Bridging Communication Gaps to Enhance Patient Safety: A Quality Improvement (QI) Project on the Role of Abbreviations, Their Risks, and Pathways to Change

弥合沟通鸿沟,提升患者安全:一项关于缩写的作用、风险及改进途径的质量改进项目

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Abstract

Introduction Effective communication within the multidisciplinary team (MDT) is critical to safe patient care. Whilst electronic health records have improved legibility, the widespread use of non-standardised abbreviations continues to cause misinterpretation, risking delays, errors, and compromised patient safety. Abbreviations are often used for efficiency, yet their meanings vary between specialties, creating barriers for rotating staff, cross-disciplinary colleagues, and patients reviewing discharge summaries. Quality improvement project We conducted a closed-loop quality improvement (QI) project structured around the SQUIRE 2.0 guidelines for QI initiatives. The project took place in a UK district general hospital to assess and improve understanding of commonly used ear, nose, and throat (ENT) specialty abbreviations. Eighty-two common abbreviations were identified and used in a written expansion test. In cycle one (n = 45), mean accuracy was 24.3%, with no participant exceeding 77%. Following targeted interventions (educational seminars and a printed reference guide displayed in shared spaces), a second assessment cycle was conducted with a new cohort. Post-teaching scores improved by a relative 40% to a mean of 35% (range 24%-52%). Mann-Whitney U testing confirmed statistical significance (p < 0.05). Implications and discussion Findings revealed a substantial baseline knowledge gap, highlighting a safety risk. Low-cost, high-visibility measures, such as reference posters and induction-based teaching, improved comprehension and could be readily adopted in other departments. However, residual gaps suggest the need for upstream interventions, including integration of documentation clarity training into medical education and continued departmental reinforcement. Conclusion Clinicians' baseline abbreviation comprehension was poor, but targeted education significantly improved understanding. Whilst no participant achieved complete proficiency, results show that simple, resource-light strategies can enhance communication clarity and support safer care. Broader adoption, alongside curricular change, offers a sustainable path to reducing abbreviation-related risks.

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