[Risk management in hospitals: standard operating procedures in aviation as a model for structuring medical communication].
OBJECTIVE
The working conditions for medical staff in German hospitals with emergency units are characterised by stress peaks. In such moments mistakes are more likely to be made. Communication problems and misunderstandings caused by these settings are the most frequent causes for blunders, errors and mistakes. The aim is to show an easy way to reduce the incidence of these problems.


METHODS
Within this prospectively randomised trial we compare the ability of 50 physicians to remember standardised information on patient's data passed on to them in a briefing. Half of the subjects used the so called 5-finger method as an easy means of memorising standardised information. The other 25 physicians memorised the patient's data in the usual way. In order to assess the information recalled by the subjects, all of them were asked to answer 15 questions on the data they had been given an hour earlier.


RESULTS
The subjects who used the 5-finger method were able to give on average 9.88 (of 15) correct answers and thus remembered significantly (p = 0.031) more information than the members of the control group.


CONCLUSIONS
Communication errors caused by homophony, ambiguity, anticipation and mental models are can be avoided in well-structured communication situations. The rules for such a type of communication can easily be learned and applied. Standardised communication has already proved to reduce the error rates in aviation. We conclude that it can be helpful to introduce standardised communication rules such as the 5-finger method in medical communication.
Schmidt
C
C
CRM Medical, Kitzbühel, Osterreich.
Ramsauer
B
B
Witzel
K
K
D000060:Accidents, Aviation / Q000517:prevention & control*; D003142:Communication; D004636:Emergency Service, Hospital / Q000592:standards*; D005858:Germany; D006801:Humans; D007318:Inservice Training; D019300:Medical Errors / Q000517:prevention & control*; D008487:Medical History Taking; D011939:Mental Recall; D019637:Orthopedic Procedures / Q000592:standards*; D011446:Prospective Studies; D012308:Risk Management / Q000592:standards*; D013647:Task Performance and Analysis; D014947:Wounds and Injuries / Q000601:surgery*