[Assessment of Communication and Handover of Clinical and Nursing Care Information in a Tertiary Care Hospital]

Ensuring adequate, efficient, and effective communication and information transfer is crucial to guaranteeing patient safety. Understanding the local context and identifying strengths and areas for improvement are essential for creating a safe environment. The aim of this study was to assess the state of communication and information transfer in a hospital setting to identify opportunities for improving patient safety.

Qualitative Phase: A cause-and-effect analysis was conducted to identify and classify the causes of faulty communication and information transfer within the hospital. Quantitative Phase: A descriptive study was carried out in a tertiary hospital using lot acceptance sampling. Ten validated indicators of good communication practices were evaluated-nine through surveys of healthcare professionals and one through audits.

Twenty-five causes of communication issues were identified, fifteen of which were modifiable and known to be associated with the problem. Audits showed 20% non-compliance with standards, with one lot accepted. The survey results indicated acceptance of six lots, with adjusted overall compliance rates of 8.6% (informed consent), 28.4% (communication of diagnostic changes), 30.7% (communication of medication changes), 32.7% (preferences of terminal patients and life support), 33.0% (repetition of verbal orders), 47.8% (documentation of verbal orders), 64.4% (clinical report generation), 67.1% (reviewed medication prescriptions), and 72.3% (chemotherapy).

Communication and information transfer have been identified as key areas for improvement in our hospital, with potential impact on patient safety. Initial interventions include safer verbal order transmission, shared decision-making, and contingency planning for electronic prescribing failures. Structured communication training for physicians, particularly residents, is also proposed as part of the safety enhancement strategy.