THE ROLE OF CULTURAL COMMUNICATION IN ENHANCING THE EFFECTIVENESS OF MEDICAL EMERGENCY TEAMS

Abstract

This essay specifically focuses on exploring the role of cultural communication in enhancing the effectiveness of medical emergency teams. It is based on the observation that communication problems have been identified as one of the leading causes in root-cause analyses of adverse events and near misses. The communication problems that contribute to these adverse outcomes are not limited to language barriers, however, language barriers are an important aspect of cultural communication that can impede the transfer of critical information. Other forms of miscommunication that are affected by culture can include: the lack of articulateness in clarifying diagnostic or treatment plans; poor questioning and listening skills; inadequate explanations for the informed consent process; inadequate assessment or reassessment of a clinical problem; and condescension or hostility that can lead to ineffective assertiveness or advocacy. It is believed that the impact of all of these communications has a disproportionately negative effect on patient safety when acute medical care is required. This could be explained by the fact that the severity of an acute illness and the rapid changes in patient acuity levels necessitate high-stakes decision making and timely precise action. This is particularly true when a MET is called. At this point, patient instability has been identified and there is acknowledgment by ward staff that additional help is needed to manage the situation. High-stakes decision making and teamwork in acute situations are known to be highly influenced by culture. Decisions are based on best evidence and clinical judgment, often under time constraints. A significant proportion of medical errors in acute scenarios are attributed to errors in judgment. Experts in clinical reasoning have shown that the quality of decisions can be compromised when there is an emotional bias that is triggered by cultural differences. This is an area that has a significant effect on patient safety where we can postulate that adverse outcomes and near misses involving acute medical care may have a relationship to cultural interactions between the treating teams and the patients.