Examining procedures to reduce communication breakdowns

Researchers have developed a set of structured tools to decrease medical communication errors during multidisciplinary morning rounds in the hospital.

Reported in Journal of Medical Internet Research Human Factors, the research centered on test rounding tools that improve effeciency and quality of care. While previous studies have shown that daily meetings between clinicians can improve patient care and outcomes, this study focused on the 70 percent of deaths caused by medical errors in the communication during patient handoffs.

The structured rounding tools were meant to "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 at University of Illinois at Chicago.

Some 82 patient cases were audio recorded, analyzed for the time spent discussing the patient and coded for communication breakdowns. Results showed that time spent per patient improved with the use of the tool and that communication breakdowns increased with the amount of time spent discussing each patient.

"This study shows that the use of structured rounding tools mitigates disproportionate time allocation and communication breakdowns during rounds," said Abraham. "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.”