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Cited by 1,069Patient Safety and Medication ErrorsHospital Admissions and OutcomesClinical Reasoning and Diagnostic Skills

Communication Failures: An Insidious Contributor to Medical Mishaps

Sutcliffe, Kathleen M., Lewton, Elizabeth, Rosenthal, Marilynn M.·2004·Academic Medicine
DOI 10.1097/00001888-200402000-00019
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Abstract

PURPOSE: To describe how communication failures contribute to many medical mishaps. METHOD: In late 1999, a sample of 26 residents stratified by medical specialty, year of residency, and gender was randomly selected from a population of 85 residents at a 600-bed U.S. teaching hospital. The study design involved semistructured face-to-face interviews with the residents about their routine work environments and activities, the medical mishaps in which they recently had been involved, and a description of both the individual and organizational contributory factors. The themes reported here emerged from inductive analyses of the data. RESULTS: Residents reported a total of 70 mishap incidents. Aspects of "communication" and "patient management" were the two most commonly cited contributing factors. Residents described themselves as embedded in a complex network of relationships, playing a pivotal role in patient management vis-à-vis other medical staff and health care providers from within the hospital and from the community. Recurring patterns of communication difficulties occur within these relationships and appear to be associated with the occurrence of medical mishaps. CONCLUSION: The occurrence of everyday medical mishaps in this study is associated with faulty communication; but, poor communication is not simply the result of poor transmission or exchange of information. Communication failures are far more complex and relate to hierarchical differences, concerns with upward influence, conflicting roles and role ambiguity, and interpersonal power and conflict. A clearer understanding of these dynamics highlights possibilities for appropriate interventions in medical education and in health care organizations aimed at improving patient safety.

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Crossref · 10.1097/00001888-200402000-00019

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14 of 14 references verified0 citation errors · 0 not checkable

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  • Communication breakdowns are an increasingly recognized preventable factor in medical mishaps.

    “Communication breakdowns are an increasingly recognized preventable factor in medical mishaps, and emerging data suggest a high prevalence of communication breakdowns among physicians, patients, and important members of the health care team who assist with the diagnostic process.21,25–32”

    From Reducing Diagnostic Errors through Effective Communication: Harnessing the Power of Information Technology (2008) · cites this paper as [32]

  • Emerging data suggest a high prevalence of communication breakdowns among physicians, patients, and important members of the health care team who assist with the diagnostic process.

    “Communication breakdowns are an increasingly recognized preventable factor in medical mishaps, and emerging data suggest a high prevalence of communication breakdowns among physicians, patients, and important members of the health care team who assist with the diagnostic process.21,25–32”

    From Reducing Diagnostic Errors through Effective Communication: Harnessing the Power of Information Technology (2008) · cites this paper as [32]

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Authors
Sutcliffe, K. M., Lewton, E., & Rosenthal, M. M.
Affiliations
University of Michigan (US)
Corresponding author
Sutcliffe, Kathleen M.
Venue
Academic Medicine
Publisher
Oxford University Press (OUP)
Published
2004-02
Volume
79
Issue
2
Pages
186-194
ISSN
1040-2446 (ISSN-L)
DOI
10.1097/00001888-200402000-00019
OpenAlex
W2033026182
Cited by
1,069
References
14
Citations by year
2026: 43 · 2025: 35 · 2024: 31 · 2023: 39 · 2022: 35 · 2021: 61 · 2020: 55 · 2019: 55 · 2018: 57 · 2017: 61 · 2016: 74 · 2015: 66 · 2014: 67 · 2013: 72 · 2012: 58
FWCI
32.77
Type
journal article
Language
en
Open access
closed
Locations
  • Academic Medicine (publishedVersion)
  • PubMed (publishedVersion)
  • Deep Blue (University of Michigan) (submittedVersion)
Topics
  • Health Sciences › Health Professions › Emergency Medical Services › Patient Safety and Medication Errors
  • Health Sciences › Medicine › Emergency Medicine › Hospital Admissions and Outcomes
  • Health Sciences › Medicine › Family Practice › Clinical Reasoning and Diagnostic Skills
Keywords
communication breakdown, medical errors, patient safety, medical residents, clinical management, organizational factors, role ambiguity, health care organization, medical education
MeSH terms
Adult, Clinical Competence, Communication, Female, Hospitals, Teaching, Humans, Internship and Residency, Interprofessional Relations, Interviews as Topic, Male, Patient Care Management, Physician-Patient Relations, Physician's Role, Random Allocation, Sampling Studies, United States, Medical Errors

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