Enhancing Patient Safety Through Effective Interprofessional Communication: A Focus on Medication Error Prevention

Background: Medication errors significantly impact patient safety and healthcare costs. This study investigates the influence of interprofessional communication on medication error rates, with a focus on identifying actionable strategies to improve communication efficacy among healthcare professionals. Methods: Utilizing a quantitative approach, this research distributed a detailed online questionnaire to a broad cohort of healthcare workers in various settings within Saudi Arabia. The survey encompassed sections on demographics, the frequency and quality of interprofessional communication, perceived barriers and facilitators to effective communication, and personal experiences with medication errors. Statistical analysis was performed using SPSS to derive descriptive and inferential statistics, alongside thematic analysis for qualitative responses. Results: The survey attracted 1165 respondents, predominantly aged 20-30 (68.58%) and female (65.49%). Pharmacists constituted the largest professional group (40.34%). We identified a notable positive correlation (r = 0.16) between high-quality interprofessional communication and employment in hospital environments or having 5-20 years of experience. In contrast, negative correlations were observed with employment in non-traditional healthcare settings (r = −0.19) and professionals with less than five years of experience (r = −0.13), indicating communication challenges. The analysis also highlighted a concerning frequency of prescription and dispensing errors, with 52.70% of participants reporting prescription errors as the most common issue encountered. Conclusion: Effective interprofessional communication is pivotal in mitigating medication errors within healthcare settings. The study illuminates specific areas for improvement, including the need for targeted communication training, particularly for less experienced professionals and those in non-traditional settings. Enhancing communication channels and fostering an environment conducive to open, interdisciplinary dialogue are essential steps towards advancing patient safety and reducing medication errors.


Introduction
Interprofessional communication, defined in our study as the exchange of information, ideas, and perspectives among healthcare professionals of different disciplines within clinical settings, is a cornerstone of healthcare and essential for ensuring patient safety and minimizing medication errors [1].Despite ongoing initiatives, medication errors remain a significant challenge, leading to adverse patient outcomes and escalating healthcare costs [2].Our research investigates the connection between interprofessional communication and medication error rates, with the aim of proposing strategies for enhancing the quality of such communication among healthcare professionals.
The existing body of literature underscores the pivotal role of effective communication between diverse healthcare roles, such as nurses and physicians, in preventing medication errors.Studies [1,3] have highlighted the critical nature of nurse-physician interactions and the nuanced impact of technologymediated communication on medication safety.Further contributions [4,5] emphasize the benefits of structured interprofessional rounds and team-based communication training in bolstering patient safety.A systematic review [6] consolidates these insights, demonstrating the critical importance of interprofessional communication in reducing medication errors.
Our research investigates the intricate dynamics of interprofessional communication within healthcare settings, with a particular focus on its influence on medication error rates.The core of our inquiry lies in understanding how communication among healthcare professionals from different disciplinesencompassing both verbal and non-verbal interactions in various clinical environments such as hospitals, clinics, and pharmacies -affects the frequency and management of medication errors, a crucial component of patient safety [4,6].We seek to identify the array of barriers healthcare professionals face in achieving effective communication, especially in the context of medication administration, and to uncover actionable strategies that can fortify communication pathways among healthcare workers, thereby contributing to a reduction in medication errors.This exploration is vital for understanding the communication processes that underpin medication safety and the collaborative efforts necessary for enhancing patient care [1,5].

Study design and period
This cross-sectional study, conducted from January to March 2024, aimed to explore the relationship between interprofessional communication and medication error rates across various healthcare settings in Saudi Arabia.The study's duration was strategically chosen to allow for a comprehensive collection of data while minimizing the impact of external variables.

Setting and participants
Participants were recruited from a broad spectrum of healthcare settings within Saudi Arabia, including hospitals, clinics, and pharmacies.The study targeted a diverse group of healthcare professionals, including physicians, nurses, pharmacists, technicians, and administrative staff, emphasizing the multidisciplinary nature of healthcare delivery.

Sample size calculation
The sample size was calculated using the Cochran formula with a 95% confidence level and a 5% margin of error.Based on the preliminary survey and the expected population variance, the calculated sample size was 385 healthcare professionals.This figure was determined to be representative of the diverse healthcare workforce in Saudi Arabia, ensuring the statistical significance of the findings.

Questionnaire development, validation, and data collection
A structured online questionnaire was developed from a thorough literature review and adapted from existing validated instruments.It underwent a pilot study for validation to test its reliability among a small group of healthcare professionals.The questionnaire, containing demographic information, experiences with medication errors, assessments of interprofessional communication, and perceived barriers and facilitators, was distributed electronically.Clear instructions were provided, highlighting the study's voluntary nature and the confidentiality of responses.

Statistical analysis
Data analysis was performed using SPSS version 26 (IBM Corp., Armonk, NY).Descriptive statistics were used to summarize demographic information and responses.Inferential statistics, including chi-square tests and logistic regression analyses, were applied to examine associations between interprofessional communication practices and medication errors.A p-value of <0.05 was considered statistically significant.Detailed statistical results, including p-values and other relevant metrics, are presented in the appendix for clarity and comprehensiveness.

Results
The study received responses from 1,165 healthcare professionals in Saudi Arabia, spanning various demographics and professional roles.The majority of respondents were in the 20-30 age range, accounting for 68.58%, or 799 respondents.Female participants constituted 65.49%, or 763 of the responses (    Correlation analysis indicated a positive relationship between the quality of interprofessional communication and working in hospital settings, as well as having 5-20 years of experience.This suggests that these factors are associated with higher perceived communication quality.In contrast, negative correlations were found for professionals in "other" healthcare settings, those with less than five years of experience, and those in "other" professional roles, pointing to perceived communication challenges in these groups. The analysis of healthcare events and associated error types among healthcare professionals offered insightful patterns about the frequency and specific errors prevalent in healthcare settings.Events categorized as "rarely" occurring were reported by 37.08% (431 out of 1165) of respondents, reflecting the largest segment.These events had an average severity rating of 2.72, pointing towards a moderate level of concern.Notably, within this "rare" category, prescription errors stood out, with 52.70% (227 out of 431) of respondents reporting such errors, underlining a critical area for improvement in prescription management practices.
On a monthly basis, 20 Data are represented as N (%) and mean ± SD where applicable.A p-value < 0.05 is considered significant.The SD is provided for the 'Rarely' category; for other categories, the specific error types and their frequencies are listed without the SD due to the categorical nature of the data.
The comprehensive assessment of interprofessional communication within healthcare environments explored several key aspects, including the frequency of interprofessional meetings, the overall quality of communication perceived by healthcare professionals, the primary channels through which communication occurs, and the notable barriers hindering effective interprofessional dialogue.In exploring the interplay between demographic factors and professional characteristics within the healthcare sector, significant associations were unearthed, as summarized in Table 5.These findings not only shed light on the current state of the healthcare workforce but also suggest potential areas for policy intervention and workforce development strategies.Table 5 delineates these associations and their broader implications for the healthcare sector.

Gender and professional role
A significant association was found, indicating a varied distribution of professional roles across genders.The quality of interprofessional communication within healthcare settings is paramount for efficient patient care and coordination between different roles.

TABLE 6: Trend analysis of quality of interprofessional communication by professional role
As illustrated in Table 6, there is a clear stratification of communication quality perceptions among different professional roles.Physicians, often at the nexus of clinical decision-making, reported the highest average quality score, which may reflect their pivotal role in the healthcare system.Similarly, administrative staff and technicians, who play crucial roles in supporting healthcare logistics and technical aspects of patient care, reported above-average communication quality.
Conversely, nurses and pharmacists, despite their critical patient-facing roles, indicated slightly lower satisfaction levels with interprofessional communication.This discrepancy may underscore the need for enhanced communication channels and collaborative frameworks that more actively incorporate these professionals' perspectives.
The 'Other Professional Roles' category, which includes a variety of positions within the healthcare spectrum, displayed the lowest average score.This finding points to the heterogeneity within this group and suggests that some professional roles may encounter specific barriers to effective communication that warrant further investigation and targeted interventions.
Effective communication in healthcare is not only influenced by individual competence but also by organizational and role-specific factors.Table 7 encapsulates the correlation between the quality of interprofessional communication and a variety of demographic and professional variables.Correlation coefficients offer a quantitative glimpse into the strength and direction of these relationships, while the ensuing discussion provides context and suggests potential implications for healthcare practice and policy.

TABLE 7: Correlation analysis between the quality of interprofessional communication and demographic/professional variables
Table 7 reveals insightful patterns regarding the factors that correlate with the perceived quality of interprofessional communication.Positive correlations with hospital settings and professionals with a range of 5 to 20 years of experience suggest that structured environments and accumulated experience enhance communication.The pivotal roles of physicians and pharmacists in patient care and medication management likely contribute to their positive perceptions of communication quality.
Conversely, the negative correlations observed for those working in 'other' healthcare settings or with less than five years of experience suggest that non-traditional work environments and relative inexperience may be associated with challenges in effective communication.The 'other' professional roles category also indicates a perceived gap in communication quality, which could be attributed to the variability in role functions and interaction opportunities within the healthcare system.Overall, the data advocate for a nuanced approach to strengthening interprofessional communication across the healthcare spectrum.

Discussion
Our study investigates the integral role of interprofessional communication in mitigating medication errors and enhancing patient safety, resonating with existing literature that positions communication as a cornerstone of patient safety strategies [1,2].The diversity in communication quality across various professional roles and healthcare settings mandates a multifaceted approach to improvement, integrating systemic changes, role-specific interventions, and individual-level training [3][4][5][6].
The positive correlations observed between high-quality communication in hospital settings and among professionals with 5-20 years of experience align with the emphasis of Greenberg et al. [7] on structured interprofessional rounds.Such structured communication platforms can significantly reduce medication errors, particularly in complex hospital environments where the stakes for accurate information exchange are high [8].
Conversely, the challenges faced by newcomers and professionals in non-traditional settings highlight a gap in tacit knowledge and confidence essential for effective communication.This gap necessitates targeted communication training programs, similar to those recommended by Manias et al. [9], which could be integrated into ongoing professional development initiatives to bridge this divide [10].
The high incidence of prescription and dispensing errors in our study points to the critical need for enhanced communication mechanisms, especially between key players like physicians and pharmacists.The adoption of technology-based solutions, such as advanced EHR systems with integrated communication tools, can facilitate more streamlined and error-proof communication channels [11][12][13][14].However, reliance on technology should be balanced with the potential risks of over-dependence, as highlighted in the literature [15].
The underrepresentation of frontline caregivers, such as nurses, in high-quality communication networks underscores a potential undervaluation of their roles.Empowering these caregivers through inclusive communication training and decision-making processes can ensure a more robust safety net for patients, as nurses often serve as the final checkpoint before medication administration [16,17].
Significant demographic associations identified in our study, such as gender disparities and preferences for specific healthcare settings, suggest the need for tailored communication strategies.Gender-sensitive career development programmes and training interventions designed to meet the unique demands of various healthcare environments can address these disparities effectively [18][19][20][21].

Study limitations
This study, while comprehensive in its exploration of interprofessional communication and its impact on medication error prevention, is not without limitations.First, the reliance on self-reported data may introduce a degree of response bias, as participants might overestimate their communication efficacy or underreport instances of medication errors due to social desirability bias.Additionally, the cross-sectional nature of the study design limits our ability to establish causality between interprofessional communication quality and medication error rates.
The sample, drawn from various healthcare settings within Saudi Arabia, may not fully represent the diversity of healthcare environments globally, potentially limiting the generalizability of the findings.Furthermore, the study predominantly focused on the quantity and perceived quality of communication without delving deeply into the specific content or the contextual factors that might influence these communications.Lastly, technological and cultural factors unique to the Saudi Arabian healthcare context may not be applicable or may manifest differently in other healthcare systems, necessitating careful consideration when extrapolating these results to different settings.

Recommendations
In light of the study's insights, it is recommended to take a multifaceted approach to enhance interprofessional communication and thereby reduce medication errors.First, the initiation of comprehensive communication training programmes for healthcare professionals is crucial.These should not only focus on the theoretical aspects but also include practical simulations to closely mimic real-life scenarios, thereby improving the applicability of the skills learned.
To foster an environment of collaboration, it is imperative to establish structured forums where professionals from various disciplines can engage in open dialogue and collaborative problem-solving.Such forums should aim to build a culture of mutual respect and understanding, recognizing the unique contributions of each professional role to patient care.
Technological advancements offer promising avenues to streamline communication within healthcare teams.The integration of communication tools within EHRs, along with the adoption of secure, healthcarespecific messaging applications, can significantly enhance the efficiency and effectiveness of interprofessional interactions.
Implementing mechanisms for structured feedback and reflective practice can significantly contribute to continuous improvement in communication skills.These could take the form of debriefing sessions following significant clinical incidents or structured peer reviews focusing on communication effectiveness.
At an organizational and policy level, there needs to be a clear prioritization of effective communication as a cornerstone of patient safety.This could involve revisiting staffing models to allow for adequate communication time, establishing clear guidelines for interprofessional interactions, and creating incentive structures that recognize and reward effective teamwork and communication.
Given the diversity inherent in healthcare teams and patient populations, training in cultural competence and sensitivity is also paramount.This ensures that communication strategies are not only effective but also respectful and inclusive across various cultural backgrounds.
Finally, the field would benefit from further research that delves deeper into the nuances of how interprofessional communication impacts medication safety.Longitudinal studies could help establish causality more definitively, and cross-cultural studies could shed light on how different healthcare systems and cultural contexts influence communication practices and their outcomes.

Conclusions
Our investigation significantly contributes to the ongoing discourse surrounding patient safety, revealing the diverse elements that either enhance or hinder effective interprofessional communication within healthcare settings.While aligning with previous research, our analysis also uncovers significant insights into the complex dynamics of communication among healthcare professionals and within different operational environments.Specifically, our findings highlight the profound impact of organizational culture on communication effectiveness, demonstrating that environments fostering transparency and constructive feedback significantly reduce the occurrence of medication errors.Additionally, our research reveals a nuanced challenge related to the integration of digital communication tools.While these tools are essential for optimizing information exchange, they can sometimes lead to information overload, complicating communication processes.These insights underscore the importance of adopting a comprehensive and thoughtful approach to developing interventions aimed at reducing medication errors.Such an approach should integrate structural, educational, and policy-driven strategies while carefully considering the interplay of organizational culture and technological advancements.

Appendices
authors have confirmed that this study did not involve animal subjects or tissue.Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work.Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work.Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.
foster better communication among professionals, potentially due to structured teams and protocols.tend to perceive better communication, likely due to their familiarity with healthcare systems and team dynamics.Professionals with 11-20 years of experience 0.16 Positive Similar to those with 5-10 years, this group perceives better communication, underscoring the value of experience in effective interprofessional interactions.Physicians 0.16 Positive The central role of physicians in patient care and team interactions may contribute to their positive perception of communication quality.Pharmacists 0.16 Positive Pharmacists' positive correlation may reflect their key role in medication management and collaboration with other healthcare professionals.Negative correlations Working in "other" healthcare settings −0.19 Negative Non-traditional healthcare settings might face unique challenges in fostering effective interprofessional communication.Less than 5 years of experience −0.13 Negative Less experienced professionals might perceive communication as less effective, highlighting a potential area for targeted training and support."Other" professional roles −0.12 Negative Professionals outside standard categories may experience or perceive communication barriers differently, indicating a need for inclusive communication strategies.

TABLE 3 : Assessment of interprofessional communication in healthcare: frequency, quality, channels, and barriers
effectiveness continuum highlight the subjective nature of these interventions, underlining the importance of tailoring communication training to meet the diverse requirements and contexts encountered by healthcare professionals.Proposals for advancing interprofessional communication varied, with equal support (24.6%, 286 out of 1165 for each) for 'standardized communication protocols' and 'regular interprofessional meetings'.This reflects a recognized need for both clearly defined communication guidelines and increased opportunities for structured interprofessional discussions.The advocacy for 'training and educational programmes' by 23.1% (269 out of 1165) underscores a strong interest in continuous skill development.Furthermore, a 16.1% (187 out of 1165) inclination towards 'technology-based solutions' reveals a readiness to embrace digital innovations to streamline communication pathways, suggesting the significant role technology could play in boosting communication efficacy and efficiency in healthcare contexts, as detailed in Table4.
EHR: electronic health recordsThis table evaluates the frequency of interprofessional meetings, the quality of interprofessional communication, and commonly used communication channels, and identifies barriers to effective communication among healthcare professionals.Data is represented as N (%), with a p-value < 0.05 considered significant.The previously existing first column has been integrated into the legend for clarity.P-values indicate the statistical significance of the association between the category and the respective aspect of interprofessional communication.A p-value < 0.05 is considered significant.Categories with p-values > 0.05 suggest that the association might not be statistically significant, warranting further investigation.accessibility,time constraints, or a lack of information on available training, underscoring the necessity of addressing these barriers to foster widespread skill development.Perceptions of the effectiveness of current communication improvement strategies were mixed, with the most considerable proportion (49.7%, 579 out of 1165) rating them as 'somewhat effective.'This moderate satisfaction level points towards the need for refining intervention designs and execution.The varied responses across the

TABLE 4 : Healthcare professionals' perceptions of communication protocols, training, intervention effectiveness, and improvement strategies
This table presents healthcare professionals' perceptions regarding communication protocols, their participation in training programmes, the perceived effectiveness of various intervention strategies to enhance communication, and their suggestions for improving interprofessional communication and medication safety.Data are represented as N (%), with the mean ± SD provided where applicable.The table clarifies that it begins with Question 13, continuing from the sequence of questions addressed in the study questionnaire.Statistical significance is considered at p < 0.05.

TABLE 5 : Significant associations in healthcare sector demographics and professional characteristics Statistical
values include the test statistic and p-value, where applicable.A p-value < 0.05 is considered statistically significant.The test statistics (χ² for chi-square tests and F for ANOVA) provide a measure of the strength of association between the variables.

Table 6
presents a trend analysis of the perceived quality of interprofessional communication as reported by various healthcare professionals on a scale of 1 to 5, where 5 represents 'Excellent' and 1 represents 'Very Poor'.The insights column offers a brief interpretation of these scores, highlighting the nuances and potential factors influencing the communication quality within each professional group.Physicians reported the highest average quality, potentially reflecting their central role in decision-making and patient care coordination.Administrative staff 4.05Administrative staff also perceive high communication quality, possibly due to their role in facilitating operations and logistics.