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Patient safety after implementation of a coproduced family centered communication programme: multicenter before and after intervention study

BMJ 2018; 363 doi: https://doi.org/10.1136/bmj.k4764 (Published 05 December 2018) Cite this as: BMJ 2018;363:k4764

Linked opinion

Improving patient safety? Ask the patient

Linked opinion

Ensure that the family’s voice is heard first and last, and in their own words

Re: Patient safety after implementation of a coproduced family centered communication programme: multicenter before and after intervention study

I am commenting on the article, “Patient safety after implementation of a coproduced family centered communication programme: multicenter before and after intervention study” written by Alisa Khan et al., published in December 2018. Medical errors have negative impact on patients’ and healthcare institutions. In the USA, in 2016 communication was found to have substantial financial and social impact, resulting in 1,744 deaths and $1.7 billion in malpractice (Alert, 2017). Several articles outline the role of communication on the incidence medical among healthcare providers (Bascuñán & Arriagada, 2016; Koller et. al., 2016).

This intervention study examined the impact of structured communication practices between healthcare providers and among providers and clients on the incidence of medical errors and harmful errors. While harmful errors decreased significantly, overall medical errors and did not significantly change with the introduction of this intervention. The authors concluded that family communication decreases harmful errors through the added safeguard that this assessment; family involvement and examination; provides to the health care team.

The findings of this study are consistent with the Caribbean and African settings that there is limited communication between health workers. The challenges with communication may stem from a lack of skill among healthcare workers and result in suboptimal patient care (Levitt, Steyn, Dave, & Bradshaw, 2011). Important to correcting the negative outcomes of communication challenges in healthcare delivery, is the inclusion of the family as a protective layer in healthcare (Khan et al, 2018). Inconsistent with this paper however, the Caribbean has not created an opportunity for family members to be included on medical rounds.

References
Alert, S. E. (2017). Inadequate hand-off communication. The Joint Commission, 58, 1-6.
Bascuñán, M. L., & Arriagada, A. M. (2016). Communication of medical errors to patients: questions and tools. Revista medica de Chile, 144(9), 1185-1190.
Khan, A., Spector, N. D., Baird, J. D., Ashland, M., Starmer, A. J., Rosenbluth, G., ... & Lipsitz, S. (2018). Patient safety after implementation of a coproduced family centered communication programme: multicenter before and after intervention study. Bmj, 363, k4764.
Koller, D., Rummens, A., Le Pouesard, M., Espin, S., Friedman, J., Coffey, M., & Kenneally, N. (2016). Patient disclosure of medical errors in paediatrics: A systematic literature review. Paediatrics & child health, 21(4), e32-e38.
Levitt, N. S., Steyn, K., Dave, J., & Bradshaw, D. (2011). Chronic noncommunicable diseases and HIV-AIDS on a collision course: relevance for health care delivery, particularly in low-resource settings—insights from South Africa. The American journal of clinical nutrition, 94(6), 1690S-1696S.

Competing interests: No competing interests

11 September 2019
Donnette A. Wright
Lecturer
The University of the West Indies, Mona
The UWI School of Nursing, Mona