How Simple Miscommunications Can Cost A Life

I recently heard a story about a STEMI patient that really drove home the magnitude of healthcare's communication problem. In this case, a member of the care team had administered a medication, and in the haste of the emergency, this critical piece of information was missed by other members of the care team. Can you predict what happened next? Yep. Another clinician administered the exact same dose again moment later. Luckily, the error wasn't life threatening, but it easily could have been.

In talking with a coworker who serves as a paramedic, he noticed that something continues to occur despite how inefficient it seems: the insane number of phone calls STEMI coordinators make in preparation for the heart attack patient. In many cases, he says he counts no less than 10-15 calls. 

In another hospital on the other side of the country, a neurologist shared that she makes an average of 17 phone calls to coordinate the stroke team BEFORE the patient arrives!

We don't have room for error in time sensitive emergencies. We can mitigate our communication crisis with simple mobile technology.

In my original example, it was 10-15 times where the STEMI Coordinator nurse has an opportunity for error. And, it's not because she's telling inaccurate information, it's simply because there is no standardized process so that everyone is shared the correct information at the same time. She is set up to fail.

Do we communicate in this ridiculously inefficient way in any other area of our lives? Absolutely not! Instead, we use group texting, conference calling, or even Slack to send a message to several people at the same time.

So why are we still wasting so much time in medicine?

Beyond the fact that we are wasting precious time that could be better spent on patient care, the ineffective communication strategies in healthcare also lead to error.

When intensity of a situation increases,
our intelligence and ability to accurately recall information
drastically decrease. 

So is it any wonder we have a miscommunication crisis in medicine? A crisis that accounts for 80% of all medical errors, costing 250,000-400,000 deaths per year? 

When all of the patient information is available to all members of the care team at all times, we can reduce miscommunication and chance of medical error. 

It's about people.