As you learned earlier, communication is a foundation of patient safety. Patient safety risks can arise from miscommunication.
Examples of case scenarios where miscommunication could contribute to patient safety events are represented below.
Case Scenario 1
The phlebotomist was unable to collect the 7 am blood draw on an inpatient because the patient refused the procedure. The phlebotomist documented in the patient's record that the patient refused, but the phlebotomist failed to communicate this to the provider per protocol. It was not until a few hours later that the provider realized that the results were not available in the patient's medical record. Due to miscommunication, the patient's treatment was delayed.
Case Scenario 2
A laboratory scientist had a critical result on a patient and called the patient care area to relay the critical result to the nurse. Both the nurse and the laboratory scientist failed to follow the protocol to have the critical result read back and this read back documented in the medical record. The information provided to the doctor by the patient care team was that the critical result was on a different patient with the same last name located in the same unit. The doctor reviewed the medical record before changing treatment so there was no harm to the patient.
