There is evidence from a variety of sources that communications between members of healthcare teams emerge as a key factor in poor care and are especially apparent where medical errors occur. Lingard et al¹ take this as their starting point for an observational study of communication failures in operating theatres published in this issue of QSHC. They found that 31% of all communications could be categorised as a failure in some way—whether the information was missing or the timing was poor, or where issues were not resolved or key people absent. Moreover, more than a third of these failures had negative effects on what was happening. If we multiply all that by the million patients treated daily in the UK alone, we are into an overwhelming amount of miscommunication. Lingard et al¹ suggest training interventions to remedy this but, to make such training appropriate, the causes of …