Medication Safety and Communication Skills
Communication with Health Care Providers
Over the phone
Distractions and noise that interfere with the transactions
Heavy accents as well as other language barriers
Obscure terminology or big terms
Similar medications when spoken
Numbers that sound alike
Handwritten communication
Poor handwriting
Names that look alike
Wrong name in the drop-down menu
Decimals either in the wrong spot or are unclear
Unclear abbreviations
Alert fatigue
How to Compensate
Get rid of distractions
Try changing the lighting
Provide feedback and open communication with other healthcare professionals
Take advantage of barcoding
For sound-alikes, add accentuates on certain syllables
For verbal order, repeat it back to verify
Communication with Patients
Common problems
Can’t comprehend
Accent
Terminology
Hearing or visual impairments: cannot understand written information
Not correctly identifying the patient
Patients not speaking up with questions
How to fix
Allow the patients to paraphrase what you just told them
Give them a written copy of the information so they can refer to it later
Allow them to ask questions
Take advantage of your resources
To error is to be human: creating a safe environment where errors are nonpunitive is essential to have an open and honest atmosphere
The purpose of reporting errors is not to get someone in trouble but to learn from it and possibly better the safety precautions
The majority of errors are caused by the system and not the person
Failure Mode and Effects Analysis and Root Cause Analysis are two ways to identify and prevent possible errors
FMEA identifies both sources and consequences of failures based on past events
RCA focuses on specific root causes of error
It asks why not how
These systems cannot prevent 100% of errors
They can only minimize how often and how severe they are
Avoidance: denial that the error happened and refusal to help fix it
Blame: “It was someone else’s fault they messed up”
Rationalizing: it wasn’t that important: it is not a big deal
Assuming someone else will catch their mistake
When meeting try to go somewhere private
Explain what happened and the short-term consequence
Tell them how the problem is being resolved
Assure them they have not been forgotten about
Once the patient has a clear idea that an error has occurred and how it is being resolved, you may want to provide additional insights into why it occurred.
Some patients might want to know how it occurred and what steps you are going to implement to prevent future occurrences.
Be honest and upfront with the patient about the long-term consequences of the error. They may be interested to learn how they will be compensated for their inconvenience or injury
You should make sure that you do not rush through the experience and allow patients time to ask questions and express their feelings.
This feedback will help you determine whether you need to conclude the interaction or continue to address the patient's remaining concerns.
A sincere closing statement, such as "This rarely happens, but it happened with your prescription and I want to resolve it," may put the error in perspective.
Be the one who controls the information
Revealing errors to other providers is helpful for their quality assurance efforts as well.
Communication with Health Care Providers
Over the phone
Distractions and noise that interfere with the transactions
Heavy accents as well as other language barriers
Obscure terminology or big terms
Similar medications when spoken
Numbers that sound alike
Handwritten communication
Poor handwriting
Names that look alike
Wrong name in the drop-down menu
Decimals either in the wrong spot or are unclear
Unclear abbreviations
Alert fatigue
How to Compensate
Get rid of distractions
Try changing the lighting
Provide feedback and open communication with other healthcare professionals
Take advantage of barcoding
For sound-alikes, add accentuates on certain syllables
For verbal order, repeat it back to verify
Communication with Patients
Common problems
Can’t comprehend
Accent
Terminology
Hearing or visual impairments: cannot understand written information
Not correctly identifying the patient
Patients not speaking up with questions
How to fix
Allow the patients to paraphrase what you just told them
Give them a written copy of the information so they can refer to it later
Allow them to ask questions
Take advantage of your resources
To error is to be human: creating a safe environment where errors are nonpunitive is essential to have an open and honest atmosphere
The purpose of reporting errors is not to get someone in trouble but to learn from it and possibly better the safety precautions
The majority of errors are caused by the system and not the person
Failure Mode and Effects Analysis and Root Cause Analysis are two ways to identify and prevent possible errors
FMEA identifies both sources and consequences of failures based on past events
RCA focuses on specific root causes of error
It asks why not how
These systems cannot prevent 100% of errors
They can only minimize how often and how severe they are
Avoidance: denial that the error happened and refusal to help fix it
Blame: “It was someone else’s fault they messed up”
Rationalizing: it wasn’t that important: it is not a big deal
Assuming someone else will catch their mistake
When meeting try to go somewhere private
Explain what happened and the short-term consequence
Tell them how the problem is being resolved
Assure them they have not been forgotten about
Once the patient has a clear idea that an error has occurred and how it is being resolved, you may want to provide additional insights into why it occurred.
Some patients might want to know how it occurred and what steps you are going to implement to prevent future occurrences.
Be honest and upfront with the patient about the long-term consequences of the error. They may be interested to learn how they will be compensated for their inconvenience or injury
You should make sure that you do not rush through the experience and allow patients time to ask questions and express their feelings.
This feedback will help you determine whether you need to conclude the interaction or continue to address the patient's remaining concerns.
A sincere closing statement, such as "This rarely happens, but it happened with your prescription and I want to resolve it," may put the error in perspective.
Be the one who controls the information
Revealing errors to other providers is helpful for their quality assurance efforts as well.