What is "SACCIA"?

SACCIA is an acronym. It stands for five core competencies that constitute safe communication in healthcare.

What terms do the letters "SACCIA" abbreviate?

The letters in the term "SACCIA" stand for Sufficiency, Accuracy, Clarity, Contextualization, and Interpersonal Adaptation.

What do these terms represent?

These five terms represent interpersonal communication processes that are considered safe because they lead to a shared understanding between all care participants as an essential foundation for successful healthcare provision.

Where did they come from?

The terms emerged from a communication science analysis of hundreds of critical incident reports and narratives. They constitute five core competencies for safe communication as the pathway to care that is safe, efficient, timely, effective and patient-centered.

What do the five core competencies of "safe communication" look like?


The first letter of the "SACCIA" acronym refers to the quantity of exchanged informational contents:

Core competency 1: Sufficiency assesses the extent to which participants convey, extract, and exchange a sufficient amount of information in order to arrive at a shared understanding.

The remaining letters in the "SACCIA" acronym address the quality of communicated contents:

Core competency 2: Accuracy refers to the extent to which participants convey correct information, interpret information correctly, and utilize their communication with each other as a collaborative process to validate the accuracy of the communicated contents.

Core competency 3: Clarity assesses the extent to which verbal and nonverbal messages are expressed and interpreted clearly (i.e., unambiguously, not misleading or unorderly), and the extent to which participants utilize their interpersonal communication with each other to reduce perceived uncertainties.

Core competency 4: Contextualization refers to the extent to which interpersonal communication is framed within the contextual circumstances that constitute barriers to a shared understanding in a given encounter. Communication is contextualized if it is sent, decoded, and dyadically exchanged in ways that directly address and neutralize these given contextual barriers. There are five different kinds of context: Functional (e.g. shared alignment of pursued communication objectives), relational (e.g. hierarchical status differences, relational history or conflict), chronological (e.g. timing, timeliness, point in time and duration for a given encounter), environmental (i.e. the physical setting of the conversation), and cultural (e.g. potentially differing rules and norms of the participants).

Core competency 5: Interpersonal Adaptation assesses the extent to which participants recognize and adapt to implicitly (nonverbal) and explicitly (verbal) expressed needs and expectations of their conversational partner for the purpose of arriving at a shared understanding.

How can I learn the SACCIA core competencies for safe communication?

Hot off the press: With Albert Wu (left) and Victor Dzau (middle) at the Ministerial Patient Safety Summit 2017 in Bonn, Germany.

Hot off the press: With Albert Wu (left) and Victor Dzau (middle) at the Ministerial Patient Safety Summit 2017 in Bonn, Germany.

I discuss the scientific evidence base and practical translations of the five SACCIA safe communication skills in my book series "New horizons for patient safety" (published by De Gruyter). Each of my books showcases dozens of patient safety cases in which I identify the various care participants' SACCIA errors and illustrate how SACCIA-safe communication practices could have prevented the incidents of harm or close calls. The books primarily target safety officers and practitioners, educators and students of medicine and nursing, but they can also be helpful resources for patients and care companions.

Beyond consulting the book series, you can also read, watch or listen to my recent media coverage or presentations here.