist, author, and science communicator Ethan Siegel for their chat about astrophysics and Nobel Prizes.