Ilinca Popovici1, Plinio P Morita2, Diane Doran3, Stephen Lapinsky4, Dante Morra5, Ashleigh Shier1, Robert Wu6, Joseph A Cafazzo7. 1. Institute of Biomaterials and Biomedical Engineering, Faculty of Medicine, University of Toronto, Toronto, ON, Canada Centre for Global eHealth Innovation, University Health Network, Toronto, ON, Canada M5G 2C4. 2. Centre for Global eHealth Innovation, University Health Network, Toronto, ON, Canada M5G 2C4. 3. Nursing Health Services Research Unit, University of Toronto, Bloomberg Faculty of Nursing, Toronto, ON, Canada M5T 1P8. 4. Division of Respirology, UHN-MSH, Toronto, ON, Canada M5G 1X5. 5. Trillium Health Partners, Mississauga, ON, Canada L5B 1B8. 6. Division of General Internal Medicine, University Health Network, Toronto, ON, Canada M5G 2C4. 7. Centre for Global eHealth Innovation, University Health Network, Toronto, ON, Canada M5G 2C4 Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada.
Abstract
OBJECTIVE: To gain insights into how technological communication tools impact effective communication among clinicians, which is critical for patient safety. DESIGN: This multi-site observational study analyzes inter-clinician communication and interaction with information technology, with a focus on the critical process of patient transfer from the Emergency Department to General Internal Medicine. SETTING: Mount Sinai Hospital, Sunnybrook Health Sciences Centre and Toronto General Hospital. PARTICIPANTS: At least five ED and general internal medicine nurses and physicians directly involved in patient transfers were observed on separate occasions at each institution. INTERVENTIONS: N/A. MAIN OUTCOME MEASURES: N/A. RESULTS: The study provides insight into clinician workflow, evaluates current hospital communication systems and identifies key issues affecting communication: interruptions, issues with numeric pagers, lack of integrated communication tools, lack of awareness of consultation status, inefficiencies related to the paper chart, unintuitive user interfaces, mixed use of electronic and paper systems and lack of up-to-date contact information. It also identifies design trade-offs to be negotiated: synchronous communication vs. reducing interruptions, notification of patient status vs. reducing interruptions and speed vs. quality of handovers. CONCLUSIONS: The issues listed should be considered in the design of new technology for hospital communications.
OBJECTIVE: To gain insights into how technological communication tools impact effective communication among clinicians, which is critical for patient safety. DESIGN: This multi-site observational study analyzes inter-clinician communication and interaction with information technology, with a focus on the critical process of patient transfer from the Emergency Department to General Internal Medicine. SETTING: Mount Sinai Hospital, Sunnybrook Health Sciences Centre and Toronto General Hospital. PARTICIPANTS: At least five ED and general internal medicine nurses and physicians directly involved in patient transfers were observed on separate occasions at each institution. INTERVENTIONS: N/A. MAIN OUTCOME MEASURES: N/A. RESULTS: The study provides insight into clinician workflow, evaluates current hospital communication systems and identifies key issues affecting communication: interruptions, issues with numeric pagers, lack of integrated communication tools, lack of awareness of consultation status, inefficiencies related to the paper chart, unintuitive user interfaces, mixed use of electronic and paper systems and lack of up-to-date contact information. It also identifies design trade-offs to be negotiated: synchronous communication vs. reducing interruptions, notification of patient status vs. reducing interruptions and speed vs. quality of handovers. CONCLUSIONS: The issues listed should be considered in the design of new technology for hospital communications.
Authors: Milisa Manojlovich; Jessica M Ameling; Jane Forman; Samantha Judkins; Martha Quinn; Jennifer Meddings Journal: Am J Crit Care Date: 2019-07 Impact factor: 2.228
Authors: Lisa M McElroy; Elizabeth Z Gillett; Cristina Nguyen; Jane L Holl; Michael M Abecassis; Daniela P Ladner Journal: Clin Liver Dis (Hoboken) Date: 2016-02-26
Authors: Allison M Kurahashi; Peter B Weinstein; Trevor Jamieson; Jennifer N Stinson; Joseph A Cafazzo; Bhadra Lokuge; Plinio P Morita; Eyal Cohen; Adam Rapoport; Andrea Bezjak; Amna Husain Journal: JMIR Hum Factors Date: 2016-03-24