Hospital Communication

Professor Diana Slade

Molly, a young woman suffering from schizophrenia, was a tragic casualty of multiple communications failure between clinicians.  When she went to hospital to give birth to her second child, her GP had failed to pass on her psychiatrist’s written and verbal handovers to the hospital that she should continue to take her medication during and after the birth. Soon after her discharge, Molly swallowed a corrosive substance and died.

According to the Australian Institute of Health and Welfare, 500,000 people a year are harmed in hospital, costing taxpayers $2 billion a year. A third of these incidents are due to communication failures in handovers between clinicians, and doctor-patient interactions.

A new initiative led by Professor Diana Slade, Director of the International Research Centre for Communication in Healthcare (IRCCH) at UTS, is attempting to reverse this trend with an innovative evidence-based program to teach doctors, nurses and clinicians how to communicate more effectively.

“There are an estimated 40 million handovers each year in Australian hospitals whether that is when patients are transferred from ward to ward or discharged back into the community. At every handover there is a possibility of miscommunication and potential risk to patients,” says Slade, an internationally-renowned linguistics expert.

“We aren’t critical of the clinicians – we are impressed by their professionalism and dedication. It is just that they receive very little evidence-based communication during university or later in professional development.”

To redress this, Slade and her team have developed an innovative program, creating videos based on authentic audio and video recordings of interactions between doctors, nurses, allied professionals and patients.

The videos are incorporated into training programs to improve clinicians’ communication skills and deliver better patient-centred care, as well as empowering junior doctors, nurses and patients to speak up too.

These training programs are drawn from recordings and videos from 829 patient handovers as well as hundreds of hours of patient-clinician consultations collected by IRCCH teams in Australian hospitals during the last eight years.

“At IRCCH we have one of the world’s largest data bases of authentic communications between patients and clinicians,” Slade says.

After a successful pilot project at Canberra Hospital training 350 nurses, IRCCH is now seeking donor funding to expand their training and train-the-trainer program across Australia and Asia.

“This is the first time that an international group of healthcare communication experts and leaders have come together to try to solve the increasing problem of communication breakdowns, medical error, avoidable patient harm and escalating patient and clinician dissatisfaction,” says Dr Elizabeth Rider, Assistant Professor of Paediatrics at Harvard Medical School.

The IRCCH initiative is timely as the World Health Organisation has cited improving clinician communication as one of the top five urgent actions to decrease patients’ hospital deaths globally.

As a unique translational and interdisciplinary centre, IRCCH is jointly convened and supported by UTS and the Hong Kong Polytechnic University, with Curtin University in Perth as an institutional node and 98 members across 17 countries in other universities internationally.

Words by Melinda Ham

Molly’s name has been changed to protect her identity.