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Abstract

Background: Poor communication in health care increases the risk for patient safety incidents. However, there is no up-to-date synthesis of this data.

Purpose: To synthesize studies investigating how poor communication between health care practitioners and patients (and between different groups of practitioners) affects patient safety.

Data Sources: Ovid MEDLINE, CINAHL, APA PsycInfo, CENTRAL, Scopus, and the ProQuest Dissertations & Theses Citation Index from 1 January 2013 to 7 February 2024.

Study Selection: Studies published in any language that quantified the effects of poor communication on patient safety.

Data Extraction: Two independent reviewers extracted data, assessed risk of bias, and appraised strength of evidence. Study heterogeneity precluded meta-analysis, so results were reported with narrative description, reporting medians and IQRs.

Data Synthesis: Forty-six eligible studies (67 639 patients) were included. Risk of bias was low for 20, moderate for 16, and high for 10 studies. Four studies investigated whether poor communication was the only identified cause of a patient safety incident; here, poor communication caused 13.2% (IQR, 6.1% to 24.4%) of safety incidents. Forty-two studies investigated whether poor communication contributed to patient safety incidents alongside other causes; here, poor communication contributed to 24.0% (IQR, 12.0% to 46.8%) of safety incidents. Study heterogeneity was high in terms of setting, continent, health care staff, and safety incident type. The strength of the evidence was low or very low.

Limitation: There was important study heterogeneity, generally low study quality, and poor reporting of essential data.

Conclusion: Poor communication is a major cause of patient safety incidents. Research is needed to develop effective interventions and to learn more about how poor communication leads to patient safety incidents.

Primary Funding Source: Stoneygate Trust. NA is funded by the National Institute for Health and Care Research (NIHR) Greater Manchester Patient Safety Research Collaboration (GM PSRC). The views expressed are those of the author(s) and not necessarily those of the funders. (PROSPERO:CRD42024507578)

Publication Type:	Article
Additional Information:	This is the prepublication, author-produced version of a manuscript accepted for publication in Annals of Internal Medicine. This version does not include postacceptance editing and formatting. The American College of Physicians, the publisher of Annals of Internal Medicine, is not responsible for the content or presentation of the author-produced, accepted version of the manuscript or any version that a third party derives from it. Readers who wish to access the definitive published version of this manuscript and any ancillary material related to this manuscript (e.g., correspondence, corrections, editorials, linked articles) should go to Annals.org) or to the issue in which the article appears. Those who cite this manuscript should cite the published version, as it is the official version of record.
Subjects:	H Social Sciences > HN Social history and conditions. Social problems. Social reform R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine R Medicine > RC Internal medicine
Departments:	Presidents's Portfolio
SWORD Depositor:	Symplectic Administrator

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