Understanding communication failures involving doctors
What were the key findings?
The research involved a qualitative study across Scotland and a literature review.
Qualitative study of complaints involving doctors and communication failures
- In primary care, the most frequently reported communications related complaints included where patients felt rushed through a consultation or where they felt a GP has been rude or dismissive.
- In secondary care, the most frequently reported included those relating to surgical consent and holding difficult conversations around prognosis and end of life care.
- Views were mixed on which complaints were most strongly associated with severe harm. Some respondents focused on breakdowns in communications between doctors, others on situations where doctors had failed to listen to patients or their families.
- Respondents emphasised how frequently issues of poor communication came up in complaints they encounter, even when the focus of a complaint is not actually on communication.
Literature review of communication failures that lead to patient harm
- The four most frequently reported communication failures were:
- a failure to provide a patient with appropriate and timely information
- a failure to keep colleagues informed/ share appropriate level of information
- a failure to listen to patient
- a failure to work in partnership or collaboratively with patient/ family or carers.
- 19 contributory factors were identified as most frequently contributing to communications failures. Those most linked to the four most frequently reported communication failures included:
- patient factors
- staff workload
- communication systems
- team factors
Why did we commission this research?
We carried out the research, in collaboration with the Scottish Government, to identify the key areas where communication failures have led to patient harm. We also wanted to identify whether it was feasible to identify interventions to reduce the risk of harm occurring. The aims were to:
- identify and understand the different types of communications failings that lead to substandard care and, in some cases, patient harm
- identify evidence-based interventions for reducing the prevalence of communication failure.
What did the research involve?
A qualitative study used seven semi-structured telephone interviews to explore the experiences of those who deal with communications related complaints involving doctors in relevant organisations in Scotland. A literature review brought together existing evidence on communications failures involving doctors, specifically with respect to frequency and impact; the parts of the care processes where such failures tend to occur and evidence of factors that contribute to such failures.