1. PATIENT-PROVIDER FAILURE TO COMMUNICATE Akil Williams 2. Fosters Story Patient Foster about to enjoy an important anniversary was admitted to a University affiliated hospital for the purpose of having a colostomy wound debrided. As a part of the procedure, a prophylactic antibiotic was to be administered. The patient suffered a sudden cardiac arrest. This cardiac arrest resulted from a rare but well-known allergic reaction to this antibiotic Cefotan. 3. Continue Fosters Story Foster was successfully resuscitated. A substitute antibiotic was employed uneventfully. The procedure was rescheduled to occur approximately thirty days later with the same surgeon who had earlier been involved. Continuity of care The anesthesiologist, who had saved Fosters life earlier, recorded in the order sheet, in the progress notes and even in a typed signed note provided to Foster Triple documented to assure patient safety 4. Fosters Surgery Foster showed her surgeon the note her anesthesiologist had provided and, rather than openly disagreeing with the note, he simply said he was aware of that. Failure to show concern for patient safety Failure to patient-provider to communicate Loss of control by the patient Loss of Dignity The anesthesiologist who came to the Fosters side assured Foster that everyone knew she was allergic to Cefotan. She said reassuringly, You will not receive Cefotan. Provided patient-provider communication Gain patient trust by reassuring patient 5. Continue Fosters Surgery The same anesthesiologist entered the room who had just offered such reassuring promises, this anesthesiologist observed the patient was about to receive a prophylactic antibiotic intravenously. The anesthesiologist promptly inquired as to the type of antibiotic ,it was Cefotan. The surgeon present was the same surgeon present at the time of the original cardiac arrest, insisted that the patient get the prophylactic antibiotic. Communication between providers declined. Surgeon refuses to take measures to increase patients survival rate. Surgeon is at border line malpractice. 6. Outcome of Fosters surgery The anesthesiologist present and the nurse anesthetist present lacked the courage to refuse. Lack of integrity Instead the anesthesiologist said to the nurse anesthetist, Well, make sure you dont give to much. Increased the chance of medical error The drug was administered which resulted in patient death. 7. Results Because of a decline in communication patient died from complication of the drug Communication is essential at every level of care. Researchers examined 24 plaintiff depositions found that 71% of the malpractice claims were initiated as a result of a physician-patient relationship problem. Closer inspection found that most litigious patients perceived their physician as uncaring. one out of four plaintiffs in malpractice cases reported poor delivery of medical information, with 13% citing poor listening on the part of the physician 8. References Asnani MR. (2009). Patient-physician communication. WestIndian Med J, 58(4):357-61. Clark, P. A. (2003). Medical practices sensitivity to patients needs: Opportunities and practices for improvement. Journal of Ambulatory Care Management, 26(2), 110-123. Beckman, H. B., Markakis, K. M., Suchman, A. L., & Frankel, R. M. (1994). The doctor-patient relationship and malpractice. Lessons from plaintiff depositions. Archives of Internal Medicine, 154(12) 1365-1370.