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Nibbelink CW, Dunn Lopez K, Reeves JJ, Horman S, El-Kareh RE. Nurse and Physician Perceptions and Decision Making During Interdisciplinary Communication: Factors That Influence Communication Channel Selection. Comput Inform Nurs 2024; 42:267-276. [PMID: 38335993 DOI: 10.1097/cin.0000000000001108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2024]
Abstract
Errors in decision making and communication play a key role in poor patient outcomes. Safe patient care requires effective decision making during interdisciplinary communication through communication channels. Research on factors that influence nurse and physician decision making during interdisciplinary communication is limited. Understanding influences on nurse and physician decision making during communication channel selection is needed to support effective communication and improved patient outcomes. The purpose of the study was to explore nurse and physician perceptions of and decision-making processes for selecting interruptive or noninterruptive interdisciplinary communication channels in medical-surgical and intermediate acute care settings. Twenty-six participants (10 RNs, 10 resident physicians, and six attending physicians) participated in semistructured interviews in two acute care metropolitan hospitals for this qualitative descriptive study. The Practice Primed Decision Model guided interview question development and early data analysis. Findings include a core category, Development of Trust in the Communication Process, supported by three main themes: (1) Understanding of Patient Status Drives Communication Decision Making; (2) Previous Interdisciplinary Communication Experience Guides Channel Selection; and (3) Perceived Usefulness Influences Communication Channel Selection. Findings from this study provide support for future design and research of communication channels within the EHR and clinical decision support systems.
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Affiliation(s)
- Christine W Nibbelink
- Author Affiliations: Hahn School of Nursing and Health Science, University of San Diego (Dr Nibbelink), CA; College of Nursing, The University of Iowa (Dr Dunn Lopez), Iowa City; University of California, San Diego; Department of Surgery (Dr Reeves), Division of Hospital Medicine (Dr Horman), and Clinical Professor, School of Medicine (Dr El-Kareh), La Jolla
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Rushton CH, Manbauman C. Web of Mutuality: Relational Integrity in Critical Care Nursing. AACN Adv Crit Care 2023; 34:381-390. [PMID: 38033212 DOI: 10.4037/aacnacc2023613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2023]
Affiliation(s)
- Cynda Hylton Rushton
- Cynda Hylton Rushton is the Anne and George Bunting Professor of Clinical Ethics, Johns Hopkins University Berman Institute of Bioethics & School of Nursing, 1809 Ashland Avenue, Baltimore, MD 21205
| | - Craig Manbauman
- Craig Manbauman is Clinical Nurse, Emergency Department, New York Presbyterian Brooklyn Methodist Hospital, Brooklyn, New York
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Rudberg I, Olsson A, Thunborg C, Salzmann-Erikson M. Interprofessional communication in a psychiatric outpatient unit - an ethnographic study. BMC Nurs 2023; 22:286. [PMID: 37626326 PMCID: PMC10463438 DOI: 10.1186/s12912-023-01446-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Accepted: 08/10/2023] [Indexed: 08/27/2023] Open
Abstract
BACKGROUND Communication in healthcare has been extensively studied, but most research has focused on miscommunication and the importance of communication for patient safety. Previous research on interprofessional communication has mainly focused on relationships between physicians and nurses in non-psychiatric settings. Since communication is one of the core competencies in psychiatric care, more research on interprofessional communication between other clinicians is needed, and should be explored from a broader perspective. This study aimed to explore and describe interprofessional communication in a psychiatric outpatient unit. METHOD During spring 2022, data consisting of over 100 h of fieldwork were collected from observations, formal semi-structured interviews and informal conversations inspired by the focused ethnography method. Data was collected at an outpatient unit in central Sweden, and various clinicians participated in the study. The data analysis was a back-and-forth process between initial codes and emerging themes, but also cyclical as the data analysis process was ongoing and repeated and took place simultaneously with the data collection. RESULTS We found that a workplace's history, clinicians´ workload, responsibilities and hierarchies influence interprofessional communication. The results showed that the prerequisites for interprofessional communication were created through the unit's code of conduct, clear and engaging leadership, and trust in the ability of the various clinicians to perform new tasks. CONCLUSION Our results indicate that leadership, an involving working style, and an environment where speaking up is encouraged and valued can foster interprofessional communication and respect for each other´s professional roles is key to achieving this. Interprofessional communication between different clinicians is an important part of psychiatric outpatient work, where efficiency, insufficient staffing and long patient queues are commonplace. Research can help shed light on these parts by highlighting aspects influencing communication.
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Affiliation(s)
- Ingela Rudberg
- Department of Health and Caring Sciences, Faculty of Health and Occupational Studies, University of Gävle, Gävle, SE-801 76, Sweden.
| | - Annakarin Olsson
- Department of Health and Caring Sciences, Faculty of Health and Occupational Studies, University of Gävle, Gävle, SE-801 76, Sweden
| | - Charlotta Thunborg
- Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
- Department of Health and Welfare, Mälardalen University, Västerås, Sweden
| | - Martin Salzmann-Erikson
- Department of Health and Caring Sciences, Faculty of Health and Occupational Studies, University of Gävle, Gävle, SE-801 76, Sweden
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Sprogis SK, Currey J, Jones D, Considine J. Exploring interdisciplinary communication pathways for escalating pre-medical emergency team deterioration: a mixed-methods study. AUST HEALTH REV 2023; 47:494-501. [PMID: 37460097 DOI: 10.1071/ah22203] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Accepted: 06/22/2023] [Indexed: 08/04/2023]
Abstract
Objective To explore clinicians' use and perceptions of interdisciplinary communication pathways for escalating care within the pre-medical emergency team (pre-MET) tier of rapid response systems. Method A sequential mixed-methods study was conducted using observations and interviews. Participants were clinicians (nurses, allied health, doctors) caring for orthopaedic and general medicine patients at one hospital. Descriptive and thematic analyses were conducted. Results Escalation practices were observed for 13 of 27 pre-MET events. Leading communication methods for escalating pre-MET events were alphanumeric pagers (61.5%) and in-person discussions (30.8%). Seven escalated pre-MET events led to bedside pre-MET reviews by doctors. Clinician interviews (n = 29) culminated in two themes: challenges in escalation of care, and navigating information gaps. Clinicians reported deficiencies in communication methods for escalating care that hindered interdisciplinary communication and clinical decision-making pertaining to pre-MET deterioration. Conclusion Policy-defined escalation pathways were inconsistently utilised for pre-MET deterioration. Available communication methods for escalating pre-MET events inadequately fulfilled clinicians' needs. Variable perceptions of escalation pathways illuminated a lack of of a shared mental model about clinicians' roles and responsibilities. To optimise timely and appropriate management of patient deterioration, communication infrastructure and interdisciplinary collaboration must be enhanced.
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Affiliation(s)
- Stephanie K Sprogis
- School of Nursing and Midwifery & Centre for Quality and Patient Safety Research in the Institute for Health Transformation, Deakin University, 1 Gheringhap Street, Geelong, Vic. 3220, Australia
| | - Judy Currey
- School of Nursing and Midwifery & Centre for Quality and Patient Safety Research in the Institute for Health Transformation, Deakin University, 1 Gheringhap Street, Geelong, Vic. 3220, Australia
| | - Daryl Jones
- Department of Intensive Care, Austin Hospital, 145 Studley Road, Heidelberg, Vic. 3084, Australia; and School of Public Health and Preventive Medicine, Monash University, 533 St Kilda Road, Melbourne, Vic. 3004, Australia; and Department of Surgery, University of Melbourne, Parkville, Vic. 3010, Australia
| | - Julie Considine
- School of Nursing and Midwifery & Centre for Quality and Patient Safety Research in the Institute for Health Transformation, Deakin University, 1 Gheringhap Street, Geelong, Vic. 3220, Australia; and Centre for Quality and Patient Safety Research - Eastern Health Partnership, 2/5 Arnold Street, Box Hill, Vic. 3128, Australia
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Barlow M, Morse KJ, Watson B, Maccallum F. Identification of the barriers and enablers for receiving a speaking up message: a content analysis approach. Adv Simul (Lond) 2023; 8:17. [PMID: 37415244 DOI: 10.1186/s41077-023-00256-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2022] [Accepted: 06/08/2023] [Indexed: 07/08/2023] Open
Abstract
BACKGROUND Within healthcare, the barriers and enablers that influence clinicians' ability to speak up are well researched. However, despite the receiver of the message being identified as a key barrier to a speaker voicing a concern, there have been very few receiver-focused studies. As a result, little is known about the barriers and enablers that influence message reception. Understanding these can help inform speaking up training and ultimately enhance patient safety through more effective clinical communication. OBJECTIVES To identify enabling or inhibiting factors that influence the receiver's reception and response to a speaking up message, and if the identified barriers and enablers are related to speaker or receiver characteristics. DESIGN AND METHODS Twenty-two interdisciplinary simulations were video recorded and transcribed. Simulation participants formed the patient discharge team and were receivers of a speaking up message, delivered by a nurse at the patient's bedside. How the message was delivered (verbose or abrupt wording), was manipulated and counterbalanced across the simulations. Within the post simulation debriefs, barriers and enablers of being a receiver of a message were explored using content analysis. SETTING/PARTICIPANTS This study took place in a large Australian tertiary healthcare setting. Participants were qualified clinicians of varying disciplines and specialties. RESULTS A total of 261 barriers and 285 enablers were coded. Results showed that how the message was delivered (differing tone, phases, and manner) influenced what receivers identified as barriers and enablers. Additionally, the receiver's own cognitive processes, such as making positive attributions of the speaker and attempting to build rapport and collegiality, better enabled message reception and response. Receiver behaviour was negatively impacted by listening to fix, rather than understand, and not knowing in the moment how to manage their own reactions and appropriately frame a response. CONCLUSION The debriefings identified key barriers and enablers to receiving a speaking up message that differ from those previously identified for senders of the speaking up message. Current speaking up programs are predominately speaker centric. This study identified that both speaker and receiver behaviour influenced message reception. Therefore, training must place equal attention on both the speaker and receiver and be inclusive of experiential conversational rehearsal of both positive and challenging encounters.
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Affiliation(s)
- Melanie Barlow
- Faculty of Health Sciences, Australian Catholic University, 1100 Nudgee Road, Banyo, QLD, Australia.
- School of Psychology, University of Queensland, St. Lucia, QLD, Australia.
| | - Kate J Morse
- College of Nursing & Health Professions, Drexel University, 245 N 15Th Street, Mail Stop 501, 4Th Floor, Room 4606, Philadelphia, PA, 19102, USA
| | - Bernadette Watson
- School of Psychology, University of Queensland, St. Lucia, QLD, Australia
- Department of English and Communication, Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong
| | - Fiona Maccallum
- School of Psychology, University of Queensland, St. Lucia, QLD, Australia
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Ruppel H, Pohl E, Rodriguez-Paras C, Froh E, Perry K, McNamara M, Muthu N, Ferro D, Rasooly I, Bonafide CP. Clinician Perspectives on Specifications for Metrics to Inform Pediatric Alarm Management. Biomed Instrum Technol 2023; 57:18-25. [PMID: 37084247 PMCID: PMC10512991 DOI: 10.2345/0899-8205-57.1.18] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/22/2023]
Abstract
Background: Ongoing management of monitor alarms is important for reducing alarm fatigue among clinicians (e.g., nurses, physicians). Strategies to enhance clinician engagement in active alarm management in pediatric acute care have not been well explored. Access to alarm summary metrics may enhance clinician engagement. Objective: To lay the foundation for intervention development, we sought to identify functional specifications for formulating, packaging, and delivering alarm metrics to clinicians. Methods: Our team of clinician scientists and human factors engineers conducted focus groups with clinicians from medical-surgical inpatient units in a children's hospital. We inductively coded transcripts, developed codes into themes, and grouped themes into "current state" and "future state." Results: We conducted five focus groups with 13 clinicians (eight registered nurses and five doctors of medicine). In the current state, information exchanged among team members about alarm burden is initiated by nurses on an ad hoc basis. For a future state, clinicians identified ways in which alarm metrics could help them manage alarms and described specific information, such as alarm trends, benchmarks, and contextual data, that would support decision-making. Conclusion: We developed four recommendations for future strategies to enhance clinicians' active management of patient alarms: (1) formulate alarm metrics for clinicians by categorizing alarm rates by type and summarizing alarm trends over time, (2) package alarm metrics with contextual patient data to facilitate clinicians' sensemaking, (3) deliver alarm metrics in a forum that facilitates interprofessional discussion, and (4) provide clinician education to establish a shared mental model about alarm fatigue and evidence-based alarm-reduction strategies.
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Milton J, M Gillespie B, Åberg D, Erichsen Andersson A, Oxelmark L. Interprofessional teamwork before and after organizational change in a tertiary emergency department: An observational study. J Interprof Care 2023; 37:300-311. [PMID: 35703726 DOI: 10.1080/13561820.2022.2065250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
In healthcare settings, suboptimal interprofessional teamwork and communication contribute to unsafe care and avoidable harm. Interprofessional teamwork is essential in high-risk clinical areas such as the emergency department (ED). The aims of this study were to describe interprofessional teamwork in a hospital ED and to evaluate factors influencing interprofessional communication before and after implementation of a department-wide multifaceted intervention. Structured observations were undertaken during 2015/16 and 2019. Differences in interprofessional communication practices, teamwork, and sources of interruptions were compared before and after the intervention. The following domains were surveilled: (a) healthcare professionals (HCPs) communication initiatives, (b) HCPs' contribution to patient assessment, (c) interprofessional communication processes, and (d) team interruptions. The intervention included strategies to enable use of communication tools, changes to team structures, changes in work environment, ethical principles, and establishment of a code of professional conduct during interprofessional communication. Team interruptions significantly decreased post-intervention, and our findings suggest that organizational changes affect domains of teamwork. Statistically significant differences were observed in the initiated communication pre-intervention and contribution to patient assessment significantly increased post-intervention. Multifaceted organizational interventions can positively affect interprofessional team communication and work-flow in the ED, thus patient safety and quality of care can be improved.
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Affiliation(s)
- Jenny Milton
- Institute of Health and Care Sciences, the Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Brigid M Gillespie
- Gold Coast Health, Gold Coast University Hospital, Gold Coast, QLD, Australia.,School of Nursing and Midwifery & NHMRC Wiser Wounds Centre of Research Excellence, Griffith University, Brisbane, QLD, Australia
| | - David Åberg
- Department of Internal Medicine, University of Gothenburg, Gothenburg, Sweden.,Department of Acute Medicine and Geriatrics, Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Annette Erichsen Andersson
- Institute of Health and Care Sciences, the Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Department of Orthopedic Surgery, Region Västra Götaland, Sahlgrenska University Hospital Mölndal, Gothenburg, Sweden
| | - Lena Oxelmark
- Institute of Health and Care Sciences, the Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Department of Acute Medicine and Geriatrics, Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden
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Vauk S, Seelandt JC, Huber K, Grande B, Kolbe M. Exposure to incivility does not hinder speaking up: a randomised controlled high-fidelity simulation-based study. Br J Anaesth 2022; 129:776-787. [PMID: 36075775 DOI: 10.1016/j.bja.2022.07.050] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Revised: 06/27/2022] [Accepted: 07/26/2022] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Speaking up with concerns is critical for patient safety. We studied whether witnessing a civil (i.e. polite, respectful) response to speaking up would increase the occurrence of further speaking up by hospital staff members as compared with witnessing a pseudo-civil (i.e. vague and slightly dismissive) or rude response. METHODS In this RCT in a single, large academic teaching hospital, a single simulated basic life support scenario was designed to elicit standardised opportunities to speak up. Participants in teams of two or three were randomly assigned to one of three experimental conditions in which the degree of civility in reacting to speaking up was manipulated by an embedded simulated person. Speaking up behaviour was assessed by behaviour coding of the video recordings of the team interactions by applying 10 codes using The Observer XT 14.1. Data were analysed using multilevel modelling. RESULTS The sample included 125 interprofessional hospital staff members (82 [66%] women, 43 [34%] men). Participants were more likely to speak up when they felt psychologically safe (γ=0.47; standard error [se]=0.19; 95% confidence interval [CI], 0.09-0.85; P=0.017). Participants were more likely to speak up in the rude condition than in the other conditions (γ=0.28; se=0.12; 95% CI, 0.05-0.52; P=0.019). Across conditions, participants spoke up most frequently by structuring inquiry (n=289, 31.52%), proactive (n=240, 26.17%), and reactive (n=148, 16.14%) instruction statements, and gestures (n=139, 15.16%). CONCLUSION Our study challenges current assumptions about the interplay of civility and speaking up behaviour in healthcare.
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Affiliation(s)
- Stefanie Vauk
- Simulation Centre, University Hospital Zurich, Zurich, Switzerland
| | - Julia C Seelandt
- Simulation Centre, University Hospital Zurich, Zurich, Switzerland
| | - Katja Huber
- Simulation Centre, University Hospital Zurich, Zurich, Switzerland
| | - Bastian Grande
- Simulation Centre, University Hospital Zurich, Zurich, Switzerland; Institute of Anaesthesiology, University Hospital Zurich, Zurich, Switzerland
| | - Michaela Kolbe
- Simulation Centre, University Hospital Zurich, Zurich, Switzerland; ETH Zurich, Zurich, Switzerland.
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Manojlovich M, Krein SL. We don't talk about communication: why technology alone cannot save clinically deteriorating patients. BMJ Qual Saf 2022; 31:bmjqs-2022-014798. [PMID: 35868850 DOI: 10.1136/bmjqs-2022-014798] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/13/2022] [Indexed: 11/03/2022]
Affiliation(s)
| | - Sarah L Krein
- School of Medicine, Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan, USA
- Center for Clinical Management Research, VA Ann Arbor Healthcare System, Ann Arbor, Michigan, USA
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Milton J, Erichsen Andersson A, Åberg ND, Gillespie BM, Oxelmark L. Healthcare professionals' perceptions of interprofessional teamwork in the emergency department: a critical incident study. Scand J Trauma Resusc Emerg Med 2022; 30:46. [PMID: 35841051 PMCID: PMC9287907 DOI: 10.1186/s13049-022-01034-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Accepted: 06/30/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Interprofessional teams contribute to patient safety during clinical care. However, little is known about how interprofessional teams manage and cope with critical incidents in the emergency department (ED). Therefore, the study aimed to describe healthcare professionals (HCPs) perceptions of critical incidents linked to the enablers of and barriers to interprofessional teamwork in a high-risk setting, the ED. METHODS Individual interviews with HCPs regarding events at the ED were held during the period of May 2019-January 2020. The Critical Incident Technique approach was used to guide the interviews and the qualitative analysis. Data were analyzed inductively using qualitative content analysis. RESULTS Interview participants (n = 28) included 7 physicians (25%), 12 registered nurses (43%), 7 nurse assistants (25%) and 2 administrators (7%). Overall, 108 critical incidents were described. Eight categories that described functional and dysfunctional experiences within interprofessional teamwork were identified: salience of reflection; professional experience makes a difference; demanding physical and psychosocial work environment; balancing communication demands; lacking management support, structure, and planning; tensions between professional role and responsibility; different views on interprofessional teamwork; and confidence in interprofessional team members. CONCLUSION Findings of this study indicate that poor ED-specific communication and limited professional experience are essential factors in handling critical incidents related to interprofessional teamwork. An important aspect of critical incident management is the ergonomics of the physical work environment and how it enables interprofessional teamwork. This study emphasizes the factors enabling interprofessional teamwork to manage critical incidents in the complex working environment of the ED.
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Affiliation(s)
- Jenny Milton
- Institute of Health and Care Sciences, The Sahlgrenska Academy, University of Gothenburg, Arvid Wallgrens backe, hus 1, 41346, Gothenburg, Sweden. .,Gothenburg Emergency Medicine Research Group (GEMREG), Sahlgrenska University Hospital, Gothenburg, Sweden.
| | - Annette Erichsen Andersson
- Institute of Health and Care Sciences, The Sahlgrenska Academy, University of Gothenburg, Arvid Wallgrens backe, hus 1, 41346, Gothenburg, Sweden.,Department of Orthopedic Surgery, Region Västra Götaland, Sahlgrenska University Hospital/Mölndal, Gothenburg, Sweden
| | - N David Åberg
- Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, The Sahlgrenska Academy, University of Gothenburg, Vita stråket SU, 41345, Gothenburg, Sweden.,Department of Acute Medicine and Geriatrics, Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Brigid M Gillespie
- Gold Coast University Hospital, Gold Coast Health, Southport, Gold Coast, Australia.,School of Nursing and Midwifery & NHMRC Centre of Research Excellence in Wiser Wound Care, Griffith University, 170 Kessels Road, Brisbane, QLD, 4111, Australia
| | - Lena Oxelmark
- Institute of Health and Care Sciences, The Sahlgrenska Academy, University of Gothenburg, Arvid Wallgrens backe, hus 1, 41346, Gothenburg, Sweden.,Gothenburg Emergency Medicine Research Group (GEMREG), Sahlgrenska University Hospital, Gothenburg, Sweden.,Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, The Sahlgrenska Academy, University of Gothenburg, Vita stråket SU, 41345, Gothenburg, Sweden
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Lee JL, Kara A, Huffman M, Matthias MS, Radecki B, Savoy A, Schaffer JT, Weiner M. Qualitative Analysis of Team Communication with a Clinical Texting System at a Midwestern Academic Hospital. Appl Clin Inform 2022; 13:391-397. [PMID: 35294986 PMCID: PMC8926456 DOI: 10.1055/s-0042-1744389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
BACKGROUND Hospitals are increasingly replacing pagers with clinical texting systems that allow users to use smartphones to send messages while maintaining compliance for privacy and security. As more institutions adopt such systems, the need to understand the impact of such transitions on team communication becomes ever more significant. METHODS We conducted focus groups with hospitalists and individual interviews with nurses at one academic medical center in the Midwest. All interviews and focus groups were audiorecorded, transcribed, and deidentified for analysis. All transcripts and notes were independently read by two members of the research team and coded for themes. RESULTS Twenty-one hospitalists and eight nurses participated in the study. Although study participants spoke favorably of texting, they identified more dissatisfactions with texting than benefits. There were disagreements regarding appropriate texting practices both within and between the hospitalists and nurses. CONCLUSION Despite the benefits of texting, there is room for improving team communication and understanding in the realm of clinical texting. A lack of shared understanding regarding when and how to use texting may require long-term solutions that address teamwork and appropriateness.
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Affiliation(s)
- Joy L Lee
- Division of General Internal Medicine and Geriatrics, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana, United States.,Regenstrief Institute, Inc., Indianapolis, Indiana, United States
| | - Areeba Kara
- Indiana University Health Methodist Hospital, Indianapolis, Indiana, United States
| | - Monica Huffman
- Regenstrief Institute, Inc., Indianapolis, Indiana, United States
| | - Marianne S Matthias
- Division of General Internal Medicine and Geriatrics, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana, United States.,Regenstrief Institute, Inc., Indianapolis, Indiana, United States.,Center for Health Information and Communication, U.S. Department of Veterans Affairs, Veterans Health Administration, Health Services Research and Development Service CIN 13-416, Richard L. Roudebush VA Medical Center, Indianapolis, Indiana, United States
| | - Bethany Radecki
- Indiana University Health Methodist Hospital, Indianapolis, Indiana, United States
| | - April Savoy
- Regenstrief Institute, Inc., Indianapolis, Indiana, United States.,Center for Health Information and Communication, U.S. Department of Veterans Affairs, Veterans Health Administration, Health Services Research and Development Service CIN 13-416, Richard L. Roudebush VA Medical Center, Indianapolis, Indiana, United States.,Department of Computer Information and Graphic Technology, Purdue School of Engineering and Technology, Indianapolis, Indiana, United States
| | - Jason T Schaffer
- Indiana University Health Methodist Hospital, Indianapolis, Indiana, United States
| | - Michael Weiner
- Division of General Internal Medicine and Geriatrics, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana, United States.,Regenstrief Institute, Inc., Indianapolis, Indiana, United States.,Center for Health Information and Communication, U.S. Department of Veterans Affairs, Veterans Health Administration, Health Services Research and Development Service CIN 13-416, Richard L. Roudebush VA Medical Center, Indianapolis, Indiana, United States
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