Communication Errors Research Articles

A Call for the Professionalization of Medical Language Education to Prevent Misuse of Limited Language Skills and Ad hoc Interpretation

In an increasingly global society, medical language courses present an opportunity to teach physicians the clinical communication skills needed to provide high quality care for patients who speak non-English languages. Yet, despite a growing number of medical language programs, most courses are missing the professional framework that typically characterizes medical education. Specifically, a lack of standardized proficiency assessment and feedback, paired with unclear institutional guidelines around interpretation and bilingual care, paves the way for communication errors and disparities in healthcare for linguistic minorities. Within the context of the hierarchy in medicine, medical trainees are potentially vulnerable to overstepping the limits of their language ability in an effort to impress their supervising physicians or to save time by attempting to communicate with patients on their own using partial language skills instead of seeking a medical interpreter. In this commentary, the authors use the case of medical Spanish in the United States to provide a framework for the professionalization of non-English language education in medical education settings, identifying three key opportunities: (1) equip learners to accurately self-assess language skills, (2) provide individualized performance feedback to learners, and (3) develop clear institutional policies regarding safe use of bilingual skills and partnership with medical interpreters.

Integrated Underwater Detection and Communication System Based on P4 Code-Modulated OFDM Signal

Because of the requirements of marine resources exploration and underwater cooperative operation, the underwater operation of common detection and communication equipment is difficult and unreliable. Therefore, it is urgent to establish an accurate underwater target detection and multi-node communication integrated system. An integrated method of underwater electric field detection and communication based on P4 code-modulated OFDM signal is proposed in response to the above requirements. The working principle, system structure, and signal processing of underwater electric field detection and electric field communication are similar. This article uses detection signal P4 code to modulate the phase of OFDM communication signal, thus realizing the integration of Underwater Detection and Communication System (IUDCS). The simulation results show that IUDCS can meet the detection range and velocity characteristics of underwater dynamic targets. The simulation results also meet the requirements for communication error rate and symbol error rate, thereby verifying the performance of underwater electric field IUDCS. This method is necessary for the realization of IUDCS in terms of reducing platform size, reducing power consumption, and enhancing concealment. Moreover, it shows good application prospects in underwater robot cluster operations.

Implementing the IMIST-AMBO tool for paramedic to trauma team handovers: a video review analysis

Patient handover betweenparamedics and the trauma team is vulnerable to communication errors that may adversely affect patient care. This study assesses the feasibility of a handover tool, IMIST-AMBO (acronym of categories), implementation in the trauma bay and evaluates the degree to which it improves handover metrics. This is a prospective observational cohort study conducted at Canada's largest level-one trauma center. Feasibility of the tool implementation and improvement in handover metrics were assessed. Strategies for implementation included distribution of an educational video and posters, and point-of-care reminders in the trauma bay. Two reviewers independently assessed video recordings of handovers to evaluate handover metrics. Findings were compared to data obtained during a knowledge gap analysis conducted prior to the initiation of this study at the same institution. Over 13weeks (August to November 2020), 140 videos were recorded, of which 80 used the IMIST-AMBO tool (compliance of 57%). Paramedic adherence to the handover structure occurred in 70.4% of cases, with greater adherence to the IMIST (82.2%) compared to the AMBO (47.1%) section. The mean (± standard deviation) handover duration was shorter (1min:58s ± 0:44s during implementation vs. 2min:47s ± 1:14s pre-implementation, [p < 0.001]). Frequency of parallel conversations and informal handovers improved (61% to 30% and 65% to 13%, [p < 0.001], respectively). Interruptions during the handover decreased from 3.05 (± 1.95) to 1.5 (± 1.7), p < 0.001. The tool was received favorably among study participants. The IMIST-AMBO tool reduced the frequency of interruptions, parallel conversations, and informal handovers during paramedic-trauma team handovers at our institution. The quality and amount of information communicated per handover improved, all with a decrease in handover duration. The IMIST-AMBO tool may be applied to other trauma centers across Canada, or more broadly on an international scale.

Development of a Shifting and Receiving Performa for ICU Patients: Reducing Communication Errors-A Delphi Study.

Critically ill patients are frequently transported between intensive care units (ICUs) and other sections of hospital, which may cause communication error. The aim of this study was to reduce errors while shifting and receiving of patients in and from the ICU. The present study was aimed to develop a Shifting and Receiving Performa for the patients admitted in the ICU of a tertiary care hospital. A multistage developmental study was conducted in ICUs. Eleven experts were selected by a purposive sampling technique, and the study was conducted in 4 phases. From the pool of items, a preliminary draft of the performa was prepared and the draft was given to experts to evaluate its content and face validity by conducting 2 Delphi rounds. The mean I-CVI of the shifting performa increased from 0.92 to 0.95, S-CVI/AVG exceeded from 0.88 to 0.96, and S-CVI/UA exceeded from 0.48 to 0.7 after Delphi round 2. In the case of the receiving performa, the mean I-CVI and S-CVI/AVG remained the same, that is, 0.98 in Delphi rounds 1 and 2. The mean S-CVI/UA also remained the same (ie, 0.9). The interrater reliability of the performa was found to be 0.95. Almost all the staff nurses found the performa to be beneficial, provided complete information, and reduced communication errors.

Self-Attention Graph Convolution Residual Network for Traffic Data Completion

Complete and accurate traffic data is critical in urban traffic management, planning and operation. In fact, real-world traffic data contains missing values due to multiple factors, such as device outages and communication errors. For traffic data completion task, most of the existing methods are matrix/tensor completion methods, which usually enforce low rank constraint on traffic data matrix/tensor. But they neglect the graph structure of traffic data, resulting in low completion performance. Recently, graph convolutional networks have achieved remarkable results in traffic data forecasting due to their abilities of feature extraction and nonlinear fitting on arbitrarily graph-structured data. However, there are few studies based on graph neural networks for traffic data completion task. In this paper, we propose a traffic data completion model based on graph convolutional network model to impute missing values from the perspective of deep learning. This model utilizes graph convolution to model the local spatial dependency. As for global spatial dependency and temporal dependency, this model incorporates self-attention mechanism, which is applied in the spatial and temporal dimensions respectively. The experimental results on the two real-time datasets demonstrate that the proposed model outperforms the baseline methods significantly under arbitrarily missing scenarios.

Investigating the Impact of Communication Errors on the Transient Characteristics of Power Systems

Investigating the Impact of Communication Errors on the Transient Characteristics of Power Systems

A Sociolinguistic Study of the Dynamics of Taboo Language in Intercultural Communication

The prevalence of intercultural communication is underpinned by the ongoing globalisation of contemporary communication. As an important branch of sociolinguistics, the issue of Chinese-English taboos has become typical of the study of intercultural communication. Based on the different linguistic features of the Chinese and English languages, and the obvious differences in such features, the two are constantly confronted with the confrontation and challenge of taboo language in intercultural communication, not to mention the new vocabulary of communication that has emerged as a result of the development of the Internet. When taboo language and specific communication situations on both sides are accurately analysed, it is more likely that the root of the problem can be identified and avoided in order to ensure the progress and quality of intercultural communication. The analysis of regular cases from recent years has shown that the active avoidance of the direct use of taboo language and the reinforcement of linguistic knowledge for reasons of cultural sensitivity are effective in preventing intercultural communication errors.

Medical interpreter-mediated genetic counseling for Spanish preferring adults at risk for a hereditary cancer syndrome.

The objective of this study was to identify interpretation challenges specific to exome sequencing and errors of potential clinical significance in the context of genetic counseling for adults at risk for a hereditary cancer syndrome. Thirty transcripts of interpreter-mediated telephone results disclosure genetic counseling appointments were coded for errors by bilingual researchers, and the coders applied an overall rating to denote the degree to which the errors interfered with communication overall. Genetic counselors reviewed a subset of errors flagged for potential clinical significance to identify those likely to have clinical impact. Qualitative interviews with 19 interpreters were analyzed to elucidate the challenges they face in interpreting for genetic counseling appointments. Our analysis identified common interpretation errors such as raising the register, omissions, and additions. Further, we found errors specific to genetic counseling concepts and content that appeared to impact the ability of the genetic counselor to accurately assess risk. These errors also may have impacted the patient's ability to understand their results, access appropriate follow-up care, and communicate with family members. Among interpreters' strengths was the use of requests for clarification; in fact, even more use of clarification would have been beneficial in these encounters. Qualitative interviews surfaced challenges stemming from the structure of interpreter work, such as switching from medical and nonmedical interpretations without substantial breaks. Importantly, while errors were frequent, most did not impede communication overall, and most were not likely to impact clinical care. Nevertheless, potentially clinically impactful errors in communication of genetics concepts may contribute to inequitable care for limited English proficient patients and suggest that additional training in genetics and specialization in healthcare may be warranted. In addition, training for genetic counselors and guidance for patients in working effectively with interpreters could enhance interpreters' transmission of complex genetic concepts.

The error rate analyze and parameter measurement on LoRa communication for health monitoring

During LoRaWAN data transmission, the Bit Rate transmitted from the transmitter to the Receiver experiences attenuation from the object being passed, so Packet Loss (Bytes) may occur due to diffraction, scattering, and reflection in the LoRa data transmission process. LoRa data that has errors is researched and further developed with a formula and method to minimize data rate errors in LoRa communication. Analysis development lies in the gateway's ability to accommodate LoRa data from end nodes. This condition requires a development method of Adaptive Data Rate, which is helpful for Battery Power Saving or power consumption of sensor nodes, especially in data communication with LoRa servers, i.e., the uplink and downlink processes that are correct, regular, and on-time. We use pulse data in the existing case examples to monitor the patient's health status. This data is applied to elderly patients and patients from victims of natural disasters. The development is the use of extra small and comfortable LoRa for all patients in the hospital. One of the mechanism developments is Blind-ADR, which is used for unpredictable Mobile LoRa data transmission, e.g., Blind-ADR is intended to monitor the movement of the patient's changing position. This research also examines the effects of increasing the number of end-nodes that cause health data collisions and the mechanisms used to avoid collisions, including the Adaptive Data Rate.

Combating errors in quantum communication: an integrated approach

Near-term quantum communication protocols suffer inevitably from channel noises, whose alleviation has been mostly attempted with resources such as multiparty entanglement or sophisticated experimental techniques. Generation of multiparty higher dimensional entanglement is not easy. This calls for exploring realistic solutions which are implementable with current devices. Motivated particularly by the difficulty in generation of multiparty entangled states, in this paper, we have investigated error-free information transfer with minimal requirements. For this, we have proposed a new information encoding scheme for communication purposes. The encoding scheme is based on the fact that most noisy channels leave some quantities invariant. Armed with this fact, we encode information in these invariants. These invariants are functions of expectation values of operators. This information passes through the noisy channel unchanged. Pertinently, this approach is not in conflict with other existing error correction schemes. In fact, we have shown how standard quantum error-correcting codes emerge if suitable restrictions are imposed on the choices of logical basis states. As applications, for illustration, we propose a quantum key distribution protocol and an error-immune information transfer protocol.

Strategies to Overcome Language Barriers Between Immigrant Patients and Hospital Staff- Health Services in India &amp; USA

Language obstacles impair the satisfaction of medical professionals and patients and the provision of high-quality care and patient safety. Several large healthcare organizations offer translator services to improve patient happiness and communication. Miscommunication in the medical industry has the potential to be lethal. With an increasing number of migrant patients and staff who have received foreign training, communication errors between healthcare practitioners and patients are becoming increasingly common. This article aims to investigate the impact of language barriers on healthcare and to provide solutions. Language difficulties have a negative impact on medical practitioner and patient satisfaction and the overall quality of healthcare and patient safety. However, there has been little systematic research on this subject. A major objective of our research is to investigate language barriers and miscommunication between patients and healthcare practitioners, particularly when one or both speakers are conversant in a second language. By writing this essay, the author hopes to raise public awareness about the magnitude of the difficulty involved in delivering health services to a community with significant ethno linguistic diversity.

Quantum Machine Learning for Distributed Quantum Protocols with Local Operations and Noisy Classical Communications

Distributed quantum information processing protocols such as quantum entanglement distillation and quantum state discrimination rely on local operations and classical communications (LOCC). Existing LOCC-based protocols typically assume the availability of ideal, noiseless, communication channels. In this paper, we study the case in which classical communication takes place over noisy channels, and we propose to address the design of LOCC protocols in this setting via the use of quantum machine learning tools. We specifically focus on the important tasks of quantum entanglement distillation and quantum state discrimination, and implement local processing through parameterized quantum circuits (PQCs) that are optimized to maximize the average fidelity and average success probability in the respective tasks, while accounting for communication errors. The introduced approach, Noise Aware-LOCCNet (NA-LOCCNet), is shown to have significant advantages over existing protocols designed for noiseless communications.

Mastering the Patient Handoff

Mastering the Patient Handoff

Komunikasi Publik Pemprov NTT Terkait Kenaikan Tiket

This study aims to evaluate public communications made by the East Nusa Tenggara (NTT) provincial government (Pemprov) regarding the increase in the entrance fee for the Komodo National Park (TNK) area. As is known, the decision caused polemic in the community due to communication errors. The research data collection was carried out using primary data, namely conducting in-depth interviews and documentation as well as secondary data in the form of literature studies. Interviews were conducted with informants and documentation as well as secondary data in the form of literature studies. The results of the study show that the NTT Provincial Government's public communication in the future must pay attention to aspects of openness, public participation, optimizing communication media and communication skills in conveying new policies to the public.

Identification and Evaluation of Nursing Errors in Kowsar Hospital by SHERPA

Background: Medical errors, including human errors, are one of the most important and sensitive issues in the health system. Human errors can endanger patients’ life during health service provision. Therefore, healthcare workers should ensure the safety by reducing human errors. This study aimed to identify and evaluate human errors among nurses working at an Iranian Hospital. Methods: This is a cross-sectional study which was carried out using SHERPA method in 2018. After explaining the purpose of the study, data were collected by observation and interview. Using the hierarchical analysis method, tasks and subtasks were determined, and finally, the worksheet on SHERPA was completed and analyzed. Results and Discussion: Thirty-two tasks covering 252 subtasks related to the nursing profession were investigated, of which 252 errors were detected. Identified errors included errors of action, revision, retrieval, communication, and selection which were responsible for 60, 23, 3, 12, and 2 percent of errors, respectively. In terms of the level of error risk, 16 were unacceptable, 96 were undesirable, 107 were acceptable, which need revision, and 33 were acceptable with no need for revision. Conclusion: Nurses' errors are more action errors because of the nature of their work, so hospital authorities for safety and prevention should prioritize these errors.

Nigerian Film Industry and Screenplay Text: Historical and Linguo-Socio-Cultural Symbiosis

The issue of the development of the Nigerian film industry and the specifics of the screenplay text as a reflection of the linguocultural picture of the world is considered. The question is raised about identifying the linguo-socio-cultural features of the screenplay text formed during the contact interaction of British English and the indigenous languages and cultures of Nigeria. It is proved that the text of the Nigerian film script has all the key textual categories, like the texts of British and American films, but in the refraction of the Nigerian linguistic culture. The scientific novelty of the study is determined by the derived new properties of the Nigerian screenplay text in the process of linguocultural adaptation of British English to the realities of Nigerian culture. The author’s development of a model of linguocultural adaptation of the Nigerian screenplay text is presented and its unique properties at the level of vocabulary and grammar are revealed. Particular attention is paid to the aspect of the sociolinguistic differentiation of the Nigerian society and the identification of errors in the dialogic communication of the characters depending on their belonging to the sociolinguistic type — acrolect, mesolect, basilect. The results obtained can be used for researchers in the field of the theory of language contacts in the field of communicative syntax.

Structured patient handover in high-risk areas : Evidence and recommendations for the practical implementation

The perioperative setting is ahigh-risk environment which is particularly susceptible to communication deficits and errors. The situation, background, assessment, recommendation (SBAR) approach provides an intuitive guideline for team communication, which is associated with an improved quality of the handover. The German Society for Anaesthesiology and Intensive Care Medicine (DGAI) has updated its recommendations in March 2022 and continues to endorse the use of the SBAR template. The impact of tools used for structured communication during patient handover are often studied in the context of alarger bundle of measures. The SBAR template is one option for establishing structured communication in clinical practice. Successful implementation is supported by clearly defined standard workflows to promote consistent use. This standardization identifies common communication barriers and assists in resolving them in ahigh-risk environment. Acommon understanding of the inherent values, and ashared interest in learning, applying, and training these techniques are paramount in establishing aculture of patient safety. This can only be reached through excellent interprofessional teamwork and supportive leadership.

Improving Communication in Intensive Care Unit to Ward Transitions: Protocol for Multisite National Implementation of the ICU-PAUSE Handoff Tool.

The intensive care unit (ICU)-ward transfer poses a particularly high-risk period for patients. The period after transfer has been associated with adverse events and additional work for care teams related to miscommunication or omission of information. Standardized handoff processes have been found to reduce communication errors and adverse patient events in other clinical environments but are understudied at the ICU-ward interface. We previously developed an electronic ICU-ward transfer tool, ICU-PAUSE, which embeds the key elements and diagnostic reasoning to facilitate a safe transfer of care at ICU discharge. The aim of this study is to evaluate the implementation process of the ICU-PAUSE handoff tool across 10 academic medical centers, including the rate of adoption and acceptability, as perceived by clinical care teams. ICU-PAUSE will be implemented in the medical ICU across 10 academic hospitals, with each site customizing the tool to their institution's needs. Our mixed methods study will include a combination of a chart review, quantitative surveys, and qualitative interviews. After a 90-day implementation period, we will conduct a retrospective chart review to evaluate the rate of uptake of ICU-PAUSE. We will also conduct postimplementation surveys of providers to assess perceptions of the tool and its impact on the frequency of communication errors and adverse events during ICU-ward transfers. Lastly, we will conduct semistructured interviews of faculty stakeholders with subsequent thematic analysis with the goal of identifying benefits and barriers in implementing and using ICU-PAUSE. ICU-PAUSE was piloted in the medical ICU at Barnes-Jewish Hospital, the teaching hospital of Washington University School of Medicine in St. Louis, in 2019. As of July 2022, implementation of ICU-PAUSE is ongoing at 6 of 10 participating sites. Our results will be published in 2023. Our process of ICU-PAUSE implementation embeds each step of template design, uptake, and customization in the needs of users and key stakeholders. Here, we introduce our approach to evaluate its acceptability, usability, and impact on communication errors according to the tenets of sociotechnical theory. We anticipate that ICU-PAUSE will offer an effective handoff tool for the ICU-ward transition that can be generalized to other institutions. DERR1-10.2196/40918.

Implementation of noise-reduction strategies and designated quiet time in an intensive care unit

Background/Aims Excessive noise is a considerable problem in intensive care units, interfering with patient rest, recovery times and patient satisfaction. This quality improvement project aimed to implement and evaluate noise-reduction strategies in a coronary intensive care unit in Doha, Qatar. Methods Rapid plan-do-study-act cycles were used to implement several noise reduction strategies, including the introduction of two designated quiet time periods per day (15:00–16:00 and 2:00–4:00), staff education about the impact of noise, environmental adjustments and an audio-visual device to alert staff, patients and visitors of excessive noise levels. A sound metre app was used to measure noise levels for 4 months before the intervention and for nearly 3 years (April 2018–December 2020) after implementation. Surveys were used to collect informal feedback from staff and patients on the ward. Results The average pre-intervention noise level on the unit were 64.6 dB, which was reduced to a consistent average of 24 dB during designated quiet times following the interventions. No adverse effects on communication or medical errors were observed. Patient and staff feedback was positive, with most patients (n=50) and all staff (n=86) being satisifed with the noise levels following the intervention. Conclusions Although the nature of activity in intensive care units makes them noisy environments, it is possible to reduce noise levels by targeting modifiable factors and implementing simple measures, such as dedicated quiet times, staff education and audio-visual noise alerts.

The error role in risk perception

After some time since the onset of the Covid19 pandemic, we believe it is now possible to reflect on how the global response to the worldwide spread of the virus has been organized, and at the same time reflect on the emergency approach that has characterized the responses on the health front but also the public communication of the same pandemic. The hypothesis around which we work is that the term of emergency itself is not appropriate except to designate a sit-uation that is strictly related to a reductionist approach to understanding and explaining phenomena. An event becomes an emergency only if we reason in terms of a linear explanation, avoiding paying attention to the real complexity of the phenomena, with a comprehensive look at systemic interrelationships. In this perspective, Horton correctly proposed the term syndemic to characterize the set of events related to Covid19 (Horton, 2020). Because the unexpected, which is experienced and managed as an emergency, arises from an obvious interpretative error if the problem is not addressed with a systemic logic. And it can perhaps also be hypothe-sized that as such - that is, as unexpected and emerging - any phenomenon legitimizes proce-dural and communicative errors, thus exonerating in some way whoever is responsible for facing them.