Communication errors in the setting of a doctor’s office, nursing home or hospital can lead to devastating, yet preventable medical errors. Despite all the talk about changes being made in the healthcare field to improve patient safety, the medical-legal team at Mishkind Kulwicki Law continues to see medical errors due to communication deficits on an ongoing basis. We have all heard people discuss a particular doctor being a great surgeon, yet he has a poor “bedside manner.” This poor communication can lead to bad outcomes in care and can overshadow the good things the doctor may have done in his treatment because of the breakdown in communication. According to the Joint Commission, an estimated 80% of serious medical errors involve miscommunication between caregivers when patients are transferred or handed off or the care is picked up by a covering physician or during shift changes. After reviewing some of our recent case experiences, in and out of the courtroom, we can summarize some of the communication errors or shortcomings to be as follow:
1) A lack of empathy. Frequently the personnel treating a patient in a business hospital or doctor’s office fail to indicate to the patient or family, “I know its scary being here. However, we are here to help you.” … “
2) A lack of hourly rounding. Many patients sit in examining rooms or in their room at a hospital waiting for care without anyone coming in to check and see if there is anything that the patient needs. Frequently, patients are told that the nurse or the doctor will be in shortly only to be disappointed without explanation when hours upon hours go by without the promise being fulfilled.
3) Physicians use medical language, but fail to explain in non-medical terms what the diagnosis or condition was. Let’s face it; we all did not go to medical school. Lawyers are taught to speak in simple terms and not use fancy legalize. Keep it simple stupid! Doctors too speak in a foreign language and fail to explain in simple understandable terms what a medical condition means and the significance of the disease process to the patient. An example is that a patient may have swelling in their lower leg and may be provided treatment for a DVT, but never explained what a DVT is so the patient understands the significance.
4) No partnership statements. Physicians don’t include patients in their care enough and fail to recognize the importance of their own patient in the process of providing safe medical care. The relationship between patient and professional is not about giving orders; it’s about forming a partnership. All patients should be asked, “What would make this an excellent experience for you?” “What does great care mean to you?” Working as partners in healthcare leads to quality improvement and better clinical outcomes. This has been shown over and over again.
5) Problems with hand-off. Again, shift changes can lead to failure in communication that can seriously harm a patient resulting in a failure to follow-up on tests ordered during the previous shift or vital communication from nurse-to-nurse or physician-to-nurse during shift changes. We have seen this rush from end of shift to the next shift result in labs overlooked, test results not reported timely, orders not followed through and other basic communication issues that are simply unacceptable. There should be a zero tolerance for such basic functions when one healthcare provider takes over or consults with another provider in the care of the same patient. Consistency and thoroughness is key. Doctors and hospitals should never put a patient’s health and well-being at risk, especially on the weekends, in the evenings, during shift change or when there is a shortage of staff.
Being an active part of the healthcare field is critical. Doctors and hospitals do not like to have claims asserted against them. However, of greater importance is that patients don’t like to be treated like second class citizens and when they are treated in such a manner and a doctor or hospital does not do his or her job and it results in injury, the doctor or hospital has only itself to blame. It is time to stop feeling sorry for doctors that get sued and look at why healthcare is not getting safer and why patients are unnecessarily being injured by healthcare providers. When we eventually put the focus on patient safety, fewer injuries will occur and fewer lawsuits will result.