Communication

Bridging Communication Gaps to Enhance Patient Safety: A Quality Improvement (QI) Project on the Role of Abbreviations, Their Risks, and Pathways to Change (2025)

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Type of publication:

Journal article

Author(s):

*Talha, Saarah; *Smith, Ben; *Khan, Ayesha; Gaddoura, Zaina.

Citation:

Cureus. 17(10):e95843, 2025 Oct.

Abstract:

Introduction Effective communication within the multidisciplinary team (MDT) is critical to safe patient care. Whilst electronic health records have improved legibility, the widespread use of non-standardised abbreviations continues to cause misinterpretation, risking delays, errors, and compromised patient safety. Abbreviations are often used for efficiency, yet their meanings vary between specialties, creating barriers for rotating staff, cross-disciplinary colleagues, and patients reviewing discharge summaries. Quality improvement project We conducted a closed-loop quality improvement (QI) project structured around the SQUIRE 2.0 guidelines for QI initiatives. The project took place in a UK district general hospital to assess and improve understanding of commonly used ear, nose, and throat (ENT) specialty abbreviations. Eighty-two common abbreviations were identified and used in a written expansion test. In cycle one (n = 45), mean accuracy was 24.3%, with no participant exceeding 77%. Following targeted interventions (educational seminars and a printed reference guide displayed in shared spaces), a second assessment cycle was conducted with a new cohort. Post-teaching scores improved by a relative 40% to a mean of 35% (range 24%-52%). Mann-Whitney U testing confirmed statistical significance (p < 0.05). Implications and discussion Findings revealed a substantial baseline knowledge gap, highlighting a safety risk. Low-cost, high-visibility measures, such as reference posters and induction-based teaching, improved comprehension and could be readily adopted in other departments. However, residual gaps suggest the need for upstream interventions, including integration of documentation clarity training into medical education and continued departmental reinforcement. Conclusion Clinicians' baseline abbreviation comprehension was poor, but targeted education significantly improved understanding. Whilst no participant achieved complete proficiency, results show that simple, resource-light strategies can enhance communication clarity and support safer care. Broader adoption, alongside curricular change, offers a sustainable path to reducing abbreviation-related risks.

DOI: 10.7759/cureus.95843

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Educating for Accuracy: Improving ENT Abbreviation Recognition (2025)

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Type of publication:

Service improvement case study

Author(s):

*Dr. Saarah Talha; *Dr. Karola Meunier; *Dr. Ayesha Khan; *Dr. Emma Richards; *Mr. Salil Sood

Citation:

SaTH Improvement Hub, July 2025

Aims:

To evaluate the understanding of commonly used clinical abbreviations among the multi-disciplinary
team. To assess the effectiveness of a structured educational intervention in improving abbreviation recognition and overall communication within the clinical team.

Link to PDF poster

Each Baby Counts: Learn and Support (2024)

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Type of publication:

Service improvement case study

Author(s):

*Paula Pryce

Citation:

SaTH Improvement Hub, September 2024

SMART Aim:

To introduce the communication tool and terminology of Each Baby Counts: Learn and Support to the team by the end of August 2024 as evidenced by observation of conversations and documentation.

Link to PDF poster

Improve legibility of clinical notes on surgical wards (2023)

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Type of publication:
Service improvement case study

Author(s):
*Fraser Morgan

Citation:
SaTH Improvement Hub, May 2023

SMART Aim:
To reduce the incidence of Nurses on Wards 33 and 37 having to clarify plans with Doctors when following written notes by 10% by 25 April 2023.

Link to PDF poster [no password required]

Reducing intra-hospital telephone communication time using app technology (2020)

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Type of publication:
Conference abstract

Author(s):
*Hamid M.

Citation:
BMJ Leader. Conference: Leaders in Healthcare Conference 2020. Virtual. 4(Supplement 1) (pp A42), 2020. Date of Publication: November 2020.

Abstract:
Background Lengthy switchboard waiting times result in delayed communication between healthcare professionals in a hospital. Wasted time impedes patient care, costs the Trust a substantial financial sum and impacts healthcare professional's morale. Aim(s): To reduce intra-hospital telecommunication time utilising the Induction phone application, an easy to use, regularly updated telephone directory. Method(s): Initial audit: Five chosen specialities were contacted between 9-10 AM from the Emergency department for 2 consecutive weeks. The time taken to reach each speciality via switchboard was recorded. A survey seeking the number of calls made per day, the preferred method of contact and the feelings associated with telephone waiting times was sent to department doctors. PDSA cycle 1: One-month application advertisement and re-audit. PDSA2: Eye-catching tele-directory board with the most used extensions and bleeps displayed in the department. Satisfaction survey sent post PDSA2. Sustainability: New doctors were provided induction information. Result(s): Initial average waiting time via switchboard was 48 seconds. The average calls made per doctor each day was 12. This calculated to a total departmental loss of 20.16 hours per week waiting on the phone, equating an annual loss of 26, 208. PDSA1: Average waiting times reduced to 12 seconds utilising the application; saving an estimate ~19,656 per annum. PDSA2: Instant availability of contact details on the display board further reduced waiting times to an average 6 seconds. 84% of doctors (n=16) disliked waiting more than 20 seconds, with associated feelings of frustration. 100% preferred the display board, then the use of the application before resorting to switchboard. 100% Sustainability was recorded one year later. Conclusion(s): The use of application technology reduces wasted time which hampers patient care; reduces Trust running costs; and improves health care professional's morale at work.

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Improving documentation of communication with parents in neonatal unit. A service development experience (2016)

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Type of publication:
Conference abstract

Author(s):
Kasim Aldaleel O., *Welch R.

Citation:
Archives of Disease in Childhood, April 2016, vol./is. 101/(A71-A72)

Abstract:
Introduction Effective communication with parents/patients is essential according to Domain 3 of the General Medical Council's (GMC) Guide for Good Medical Practice. Documentation of communication is crucial for clinical and medicolegal aspects. A local survey in our unit revealed a room for development, when 35.3% only of communication with parents was documented. Aim To improve documentation of communication with parents in the neonatal unit, in line with GMC Good Medical Practice Guide, aiming at 100% documentation of communications with parents. Method A development team was assigned with clear responsibilities and leadership. As part of PDSA (Plan-Do-Study-Act) cycle for improvement, tools were developed as an Act to improve documentation of communication with parents. The developed tools were; making documentation of communication with parents a handover component, making the documentation in the notes a personal responsibility of the doctor who spoke to parents and recording that, creating posters about documenting communication with parents and distributing them in different areas of the department as reminders and having a weekly updated Statistical Process Control chart (SPC chart) clearly visible in the unit. Results A Test of the Change was carried out after 2 months by a review of the last 6 weeks of the SPC Chart. The overall percentage of documented communication with parents was 72.85% (51/70) over 6 weeks period. The first week did not show significant change when 36% (4/11) of communications were documented. However, there was a steady improvement between the second and the fifth weeks, ranging from 71% to 80%, before reaching 92% in the sixth week. That was a positive test of change which was highlighted and implementation of these tools was agreed. High quality documented communications were selected and presented to trainees for learning benefits. Conclusion Having accurate medical records is medicolegally essential. Developing local tools to improve documentation of communication with parents is important when that documentation is sub-optimal. The SPC chart, posters, and communication documentation handing over are effective tools. However, other tools might be effective depending on each unit's needs.