Advertisement
ADVANCED SEARCH

This Article Figures Only Full Text Full Text (PDF) Résumé Submit a response Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Bartlett, G. Articles by MacGibbon, B. Search for Related Content PubMed PubMed Citation Articles by Bartlett, G., PhD Articles by MacGibbon, B., PhD Related Collections Quality improvement Patient safety, clinical risk, medical error Related Articles

Impact of patient communication problems on the risk of preventable adverse events in acute care settings

From the Department of Family Medicine (Bartlett), McGill University; the Department of Health Administration (Blais), Université de Montréal; the Departments of Medicine, and of Epidemiology and Biostatistics (Tamblyn), McGill University; the Département de médecine (Clermont), Centre hospitalier de l'Université de Montréal, Hôpital Hôtel-Dieu; and the Département de mathématiques (MacGibbon), Université du Québec à Montréal, Montréal, Que.

Correspondence to: Dr. Gillian Bartlett, 515-517 Pine Ave. W, Montréal, QC H2W 1S4; fax 514 398-4202; gillian.bartlett{at}mcgill.ca

Background: Up to 50% of adverse events that occur in hospitals are preventable. Language barriers and disabilities that affect communication have been shown to decrease quality of care. We sought to assess whether communication problems are associated with an increased risk of preventable adverse events.

Methods: We randomly selected 20 general hospitals in the province of Quebec with at least 1500 annual admissions. Of the 145 672 admissions to the selected hospitals in 2000/01, we randomly selected and reviewed 2355 charts of patients aged 18 years or older. Reviewers abstracted patient characteristics, including communication problems, and details of hospital admission, and assessed the cause and preventability of identified adverse events. The primary outcome was adverse events.

Results: Of 217 adverse events, 63 (29%) were judged to be preventable, for an overall population rate of 2.7% (95% confidence interval [CI] 2.1%–3.4%). We found that patients with preventable adverse events were significantly more likely than those without such events to have a communication problem (odds ratio [OR] 3.00; 95% CI 1.43–6.27) or a psychiatric disorder (OR 2.35; 95% CI 1.09–5.05). Patients who were admitted urgently were significantly more likely than patients whose admissions were elective to experience an event (OR 1.64, 95% CI 1.07–2.52). Preventable adverse events were mainly due to drug errors (40%) or poor clinical management (32%). We found that patients with communication problems were more likely than patients without these problems to experience multiple preventable adverse events (46% v. 20%; p = 0.05).

Interpretation: Patients with communication problems appeared to be at highest risk for preventable adverse events. Interventions to reduce the risk for these patients need to be developed and evaluated.

This article has been cited by other articles:

				A. Frankel MD Health literacy and harm: Who is at risk? What is the fix? Can. Med. Assoc. J., June 3, 2008; 178(12): 1573 - 1574. [Full Text] [PDF]

HOME	CURRENT ISSUE	PAST ISSUES	COLLECTIONS	HELP	SEARCH
Copyright 1995-2008, Canadian Medical Association. All rights reserved. ISSN 1488-2329 (e) 0820-3946 (p) All editorial matter in CMAJ represents the opinions of the authors and not necessarily those of the Canadian Medical Association.