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Barriers to Effective Communication II01:21

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The barriers to effective communication also include cultural barriers, semantic barriers, gender barriers, and time constraints.
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Risk factors for unexpected death in patients identified by a communication and resolution program.

Peter Lodato1, Neal D Goldstein2,3, Alexandra M Mapp4

  • 1Department of Patient Safety and Accreditation, ChristianaCare, Newark, DE, United States.

Frontiers in Health Services
|December 8, 2025
PubMed
Summary

Communication and Resolution Programs (CRPs) help manage unexpected healthcare harm. This study found Black patients, those with more comorbidities, and lower relative expected mortality were more likely to experience unexpected death.

Keywords:
CANDORCRPSDOHcommunication and resolutiondisparitiespatient harmpatient safetysocial drivers of health

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Area of Science:

  • Healthcare quality and safety
  • Patient outcomes research
  • Health equity

Background:

  • Unexpected patient harm is a significant issue in healthcare.
  • Communication and Resolution Programs (CRPs) offer a structured approach to managing adverse events.
  • Understanding demographic factors in unexpected mortality is crucial for targeted interventions.

Purpose of the Study:

  • To determine if demographic factors influence unexpected patient death within a Communication and Resolution Program.
  • To identify specific patient characteristics associated with unanticipated mortality.

Main Methods:

  • A nested case-control study was conducted over a 10-year period.
  • Compared 236 patients with unexpected death to 2,360 controls with expected death.
  • Analyzed demographic factors, comorbidity burden, and Relative Expected Mortality.

Main Results:

  • Patients experiencing unexpected death were more likely to be Black (AOR 2.18).
  • Higher comorbidity burden was associated with unexpected death (AOR 1.07 per comorbidity).
  • Lower Relative Expected Mortality significantly increased the odds of unexpected death (AOR 5.39).

Conclusions:

  • Demographic factors, particularly race and comorbidity, play a role in unexpected patient mortality.
  • Awareness of these risk factors can inform patient evaluation and treatment strategies.
  • CRPs can be instrumental in identifying high-risk patients for unexpected outcomes.