Hospital Communication Breakdown and Diagnostic Errors Case Study

This case study analyzes a scenario involving Mr. Woods, a patient whose treatment was significantly delayed due to communication breakdowns within an urban hospital. The assignment highlights critical flaws in diagnostic processes, including discrepancies in CT scan results that were not communicated to the physician, leading to delayed tuberculosis diagnosis. The study emphasizes the importance of proper data preservation, regular equipment checks, and timely communication of results. It further explores the benefits of information technology, particularly Electronic Medical Records (EMR) at stage 7, for efficient data management, clinical information sharing, and improved patient outcomes. The case underscores the significance of structured handoffs and comprehensive documentation for accurate diagnosis and treatment, while also advocating for strict adherence to EMR guidelines and the adoption of technology to prevent documentation errors and enhance care delivery. The study references several academic articles to support the analysis and recommendations.

Running head: Communications in hospital
Communications in hospital
Name of the student:
Name of the university:
Authors notes:

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Mr Woods was admitted in an urban hospital for his treatment which heavily relied on
diagnostic system and various communications. The results were the basis of his treatment
but due to faulty communications and resultant delays led to substantial delay in detecting
tuberculosis that he was suffering from. there was discrepancy in the findings of CT scan,
which was conducted on the patient, but this result was not communicated to the physician
and hence treatment was not provided to Mr Woods (Weng, 2017). The abnormal results
were not properly preserved for future preferences and this led to complications in his future
diagnosis as medical science is highly reliable on the test results. The diagnosis instruments
were not checked before the diagnosis as many times they may show errors in results so
checking it is mandatory. Another major flaw in this case study was delay in communicating
the result to the physician.
The outcome of Mr Wood could have been avoided if there was proper management
in analysing and detecting the diagnostic results. Information technology is advancing day by
day and it must be exploited in health care as this would help minimise the errors in results.
Mr Woods was readmitted due to no improvement in his health and if the health members
would have taken serious considerations regarding his diagnosis without any delay he would
have got the desired treatment ( Lakin et al., 2015). These situations can be handled by
equipping the technologists with experience and responsibility to cope with patients like Mr
Woods. The diagnosis results must be preserved as it can be used for future preferences if
patient is readmitted or to analyse the diagnostic result for similar diseases. There must be
systematic management of medical data and information, strict actions must be taken if there
is discrepancy in results.
The facilitation of various hospital systems is very important in governing the faulty
results. Information technology must be utilised to check the diagnostic machinery (Hanaber
et al.,2015). It must be ensured that the tests are done twice to check to ascertain the best

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result. The technologists involved must check and see to it that the test result is conveyed to
the physician without fail. In case of Mr Woods the delay in test results led to this outcome
where the physician could not diagnose the disease and he could not get adequate treatment.
The faults in the diagnostic system must be checked regularly and alert systems may be
installed.
EMR at stage 7 is employed with efficient governance in data science that would have
improved the workflow process. The hospital data are preserved through electronic means,
which prevent delay of reports (Alkureshi et al., 2016). Clinical information can be shared via
electronic means which would monitor clinical outcomes. In case of Mr Woods situation the
EMR would have been beneficial which would not result into delay of the diagnostic results.
Handoff are structured and detailed content of medical examination done on patients which
makes the physician to ascertain the disease and opt for suitable treatment. Handoffs make
use of technology and information, which make the process easier to handle, and the health
specialists face less obstacles (Ford et al., 2016). Mr Woods did not get the needed treatment
because the physician could not understand the real ailment as the reports and medical history
carried flawed information. Handoffs if used in Mr Woods treatment could be informative for
the medical staff to undergo the treatment based on results and medical history. The summary
data must be kept carefully for every patient be it inpatient or outpatient as per EMR stage 7
guidelines. EMR data needs no man power and can be retrieved whenever needed. This form
of documentation is needed in every hospital for analysing as this process has proved to be
beneficial in many records. EMR could have saved Mr Woods life if seven stage EMR
guidelines and process were used. Important measures can be taken using technology in the
form of documentation to ensure care delivery efficiency. Storage of clinical information in
the form of charts or paperwork is difficult as they have increased chance to get misplaced.
The technology and information systems efficient management needs for accurate results.

3COMMUNICATIONS IN HOSPITAL
Therefore, to control the outcome as faced by Mr Woods’s electronic medical record must be
used to ensure there is no fault in documentation (Wittels et al., 2017). The adoption model
must be strictly followed by every hospitals to check and keep the diagnostic results in one
place.

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References
Alkureishi, M. A., Lee, W. W., Lyons, M., Press, V. G., Imam, S., Nkansah-Amankra, A., ...
& Arora, V. M. (2016). Impact of electronic medical record use on the patient–doctor
relationship and communication: a systematic review. Journal of general internal
medicine, 31(5), 548-560.
Ford, E., Carroll, J. A., Smith, H. E., Scott, D., & Cassell, J. A. (2016). Extracting
information from the text of electronic medical records to improve case detection: a
systematic review. Journal of the American Medical Informatics Association, 23(5),
1007-1015.
Hanauer, D. A., Mei, Q., Law, J., Khanna, R., & Zheng, K. (2015). Supporting information
retrieval from electronic health records: A report of University of Michigan’s nine-
year experience in developing and using the Electronic Medical Record Search
Engine (EMERSE). Journal of biomedical informatics, 55, 290-300.
Lakin, J. R., Isaacs, E., Sullivan, E., Harris, H. A., McMahan, R. D., & Sudore, R. L. (2016).
Emergency physicians' experience with advance care planning documentation in the
electronic medical record: Useful, needed, and elusive. Journal of palliative medicine,
19(6), 632-638.
Weng, C. Y. (2017). Data accuracy in electronic medical record documentation. JAMA
ophthalmology, 135(3), 232-233.
Wittels, K., Wallenstein, J., Patwari, R., & Patel, S. (2017). Medical student documentation
in the electronic medical record: patterns of use and barriers. Western Journal of
Emergency Medicine, 18(1), 133.

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