Study co-author James Bagian is a Veterans Administration doctor.

JAMES BAGIAN: "Better communications by briefings and debriefings that are guided by checklists enhance teamwork."

DOCTOR: "Were there any difficulties or anything for anesthesia?"

ANESTHESIOLOGIST: "No."

The study is in this week's Journal of the American Medical Association.

At first, some team members questioned the value of the communication training. But another new study shows how a lack of communication can lead to mistakes like operating on the wrong site or the wrong patient.

Since two thousand four, hospitals and surgical offices in the United States have had a "universal protocol." For example, they are supposed to mark the surgical site and perform a "time-out" immediately before the procedure.

The study looked at records of a company that provides liability insurance to six thousand doctors in Colorado.

The doctors reported twenty-five cases involving the wrong patient between January of two thousand two and June of two thousand eight. Five patients suffered serious harm.

Surgeons and other doctors also reported one hundred seven cases involving the wrong site. More than one-third led to serious harm. One patient died.

The researchers blamed most of the wrong-site cases on errors in judgment or a lack of a time-out. But they say errors in communication were at least one cause of all the patient mix-ups involving the wrong patient.