PT - JOURNAL ARTICLE AU - Gillian Bartlett, PhD AU - Régis Blais, PhD AU - Robyn Tamblyn, PhD AU - Richard J. Clermont MD AU - Brenda MacGibbon, PhD TI - Impact of patient communication problems on the risk of preventable adverse events in acute care settings AID - 10.1503/cmaj.070690 DP - 2008 Jun 03 TA - Canadian Medical Association Journal PG - 1555--1562 VI - 178 IP - 12 4099 - http://www.cmaj.ca/content/178/12/1555.short 4100 - http://www.cmaj.ca/content/178/12/1555.full SO - CMAJ2008 Jun 03; 178 AB - 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.