Read-back improves information transfer in simulated clinical crises

BMJ Qual Saf. 2014 Dec;23(12):989-93. doi: 10.1136/bmjqs-2014-003096. Epub 2014 Aug 11.

Abstract

Background: Safe and effective healthcare is frustrated by failures in communication. Repeating back important information (read-back) is thought to enhance the effectiveness of communication across many industries. However, formal communication protocols are uncommon in healthcare teams.

Aims: We aimed to quantify the effect of read-back on the transfer of information between members of a healthcare team during a simulated clinical crisis. We hypothesised that reading back information provided by other team members would result in better knowledge of that information by the receiver than verbal response without read-back or no verbal response.

Method: Postanaesthesia care unit nurses and anaesthetic assistants were given clinically relevant items of information at the start of 88 simulations. A clinical crisis prompted calling an anaesthetist, with no prior knowledge of the patient. Using video recordings of the simulations, we noted each time a piece of information was mentioned to the anaesthetist. Their response was coded as read-back, verbal response without read-back or no verbal response.

Results: If the anaesthetists read back the item of information, or otherwise verbally responded, they were, respectively, 8.27 (p<0.001) or 3.16 (p=0.03) times more likely to know the information compared with no verbal response.

Conclusions: Our results suggest that training healthcare teams to use read-back techniques could increase information transfer between team members with the potential for improved patient safety. More work is needed to confirm these findings.

Keywords: Communication; Crew resource management; Critical care; Human factors; Teamwork.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Anesthesiology / methods*
  • Clinical Competence
  • Emergencies
  • Humans
  • Information Dissemination / methods*
  • Interdisciplinary Communication*
  • Nurse Anesthetists*
  • Patient Care Team / standards*
  • Patient Safety
  • Patient Simulation
  • Retrospective Studies
  • Video Recording