This chapter examines communication in high-risk healthcare settings, focusing on intensive care units (ICUs) and emergency departments (EDs) in Hong Kong. Drawing from interdisciplinary studies, it explores challenges and strategies for fostering effective communication in these environments. In ICUs, the chapter highlights the significance of a “speak-up culture” among clinicians, emphasizing the barriers imposed by hierarchical structures and cultural norms. It also addresses the communication needs of mechanically ventilated (MV) patients, advocating for tools and practices that facilitate both medical and emotional expression. For EDs, the chapter identifies issues arising from trilingual interactions, time constraints, and inconsistent documentation. It proposes frameworks to improve clinician-patient communication, enhance teamwork, and mitigate risks associated with miscommunication. The findings underscore the importance of cultural sensitivity, comprehensive training, and patient-centred approaches to advance safety and quality in high-stress medical settings.