title: Failures in communication and information transfer across the surgical care pathway: interview study.
abstract: OBJECTIVE
  Effective communication is imperative to safe surgical practice. Previous studies have typically focused upon the operating theatre. This study aimed to explore the communication and information transfer failures across the entire surgical care pathway.
  
  
  METHODS
  Using a qualitative approach, semi-structured interviews were conducted with 18 members of the multidisciplinary team (seven surgeons, five anaesthetists and six nurses) in an acute National Health Service trust. Participants' views regarding information transfer and communication failures at each phase of care, their causes, effects and potential interventions were explored. Interviews were recorded, transcribed verbatim, and submitted to emergent theme analysis. Sampling ceased when categorical and theoretical saturation was achieved.
  
  
  RESULTS
  Preoperatively, lack of communication between anaesthetists and surgeons was the most common problem (13/18 participants). Incomplete handover from the ward to theatre (12/18) and theatre to recovery (15/18) were other key problems. Work environment, lack of protocols and primitive forms of information transfer were reported as the most common cause of failures. Participants reported that these failures led to increased morbidity and mortality. Healthcare staff were strongly supportive of the view that standardisation and systematisation of communication processes was essential to improve patient safety.
  
  
  CONCLUSIONS
  This study suggests communication failures occur across the entire continuum of care and the participants opined that it could have a potentially serious impact on patient safety. This data can be used to plan interventions targeted at the entire surgical pathway so as to improve the quality of care at all stages of the patient's journey.
authors: Department of Biosurgery and Surgical Technology, Imperial College London, 10th floor, QEQM, St Mary's Hospital, South Wharf Road, London W2 1NY, UK.
authors: Kamal
authors: K
authors: Nagpal
authors: Sonal
authors: S
authors: Arora
authors: Amit
authors: A
authors: Vats
authors: Helen W
authors: HW
authors: Wong
authors: Nick
authors: N
authors: Sevdalis
authors: Charles
authors: C
authors: Vincent
authors: Krishna
authors: K
authors: Moorthy
mesh_terms: D019091:Critical Pathways; D006801:Humans; D033181:Information Dissemination; D007400:Interprofessional Relations; D007407:Interviews as Topic