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Ken Margolin
Ken Margolin
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More on Medical Miscommunication

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The image is familiar from television and real life alike: doctors, nurses, orderlies, scurrying through maze-like hospital hallways, off to one task or another. The size and varied crises faced in hospitals makes a certain amount of apparent chaos inevitable. When there is real disorganization, though, the results can be tragic. Miscommunication between medical professionals remains one of the most significant causes of medical malpractice causing serious harm to patients.

As discussed in yesterday’s blog, anesthesia mistakes caused by miscommunication, despite all the advances in error-prevention that profession has made, remains an area of potential danger. Most patients may not realize that it is not unusual for 3 different anesthesiology professionals to be involved in the administration of anesthesia. Pre-surgical exam of the patient may involve a nurse anesthetist and anesthesiologist, while the surgical anesthesiologist may be someone different. According to standards of the American Anesthesiology Association, the anesthesiologist in charge must prepare a written anesthesiology plan before any anesthetic medication is administered. If all relevant medical professionals treating the patient read the anesthesiology plan, a serious anesthesia error due to miscommunication should be very unlikely. In reality, though, sometimes plans are not prepared or are written illegibly or are so skeletal that it is easy to mistake the type and level of anesthesia that will be administered.

Another are of hospital miscommunication that can cause problems is between hospital administration personnel and surgeons – particularly in the scheduling of surgery. There have been instances of patients being prepped for surgery with no surgeon available, or insufficient support staff for the operating team because of scheduling miscommunication. Fortunately, these errors usually result in no more than inconvenience, though hospital scheduling errors have at times resulted in serious harm. Communication between medical professionals in a hospital is both a top-down and bottom-up task. The top hospital administrators, as well as department chairs, must constantly work to understand why communication errors occur and to eliminate the causes. Each individual medical professional must understand that miscommunication can harm their patient, and be vigilant to avoid them.