Getting on the Same Page: Opportunities to Improve Parent-Provider Communication

摘要

According to the Joint Commission, the leading root causes of hospital sentinel events are communication-related. Communication contributes not only to patient and physician understanding of medical problems and the risks and benefits of treatment but also impacts outcomes, such as satisfaction and adherence. Consequently, it is not surprising that miscommunications are associated with care quality and patient safety problems. Although there is a large body of literature examining communication between patients and providers, fewer researchers have considered communication among parents and providers. In this issue of Hospital Pediatrics, Khan et al have put forth one of the first pediatric studies to evaluate parent-provider miscommunications and their association with parent-reported medical errors in the hospital setting. In this single-center study, investigators examined the rates and types of parent-provider miscommunications and their association with top-box experience and parent-reported errors in a cohort of hospitalized children. Over 18 months, 471 English-speaking parents of children on 2 medical units were surveyed on discharge from the hospital about miscommunications with their child's care team (defined as physicians and nurses) and possible negative consequences of these miscommunications. Attending physicians caring for these children on their discharge from the hospital completed a similar survey. Of 406 parent respondents, 15,3% reported miscommunications with their care team during their hospital stay. Parents of children with longer lengths of stay and those who were nonpublicly insured were more likely to report miscommunications. In addition, parents reporting miscommunications were significantly less likely to report top-box experiences and more likely to report errors than those not reporting miscommunications. Within parent-physician respondent dyads, only 3.7% of attending physicians reported miscommunications, significantly fewer than their parent counterpart. However, both parents and physicians reported that providing conflicting information to families was the main source of miscommunication, followed by concerns about delayed provisioning of information and families being upset about the way communication occurred.