To access prior columns from 2025-2019:
https://www.healthcarehygienemagazine.com/patient-safety-quality/2025-patient-safety-columns/
https://www.healthcarehygienemagazine.com/patient-safety-quality/2024-patient-safety-columns/
https://www.healthcarehygienemagazine.com/patient-safety-quality/2023-patient-safety-columns/
https://www.healthcarehygienemagazine.com/patient-safety-quality/2022-patient-safety-columns/
https://www.healthcarehygienemagazine.com/patient-safety-quality/2021-patient-safety-columns/
https://www.healthcarehygienemagazine.com/patient-safety-quality/2020-patient-safety-columns/
2026 articles:
Healthcare Communication and Patient Safety
By Kristina Pirollo-Ketchum, BA, AA, CHL, CRCST
This article originally appeared in the May-June 2026 issue of Healthcare Hygiene magazine.
The provision of quality care not only needs clinical expertise but also the interplay between clinicians and patients in the bedside setting. Bedside communication manner has been a misperceived soft skill, but it is directly involved in patient outcomes and safety. Effective, sensitive, and respectful communications will enable the patient to comprehend their conditions, adhere to the treatment regimen, and feel safe. According to Anshasi and Almayasi (2024), bedside communication is even more important in the context of modern healthcare systems, where complexity and speed are rising. This paper states that bedside communication is a core part of patient safety, and it should be viewed as a quantifiable and correctable part of clinical practice to enhance patient outcomes.
Bedside communication is one of the critical patient safety components, as it pre-establishes the appropriate information communication between healthcare providers and patients. Patients have higher chances of understanding and adhering to their treatment plans when clinicians can discuss with them what is wrong with them, what to administer, and how. Additionally, communication enables patients to inquire and give information about the symptoms and enables the providers to make the correct decisions. Safe and effective care cannot be done without bedside communication, which is mandatory and not optional.
Lack of effective communication can result in very serious consequences, and such consequences might comprise medical errors and lateness in interventions. The inability of a healthcare provider to communicate effectively can lead to a failure to comprehend or even not receive the essential information. To illustrate this, a physician may give unclear information about the dosage of a medication, and a nurse or a patient can take it incorrectly. Poor communication between shifts, on the same note, can result in unaddressed or untimely symptoms (Howick et al., 2024). These may be caused by assumptions, lack of clarity, and not checking the information. Consequently, the patients can be harmed, which would not have happened with improved communication practices.
Poor bedside communication is also caused by systemic problems in healthcare settings. Lack of time may compel providers to hurry up in their interactions and prevent any meaningful dialogue. Moreover, hierarchal relationships may hinder open communication, particularly when the nurse or junior staff of an organization feels powerless to challenge the decision of senior physicians. This disconnection of collaboration may result in a situation where errors are not challenged (Alder, 2026). Moreover, overworking and burnout lower the quality of interactions with patients, and communication becomes less efficient. Such systemic issues raise concerns about organizational change that emphasizes communication as a component of patient safety.
Considering these threats, bedside manner must be regarded as a quantifiable and enforcing part of clinical performance. Standardized communication protocols, including checklists and training in patient-centered communication, can be adopted in healthcare institutions (Ahmed et al., 2025). Communication skills should be part of a performance evaluation, and effectiveness should be determined through feedback by patients. By making providers accountable, organizations can guarantee a regular focus on communication.
Bedside communication is an essential aspect of patient safety that is not about mere politeness. Any delay in communication can lead to serious adverse consequences, and the obstacles on the systemic level will not allow the interactions to be successful. Bedside communication should thus be recognized as a significant clinical skill in healthcare systems, and standards should be placed on it to promote effective, explicit, and empathetic communication to improve patient safety and outcomes.
References
Ahmed, W. E., Fakhry, S. F., & Mohamed Badran, F. M. (2025). Bedside handover training and its effects on nurses’ knowledge and compliance. BMC Nursing. https://doi.org/10.1186/s12912-025-04075-9
Alder, S. (2026, January 2). Effects of Poor Communication in Healthcare - 2026 Update. The HIPAA Journal. https://www.hipaajournal.com/effects-of-poor-communication-in-healthcare/
Anshasi, H., & Almayasi, Z. A. (2024). Perceptions of Patients and Nurses about Bedside Nursing Handover: A Qualitative Systematic Review and Meta-Synthesis. Nursing Research and Practice, 2024(1), 1–18. https://doi.org/10.1155/2024/3208747
Howick, J., Weston, A. B., Solomon, J., Nockels, K., Bostock, J., & Keshtkar, L. (2024). How does communication affect patient safety? Protocol for a systematic review and logic model. BMJ Open, 14(5), 1–8. https://doi.org/10.1136/bmjopen-2024-085312
Handling Healthcare Personnel Behavior-Related Deviance to Uphold Patient Safety and Quality
By Kristina Pirollo-Ketchum, BA, AA, CHL, CRCST
This article originally appeared in the Jan-Feb 2026 issue of Healthcare Hygiene magazine.
Patient safety and quality of care are primary topics of contemporary healthcare systems, as they have a direct impact on patient outcomes, organizational performance, and the trust of the population. Despite technological progress and intellectual standards of care, patient safety incidents are still taking place in terrifying proportions. Such incidents are mostly blamed on human error, but Tariq, et al. (2024) have proved that the root cause is the failure of systems. The normalization of deviance is one of the most alarming failures in the system because over time the unsafe practices develop into a routine. This article presents the argument that deviance is a normal state of affairs in patient safety and quality of care and that deviance can only be dealt with through strong leadership, psychological safety, and well-designed systems, but none through enforcement of policies.
The events associated with patient safety involve medication errors, patient falls, healthcare-associated infections, and delays in the diagnosis. These happenings are very infrequent since one person does not succeed; rather, they come out of complex arrangements in which minute variances compound without being noticed. When such deviations do not cause immediate harm, then normalization of deviance emerges. Employees might start to consider unsafe practices as normal due to the lack of any negative consequences in the previous instances (Wright, 2023). Eventually, standards are compromised, and unsafe habits become institutionalized in clinical practice.
Clinical settings that demand high levels of pressure are highly open to normalization of deviance. The problem of staffing, a high workload, and the necessity to spend more time on productivity promote shortcuts and workarounds. Sometimes staff can rush to work and overlook safety checks or even disregard protocols to accomplish work fast. Unless leaders act on these acts, they become normal. New workers tend to acquire unsafe behaviors through observation of old workers, a fact that perpetuates the issue among crews and divisions.
Unsafe practices are enabled by several conditions in an organization. The lack of leadership visibility conveys a message that safety is not a priority. Leaders are no longer present in clinical areas and therefore have not been able to assess risks and assist staff. Psychological safety is of importance as well. The fear of being blamed or punished does not make employees report about any mistakes or near misses. The lack of the proper system design aggravates the situation (Wright, 2023). Inefficient workflows, insufficient staffing, and unreliable technology complicate adherence of clinicians to safe practices regularly.
The effect of the normalization of deviance on patient safety and quality of care is harsh. It adds variability in care processes and the exposure to potential harm that can be avoided. Patient quality is compromised, expenses escalate, and employee morale goes down (Sedlar, et al., 2023). Distrust in the healthcare organization is destroyed with the course of time. The following impacts demonstrate the urgency of prevention-based measures.
To deal with the normalizing of deviance, there is a need to enforce policies and procedures. The change of ingrained behavior cannot be done with policies alone. There is a need to have visible and active leadership to guarantee safety expectations. Top management should be able to hear lower-level employees and take action on safety issues. The psychological safety should be provided to make the staff feel free to speak. To promote safe practice, system design must lessen complexity and workload. Constant monitoring can determine unsafe drift in time.
Normalization of deviance is a silent yet powerful risk to the quality and safety of the patients in the healthcare environment. It takes more than rules and policies to prevent the unsafe practices from turning into the standard operations. In order to facilitate safe care, healthcare institutions should encourage visible leadership, psychological safety, and systems. An efficient and proactive safety culture is a key to attaining sustainable patient-focused quality-based care.
Kristina Pirollo-Ketchum, BA, AA, CHL, CRCST, is an independent consultant and principal of Ketchum Konsulting, LLC.
References:
Sedlar N, et al. (2023). A qualitative systematic review on the application of the normalization of deviance phenomenon within high-risk industries. J Safety Research. 84, 290-305. https://doi.org/10.1016/j.jsr.2022.11.005
Tariq RA, et al. (2024). Medication Dispensing Errors and Prevention. NIH.gov; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK519065/
Wright I. (2023). Normalization of Deviance Is Contrary to the Principles of High Reliability. AORN Journal. 117(4), 231–238. https://doi.org/10.1002/aorn.13894