Preventing communication errors in telephone medicine

Abstract

Errors in telephone communication can result in outcomes ranging from inconvenience and anxiety to serious compromises in patient safety. Although 25% of interactions between physicians and patients take place on the telephone, little has been written about telephone communication and medical mishaps. Similarly, training in telephone medicine skills is limited; only 6% of residency programs teach any aspect of telephone medicine. Increasing familiarity with common telephone challenges with patients may help physicians decrease the likelihood of negative outcomes. We use case vignettes to highlight communication errors in common telephone scenarios. These scenarios include giving sensitive test results, requests for narcotics, managing ill patients who are not sick enough for the emergency room, dealing with late-night calls, communicating with unintelligible patients, and handling calls from family members. We provide management strategies to minimize the occurrence of these errors.

Training interventions for improving telephone consultation skills in clinicians

“…Interestingly, Patel 2009 shows that primary care physicians do not feel there is a need for specific training, as they perceive telephone consultations as just another form of history-taking. Another study, Reisman 2005, reports that only 6% of residency programs in the US teach any aspect of telephone communication. The authors suggest the paucity of training in telephone medicine in residency programs may be a significant contributor to telephone communication errors.…”

Telephone consultations

“…Fact— The potential for both medical and legal consequences can be minimised by awareness of common risks such as inadequate documentation, by training, and by analysing the quality and safety of telephone consultations (similar to face-to-face ones) as outlined in guidelines (such as from the Medical Defence Union and HIPAA) and textbooks71516182425…”

A metric-based analysis of structure and content of telephone consultations of final-year medical students in a high-fidelity emergency medicine simulation

“…15 Although much medical consultation is conducted over the telephone, relatively little research has been conducted into how best we can prepare our undergraduates for this important skill in their role as a hospital doctor. 16 One of the fundamental structures for enhancing safe practice is the successful transfer of clinical information between individuals. Accurate information transfer between individuals is dependent upon them both sharing the same mental model for information transfer.…”