SACCIA Safe Communication

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SACCIA Safe Communication is a scientifically grounded competence framework designed to reduce communication-related risks in high-stakes environments. Developed by Swiss communication scientist Annegret Hannawa, the SACCIA model identifies five key interpersonal communication competencies that ensure a shared understanding under conditions of pressure. It is applied across various high-risk sectors, including healthcare, aviation, energy, emergency response and crisis management.^[1][2]

Communication failures have been identified as a significant contributing factor to preventable harm in high-risk sectors. In healthcare, studies estimate that over 43 million patients are affected annually by avoidable medical errors, with poor communication implicated in up to 80% of serious adverse events.^[3][4] In aviation, communication issues have likewise been identified as contributing factors in a substantial proportion of accidents and incidents. Despite the use of technical systems and standardised protocols, problems such as unclear messaging, misinterpretation, and breakdowns in hierarchical communication continue to pose risks to operational safety.^[5]

The SACCIA model emerged from Hannawa’s systematic investigation into how interpersonal communication processes have contributed to adverse patient outcomes, addressing a gap in the literature where structured analyses of communication-related factors were lacking.^[6] Her subsequent research revealed that many reported errors were due to care participants' failures to attain a shared understanding. These insights informed the development of the SACCIA model, which conceptualises safe communication as a set of empirically grounded interpersonal competencies aimed at preventing communication-based sources of harm.^[1][7]

SACCIA is an acronym denoting five communication competencies, each targeting a common factor associated with unsafe communication in high-risk settings. The model is evidence-based, cross-sectoral, and applicable to various professions and industries:^[8][1]

• Sufficiency – Ensures the complete extraction, transmission and confirmation of all relevant accessible information in order to mitigate safety risks resulting from information gaps.
• Accuracy – Involves interpersonal verification; verifying that information is correct and interpreted as intended. This includes the confirmation of facts, figures, and meanings through interpersonal exchange.
• Clarity – Entails the use of explicit, unambiguous language that minimizes the potential for confusion or misinterpretation; includes interpersonal efforts to reduce communicative uncertainty.
• Contextualization – Involves the process of identifying and addressing situational factors that may impede mutual understanding. Such factors can include functional barriers (e.g., incompatible goals), relational barriers (e.g., hierarchical status differences, prior conflicts or relationship history), chronological barriers (e.g., timing, timeliness, or duration of the interaction), environmental barriers (e.g., physical settings with noise, distractions, or lack of privacy) and cultural barriers (e.g., differing social norms and expectations among participants).
• Interpersonal Adaptation – Requires in situ communicative adaptations to each other's emotional, cognitive or linguistic needs to make sure a shared understanding can be attained.

Applications of the SACCIA model span multiple high-risk sectors. Its most extensive use has been in healthcare, where it has informed professional education, patient safety strategies, error disclosure protocols, and interprofessional communication practices. Structured integration of the competencies has been associated with a reduction in preventable harm.^[9][10] Empirical evidence for these applications includes its use in Swiss hospital communication during the COVID-19 pandemic,^[11] in emergency medicine and in mountain rescue operations.^[9][12] The model has also been applied in other crisis management contexts (e.g., climate coordination), aviation and the energy sector.^[2]

The SACCIA model has been incorporated into national and international safety structures. It has been referenced by the World Health Organization^[3] and applied by health ministries in Switzerland, Germany, and Iceland.^[13] Training programs by organisations such as the German Coalition for Patient Safety (Aktionsbündnis Patientensicherheit) make use of the model.^[14] SACCIA has also been presented at international forums, including the Ministerial Patient Safety Summit,^[15] and has informed research supported by the Swiss National Science Foundation and Germany’s Innovationsfonds.^[16] In addition, it serves as the competence framework of the European Institute for Safe Communication.^[8][17]

• Hannawa, Annegret F.; Wu, Albert; Juhasz, Robert (2017). New Horizons in Patient Safety: Case Studies for Physicians. Berlin/Boston: De Gruyter. ISBN 978-3-11-045300-3.
• Hannawa, Annegret F.; Jönitz, Günther (2017). Neue Wege für die Patientensicherheit: Sichere Kommunikation: Evidenzbasierte Kernkompetenzen mit Fallbeispielen aus der medizinischen Praxis. Berlin/Boston: De Gruyter. ISBN 978-3-11-053557-0.
• Hannawa, Annegret F. (2018). SACCIA — Sichere Kommunikation: Fünf Kernkompetenzen Mit Fallbeispielen Aus der Pflegerischen Praxis (in German) (1st ed.). Berlin/Boston: De Gruyter. ISBN 978-3-11-056073-2.
• Hannawa, Annegret F (2018-06-01). "SACCIA Safe Communication: Five core competencies for safe and high-quality care". Journal of Patient Safety and Risk Management. 23 (3): 99–107. doi:10.1177/2516043518774445. ISSN 2516-0435.
• Hannawa, Annegret F.; Wendt, Anne L.; Day, Lisa J. (2018). New horizons in patient safety: evidence-based core competencies with case studies from nursing practice: Safe communication. Berlin/Boston: De Gruyter. ISBN 978-3-11-045485-7.

• Patient safety
• Medical error
• Aviation safety
• Crisis communication
• Human error