Improving communication in the emergency department

Area of Science:

• Healthcare systems engineering
• Patient safety research
• Emergency medicine

Background:

• Emergency department (ED) communication is complex with high error potential.
• Previous studies identified critical failure points in ED communication.
• This study focuses on interventions for two high-risk communication steps.

Purpose of the Study:

• To enhance the reliability of information transfer from ambulance crews to ED staff.
• To improve the accuracy of written documentation post-patient assessment.
• To reduce communication failures in critical care settings.

Main Methods:

• Quantitative assessment of communication reliability using failure modes and effects analysis (FMEA).
• Implementation of targeted process improvements.
• Re-evaluation of communication processes to measure intervention impact.

Main Results:

• High rates of communication failure were initially observed, especially in written information transfer.
• Introduced countermeasures substantially decreased missing and incorrect patient information.
• A threefold increase in correct clinical document usage was achieved in the resuscitation room.

Conclusions:

• Initial FMEA accurately identified significant communication process failures.
• Simple communication system modifications led to marked improvements in clinical information availability and quality.
• Enhanced information accuracy has considerable implications for patient care timeliness and quality.