Reducing the malpractice threat through patient communications

The majority of malpractice claims do not result from fatalities or even severe disabilities, but occur because the patient is angered when his or her often exaggerated expectations are not met. Three out of four of these claims arise primarily from a breakdown in patient communications. Understanding four major types of communication breakdowns can help administrators formulate more effective loss prevention programs. Administrators need to remedy problems such as inadequate discharge instructions, lack of informed consent, lack of courtesy and respect, and inadequate handling of angry patients. Administrators would do well to assess their institution's patient communications. To gain the patient's perspective--to experience the hospital as if he or she were stretched out helpless on a gurney--an outside specialist should conduct a "gurney survey," looking at the communication skills in the departments and activities most crucial for communications. An institution-wide patient education program needs to be led by one coordinator, to involve all departments, to be adequately funded, and to have an identifiable quality assurance component.