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Poor communication is the leading cause of adverse events. This is not surprising; to have an effective team there needs to be good communication. The leader needs to communicate with the followers, and followers communicate with leaders and other followers. Communication is not just saying something – it is ensuring that information is accurately passed on and received. We all want to ensure effective communication at all times. Remember there are multiple components to effective communication (Table 4.2).

Table 4.2 Elements of communication

Sender	Sender	Transmitted	Receiver	Receiver
Thinks of what to say	Communicates message	Face to face/phone/email	Hears and confirms message	Considers and acts

When communicating face to face a lot of the information is transmitted non‐verbally, which can make telephone or email conversations more challenging. Communication can be more difficult when talking across professional, specialty or hierarchal barriers as we do not always talk the same technical language, have the same levels of understanding, or even have a full awareness of the other person’s role.

There are a variety of tools to aid communication, for example SBAR (situation, background, assessment and recommendation). SBAR is designed for acute clinical communications. It facilitates the sender to plan and organise the message, make it succinct and focused, and provide it in a logical and expected order. It is also an empowerment tool allowing the sender (who may be more junior) to request an action from a more senior individual. Find out what communication tool your organisation uses and practise using it; look out for other staff using it too. While these tools are useful, they tend to be reserved for certain situations, whereas we want to establish effective communication as the routine not the exception. One method to routinely improve communication is to incorporate a feedback loop.