Impacts of communication type and quality on patient safety incidents: a systematic review

Background: Poor communication in health care increases the risk for patient safety incidents. However, there is no up-to-date synthesis of these data. Purpose: To synthesize studies investigating how poor communication between health care practitioners and patients (and between different groups of practitioners) affects patient safety. Data Sources: Ovid MEDLINE, CINAHL, APA PsycInfo, CENTRAL, Scopus, and the ProQuest Dissertations & Theses Citation Index from 1 January 2013 to 7 February 2024. Study Selection: Studies published in any language that quantified the effects of poor communication on patient safety. Data Extraction: Two independent reviewers extracted data, assessed risk of bias, and appraised strength of evidence. Study heterogeneity precluded meta-analysis, so results were reported with narrative description, reporting medians and interquartile ranges (IQRs). Data Synthesis: Forty-six eligible studies (67 826 patients) were included. Risk of bias was low for 20, moderate for 16, and high for 10 studies. Four studies investigated whether poor communication was the only identified cause of a patient safety incident; here, poor communication caused 13.2% (IQR, 6.1% to 24.4%) of safety incidents. Forty-two studies investigated whether poor communication contributed to patient safety incidents alongside other causes; here, poor communication contributed to 24.0% (IQR, 12.0% to 46.8%) of safety incidents. Study heterogeneity was high in terms of setting, continent, health care staff, and safety incident type. The strength of the evidence was low or very low. Limitation: There was important study heterogeneity, generally low study quality, and poor reporting of essential data. Conclusion: Poor communication is a major cause of patient safety incidents. Research is needed to develop effective interventions and to learn more about how poor communication leads to patient safety incidents.