Communication

Errors in medicine are common. Really common. Like, shockingly, awfully common.

Luckily many of these errors result in no or minimal harm to patients, either because they're caught in time or because they're relatively minor mistakes. Yet, small errors could just as easily be big errors and small errors have a tendency to snowball, where a series of small errors results in big harm.

Most commonly, medical errors are due to poor communication. That is, everyone is acting as they think is appropriate, but they're missing information that would change their actions, information other persons have.

I'm on my CTU rotation now and it's striking to see how often communication errors occur in inpatient medicine. It's not just every day, it's every hour of every day, involving every patient who steps through the hospital doors.

Yet, the prevailing attitude seems to be that most communication errors are either expected, someone else's fault, or weren't actually errors at all. It's not a horribly surprising outcome, considering the system in most hospitals is not set up for effective or efficient transmission of information, there is little accountability for communication errors, and training in proper communication is practically non-existent. Heck, even training in the improper communication typical of inpatient hospital services is practically non-existent, being delivered "on the job" in bits and pieces, typically while a student or resident is already being given patient care responsibilities and having to figure out how to perform on the fly.

I knew communication was a big problem in medicine before I started medical school, one that contributed to sub-optimal patient comes. Nevertheless, being on the physician side of things has been disturbingly revealing. Communication errors are routine, pervasive, and we're nowhere close to fixing those issues. For the most part, I'm not even sure we're trying to fix them.