It's not about pager replacement: An in‐depth look at the interprofessional nature of communication in healthcare
| Autor: | Sherman Quan, Brian M. Wong, Rodrigo B. Cavalcanti, Francis Lau, Teri Arany, Silvi Groe, Robert Wu, William Coke, Dante Morra, Peter G. Rossos |
|---|---|
| Rok vydání: | 2013 |
| Předmět: |
business.product_category
Sociotechnical system Leadership and Management Health information technology Interprofessional Relations Assessment and Diagnosis Health care Humans Medicine Operations management Care Planning Medical education Social work business.industry Unintended consequences Health Policy General Medicine Hospital medicine Workflow Interdisciplinary Communication Fundamentals and skills Hospital Communication Systems Patient Care business Pager Delivery of Health Care Cell Phone |
| Zdroj: | Journal of Hospital Medicine. 8:137-143 |
| ISSN: | 1553-5606 1553-5592 |
| Popis: | BACKGROUND Institutions have tried to replace the use of numeric pagers for clinical communication by implementing health information technology (HIT) solutions. However, failing to account for the sociotechnical aspects of HIT or the interplay of technology with existing clinical workflow, culture, and social interactions may create other unintended consequences. OBJECTIVE To evaluate a Web-based messaging system that allows asynchronous communication between health providers and identify the unintended consequences associated with implementing such technology. DESIGN Intervention—a Web-based messaging system at the University Health Network to replace numeric paging practices in May 2010. The system facilitated clinical communication on the medical wards for coordinating patient care. Study design—pre-post mixed methods utilizing both quantitative and qualitative measures. PARTICIPANTS Five residents, 8 nurses, 2 pharmacists, and 2 social workers were interviewed. Pre-post interruption—15 residents from 5 clinical teams in both periods. MEASUREMENTS The study compared the type of messages sent to physicians before and after implementation of the Web-based messaging system; a constant comparative analysis of semistructured interviews was used to generate key themes related to unintended consequences. RESULTS Interruptions increased 233%, from 3 pages received per resident per day pre-implementation to 10 messages received per resident per day post-implementation. Key themes relating to unintended consequences that emerged from the interviews included increase in interruptions, accountability, and tactics to improve personal productivity. CONCLUSIONS Meaningful improvements in clinical communication can occur but require more than just replacing pagers. Introducing HIT without addressing the sociotechnical aspects of HIT that underlie clinical communication can lead to unintended consequences. Journal of Hospital Medicine 2013;8:137–143. © 2013 Society of Hospital Medicine |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Plný text