Multi-professional patterns and methods of communication during patient handoffs
Multi-professional patterns and methods of communication during patient handoffs
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DOI：
10.1016/j.ijmedinf.2009.12.005
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发表时间：
2010-04-01
影响因子：
4.9
通讯作者：
Effken, Judith A.
中科院分区：
文献类型：
--
作者：
Benham-Hutchins, Marge M.;Effken, Judith A.
目标：健康信息技术已被证明会影响医疗保健提供者的沟通模式。本研究的目的是更多地了解医疗保健提供者在急症护理环境中的各科室之间进行患者交接（转移）期间如何沟通和交换患者临床信息。方法：使用便利抽样来选择 5 名患者交接。调查问卷已分发给通过观察和滚雪球抽样确定的提供者。社交网络分析方法用于开发新兴通信模式的社会图，并根据与其他提供商的联系数量以及传入和传出的通信活动来确定各个提供商在切换过程中的角色。单个切换网络的规模从 11 到 20 个提供商不等。参与者被要求描述他们用于访问或与其他提供者共享临床信息的通信方法、他们首选的通信方法；他们对可用选项的满意度；以及他们对如何改进流程的建议。 结果：出现的网络模式揭示了同步和异步通信方法的重叠使用（通过电话或亲自口头；或通过纸质图表和/或电子记录书写）。没有特定的专业群体主导或协调信息流；相反，每个交接网络都表现出独特的通信模式和信息协调，由来自护理、医学或药学的两个或多个有影响力的提供者进行。大多数（84%）参与者更喜欢口头交流。对当前沟通流程的总体满意度因单位而异：82% 的急诊科提供者和 54% 在入院单位工作的提供者表示满意或非常满意。改进建议包括将所有单位转换为电子健康记录、电子切换通信模块和异步多专业通信日志。结论：这项探索性研究的结果为未来研究奠定了基础，研究如何使用网络结构和通信原理来设计健康信息技术，以补充来自多个专业的提供者的非线性信息收集和传播行为。 (C) 2009 Elsevier Ireland Ltd. 保留所有权利。
Objective: Health information technology has been shown to influence the communication patterns of healthcare providers. The goal of this study was to learn more about how healthcare providers communicate and exchange patient clinical information during patient handoffs (transfers) between units in an acute care setting.Methods: Convenience sampling was used to select five patient handoffs. Questionnaires were distributed to providers identified through observation and snowball sampling. Social network analysis methodology was used to develop sociograms of the emergent communication patterns and identify the role of individual providers in the handoff process based on the number of contacts with other providers and incoming and outgoing communication activity. Individual handoff network size ranged from 11 to 20 providers. Participants were asked to describe the method of communication they used to access or share clinical information with other providers, their preferred method of communication; their satisfaction with the available options; and their suggestions for how the process could be improved.Results: The network patterns that emerged uncovered the overlapping use of synchronous and asynchronous communication methods (verbally via phone or in person; or written via paper charts and/or an electronic records). No particular professional group dominated or coordinated information flow; instead each handoff network exhibited unique communication patterns and information coordination by two or more influential providers from nursing, medicine, or pharmacy. Most (84%) participants preferred verbal communication. Overall satisfaction with the current communication process varied by unit: 82% of emergency department providers and 54% of the providers working in the admitting units stated they were satisfied or very satisfied. Recommendations for improvement included converting all units to the electronic health record, electronic handoff communication modules and asynchronous multi-professional communication logs.Conclusions: The results of this exploratory study provide a foundation for future research examining how network structure and communication principles can be used to design health information technology that compliments the non-linear information gathering and dissemination behaviors of providers from multiple professions. (C) 2009 Elsevier Ireland Ltd. All rights reserved.