Poor communication is a major cause of medical malpractice, especially among staff in training, according to a study in today’s edition of the Archives of Internal Medicine. (See Medical News Today.)
Researchers examining 889 closed medical malpractice cases found that 27 percent involved trainees whose role in the error was considered to be at least moderately important, of which 87 percent involved residents. According to the Medical News Today summary:
Cognitive factors contributed to the majority of trainee errors, according to the study. Nearly three-fourths (72 percent) involved errors in judgment, more than half (58 percent) were caused by a lack of technical knowledge, and more than half (57 percent) were due to failure of vigilance or memory. Teamwork factors, notably lack of supervision and handoff problems, were also a significant issue, accounting for 70 percent of the cases involving trainee errors. A lack of supervision accounted for more than half (54 percent) of the trainee errors, and handoff problems accounted for nearly one-fifth (19 percent). Because multiple factors contributed to trainee errors, the percentages do not add up to 100 percent.
Further, attending physicians’ failure to oversee the work of trainees was identified as a factor in 82 percent of the 129 cases where a lack of supervision contributed to a medical error.
None of this comes as a surprise to medical malpractice practitioners, as the failure to properly communicate and supervise often comes up. The degree to which this is due to the high pressure of managed care, systems breakdowns, or simple sloppiness varies from case to case.
Since hand written notes in medical charts are a primary tool of communication from doctor to doctor, and since such writing is often unintelligible (sometimes even to the doctor that wrote it) you can be sure that communications problems will continue to exist to the detriment of patients.
On the web:
Archives of Internal Medicine (article not yet available online)
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hwr: the anti-halloween edition
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