TL;DR — Communication failures cause one in ten patient safety incidents and cost hospitals millions in preventable turnover. After a decade, the numbers haven’t improved — because the problem isn’t awareness, it’s design. Healthcare teams need communication treated as a competency: assessed at hire, developed after, and reinforced by culture. This post covers how to hire for communication, why strong clinicians sometimes fail at it (the alpine divorce problem), and what it looks like to build communication capability across an organization.
In 2017, we compared healthcare teams to pit crews and Special Ops Forces. The analogy still holds — except pit crews don’t have to document their tire changes in three different healthcare systems.
That comparison, borrowed from Atul Gawande, was aspirational then. It still is. A NASCAR crew executes a full pit stop in under twelve seconds because every role, every handoff, every signal is designed and rehearsed. Healthcare teams face the same stakes — sometimes higher — with far less choreography. The question isn’t whether communication matters. It’s why, after a decade of knowing this, the numbers are still stuck — or worse.
Communication failures remain the sole cause of one in ten patient safety incidents and a contributing factor in one in four. Over two-thirds of f communication errors relate to handoffs — the exact transitions where pit crew precision is supposed to apply. The Joint Commission reported 1,575 sentinel events in 2024, a 12% increase from the prior year. And nearly 27% of 30-day readmissions could still be prevented with better discharge communication — the same proportion we cited eight years ago.
The technology has improved. The training has improved. The awareness has improved. The outcomes haven’t. That tells us the problem isn’t information — it’s the people and the culture carrying it.
Hiring for Communication: What Assessments Reveal
Communication is complex because it is shaped by personality, experience, and the expectations we carry from previous work environments. Consider a nurse who previously worked in a unit with a strict chain of command, where voicing opinions was quietly discouraged. She now joins an organization where every member of the care team is expected to contribute to care plans and transparency is the norm. Without understanding how her experience has shaped her communication instincts, her new team may mistake caution for disengagement. And she may mistake their directness for conflict.
This is where hiring assessments provide something interviews alone cannot: a structured view of the qualities that influence how someone communicates under real conditions. Two characteristics consistently predict how well care team members communicate across professional boundaries.
The first is locus of control — the degree to which someone believes they can influence events and outcomes. Healthcare professionals with a greater internal locus of control are more likely to initiate communication with colleagues outside their own discipline. They don’t wait for permission to share what they’ve observed.
The second is emotional intelligence. Professionals with greater emotional intelligence regulate their own responses in stressful moments and read the emotions and behaviors of others more accurately. Patient safety depends on situational awareness — the team’s shared understanding of a patient’s condition, not just any one clinician’s view. Emotional intelligence is what allows that awareness to stay shared when the pressure rises.
Knowing how personality influences day-to-day communication behaviors is valuable because it means we can start building more effective care teams — through hiring the right people and building on their strengths through development.
The 'Alpine Divorce' Problem in Healthcare Teams
Sometimes the communication breakdown isn’t about a bad hire. It’s about a mismatch between what got someone here and what the role actually requires.
We’ve written about the parallel of alpine divorces in the workplace — moments when support disappears at the exact point where dependence is highest. In healthcare, these moments are predictable and the consequences are immediate.
Think of a charge nurse promoted for clinical excellence who can’t run a huddle. She was the best bedside nurse on the unit — calm under pressure, technically flawless, trusted by patients. But a huddle requires a different set of skills: reading the room, drawing out the quieter voices, synthesizing information from multiple disciplines in real time, and making priorities visible. The skills that earned the promotion aren’t the skills the promotion demands.
Or consider a physician assistant who thrived in a solo practice model but now works in a team-based care environment. His clinical judgment is strong, but his instinct is to decide and act, not to loop in the team. He’s not withholding information on purpose. He’s operating from a communication model that worked somewhere else.
These aren’t bad hires. They’re alpine divorces — people whose prior skills actively misfire in a new context. And in healthcare, where a missed handoff or an unclear care plan can directly harm a patient, the cost of assuming communication will transfer naturally is too high.
The fix isn’t just hiring differently. It’s recognizing that communication in healthcare is a capability that needs to be assessed at hire and deliberately developed after. Which brings us to how we think about communication as a competency.
Communication as a Competency, Not Just a Trait
We often treat communication as a binary — someone is either “a good communicator” or they’re not. But communication in healthcare isn’t a fixed personality trait. It’s a competency: observable, assessable, and developable.
A competency model gives you a way to define what communication looks like at different levels of the organization, and to measure growth against those definitions. Consider three tiers:
Learning. An RN learning to deliver structured handoff reports. She’s building the mechanics — what information to include, how to organize it, how to flag what’s urgent. The communication is scripted, supported, and supervised.
Achieving. A nurse manager facilitating interdisciplinary rounds. She’s not just relaying information — she’s synthesizing input from dietary, pharmacy, physical therapy, and social work into a shared care plan. She reads the room, redirects when someone’s concern is getting lost, and ensures the quietest voice in the room has been heard. The communication is adaptive.
Leading. A director building communication systems across units. She’s designing the structures — standardized handoff protocols, escalation pathways, feedback loops — that make effective communication the default rather than the exception. The communication is architectural.
When organizations define communication this way, two things happen. First, hiring gets sharper. You can assess where a candidate sits on this continuum and match them to the role’s actual communication demands, not just a generic “good communicator” checkbox. Second, development gets targeted. Instead of sending everyone to the same communication workshop, you’re building specific capabilities at specific levels.
Every one-percent shift in nurse turnover translates to about $289,000 gained or lost annually for a typical hospital. Replacing a single staff RN costs an average of $60,090. And over 95 percent of all hospital separations are voluntary — people choosing to leave. That’s the turnover communication and culture can reach.
Communication competency isn’t soft. It’s expensive when it’s missing.
Building a Communication Culture That Breaks Silos
Hiring the right people is half the equation. The other half is building a culture where communication across professional boundaries is expected, supported, and rewarded.
In any work environment, people communicate most comfortably within their own group. Healthcare research on social networks and communication patterns has found that nurses are most likely to communicate with other nurses, while physicians and allied health professionals — dietitians, social workers, physical therapists — have the strongest ties across professional groups. These silos form naturally, but they jeopardize patient safety by fragmenting the situational awareness that care teams depend on.
Healthcare organizations with shared beliefs about what it means to be an effective team not only achieve greater patient outcomes but also report higher job satisfaction. Building that kind of culture requires setting clear standards for communication and behavior while also hiring for the qualities essential for living those cultural values.
This is where communication and culture reinforce each other. A strong culture makes communication safer. Better communication makes the culture stronger. The organizations that break through the numbers — that actually reduce sentinel events, cut preventable readmissions, and retain their best clinicians — are the ones that treat both as systems to be designed, not outcomes to be hoped for.
How Corvirtus Helps Healthcare Teams Communicate
In 2017, we closed this post with a comparison: racing teams and Special Ops Forces are extraordinarily selective because one person can bring down the team. That’s still true. But the lesson isn’t just about selection — it’s about choreography.
The best pit crews don’t rely on individual heroics. They design the system so that every handoff, every role, every signal works the same way every time. When something goes wrong, the team adjusts together. Nobody unclips the rope.
Healthcare teams deserve the same design. Assessments that measure communication competency at hire — not just whether someone interviews well, but whether their communication instincts match what the role and the team actually need. Development tools that build communication capability after hire, targeted to where each person is on the competency continuum. Culture surveys that reveal where silos persist and where the communication architecture needs repair.
The numbers haven’t moved in a decade. The path forward isn’t more awareness — it’s more design. And it starts with the people you hire, the capabilities you develop, and the culture you choose to build.
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Frequently Asked Questions
What are healthcare communication skills? Healthcare communication skills are the competencies that allow care team members to share clinical information accurately, coordinate during handoffs and transitions, and maintain shared situational awareness across professional disciplines. They include both interpersonal qualities — like emotional intelligence and locus of control — and structural practices like standardized handoff protocols. Unlike general communication, healthcare communication carries direct patient safety consequences: breakdowns are linked to one in ten patient safety incidents.
What is communication competency in healthcare? Communication competency is the ability to communicate effectively at the level a specific role demands. It is observable, assessable, and developable — not a fixed personality trait. A CNA delivering a structured handoff report is demonstrating communication competency at a foundational level. A nurse manager synthesizing input from multiple disciplines during rounds is demonstrating it at an adaptive level. A director designing communication systems across units is demonstrating it at an architectural level. Treating communication as a competency means it can be measured at hire and grown through targeted development.
What is an alpine divorce in the workplace? An alpine divorce occurs when someone’s prior skills or work habits actively misfire in a new role or environment. In healthcare, this often happens when a strong clinician is promoted or transferred into a position with different communication demands — for example, a bedside nurse promoted to charge nurse, where the job shifts from individual patient care to facilitating team huddles and coordinating across disciplines. The skills that earned the promotion aren’t the skills the promotion requires. Alpine divorces aren’t hiring mistakes — they’re mismatches between past context and present demands.
What is situational awareness in healthcare teams? Situational awareness is the team’s shared understanding of a patient’s current condition, risks, and care plan — not just any one clinician’s individual assessment. It depends on communication: information must flow across professional boundaries so that every team member is working from the same picture. When silos form — nurses communicating primarily with nurses, physicians primarily with physicians — situational awareness fragments, and patient safety risk increases.
What is locus of control in healthcare hiring? Locus of control is the degree to which someone believes they can influence events and outcomes. Healthcare professionals with a greater internal locus of control are more likely to initiate communication across professional boundaries — reaching out to colleagues in other disciplines rather than waiting for someone to ask. In team-based care environments, this quality predicts whether someone will actively contribute to the shared awareness that patient safety depends on. It can be measured through validated assessments during the hiring process.
About Corvirtus
Corvirtus is a talent management firm built on the science of industrial-organizational psychology. We bring five decades of serving service-driven organizations in how they hire, develop, and retain exceptional people. In healthcare, that means building care teams where communication isn’t left to chance, but potential is assessed at hire, developed through targeted tools, and reinforced by a culture designed for it. Corvirtus works with hospitals, senior care communities, dental service organizations, and health systems to measure the competencies that predict team performance, reduce preventable turnover, and improve the patient experience. Learn more about Corvirtus in healthcare.
