Advertisement

Facilitating Interactions Between Healthcare Providers in the ICU

  • Andre Carlos Kajdacsy-Balla AmaralEmail author
Chapter
Part of the Respiratory Medicine book series (RM, volume 18)

Abstract

Healthcare organizations are dynamic and complex systems that require multiple subjects to achieve its goals. Therefore it is no surprise that communication is a fundamental process in these systems, and that failures in communication are associated with worse outcomes. However, the term communication without a formal definition is nothing more than an elusive concept. In this chapter we borrow from an established mathematical framework of communication and use it as the basis to identify sources of errors in communication, discuss the main moments of communication in the ICU, and contextualize how communication tools, such as interdisciplinary rounds, standardization, pre-printed orders (PPOs), algorithms and language style, can help improve communication and increase the efficiency of healthcare and patient safety.

Keywords

Communication Mathematical theory Patient safety Efficiency Interdisciplinary rounds Protocols Language 

References

  1. 1.
    Eco U. A theory of semiotics. Bloomington: Indiana University Press; 1978.Google Scholar
  2. 2.
    Shannon CE. A mathematical theory of communication. Bell Syst Tech J. 1948;27:379–423.CrossRefGoogle Scholar
  3. 3.
    Kluver J, Kluver C. On communication: an interdisciplinary and mathematical approach. Dordrecht: Springer; 2007.Google Scholar
  4. 4.
    Buckley W. Social stratification and the functional theory of social differentiation. Am Sociol Rev. 1958;23:369–75.CrossRefGoogle Scholar
  5. 5.
    Miller GA. The magical number seven plus or minus two: some limits on our capacity for processing information. Psychol Rev. 1956;63:81–97.PubMedCrossRefGoogle Scholar
  6. 6.
    Paris CR, Salas E, Cannon-Bowers JA. Teamwork in multi-person systems: a review and analysis. Ergonomics. 2000;43:1052–75.PubMedCrossRefGoogle Scholar
  7. 7.
    Pronovost P, Berenholtz S, Dorman T, Lipsett PA, Simmonds T, Haraden C. Improving communication in the ICU using daily goals. J Crit Care. 2003;18:71–5.PubMedCrossRefGoogle Scholar
  8. 8.
    Kim MM, Barnato AE, Angus DC, Fleisher LF, Kahn JM. The effect of multidisciplinary care teams on intensive care unit mortality. Arch Intern Med. 2010;170:369–76.PubMedCrossRefGoogle Scholar
  9. 9.
    Cohen MD, Hilligoss B, Kajdacsy-Balla Amaral AC. A handoff is not a telegram: an understanding of the patient is co-constructed. Crit Care. 2012;16:303.PubMedCentralPubMedCrossRefGoogle Scholar
  10. 10.
    Cohen MD, Hilligoss PB. The published literature on handoffs in hospitals: deficiencies identified in an extensive review. Qual Saf Health Care. 2010;19:493–7.PubMedGoogle Scholar
  11. 11.
    Arora V, Johnson J, Lovinger D, Humphrey HJ, Meltzer DO. Communication failures in patient sign-out and suggestions for improvement: a critical incident analysis. Qual Saf Health Care. 2005;14:401–7.PubMedCentralPubMedCrossRefGoogle Scholar
  12. 12.
    Petersen LA, Brennan TA, O’Neil AC, Cook EF, Lee TH. Does housestaff discontinuity of care increase the risk for preventable adverse events? Ann Intern Med. 1994;121:866–72.PubMedCrossRefGoogle Scholar
  13. 13.
    Fins JJ. Professional responsibility: a perspective on the Bell Commission reforms. Bull N Y Acad Med. 1991;67:359–64.PubMedCentralPubMedGoogle Scholar
  14. 14.
    Laine C, Goldman L, Soukup JR, Hayes JG. The impact of a regulation restricting medical house staff working hours on the quality of patient care. JAMA. 1993;269:374–8.PubMedCrossRefGoogle Scholar
  15. 15.
    Gawande AA, Zinner MJ, Studdert DM, Brennan TA. Analysis of errors reported by surgeons at three teaching hospitals. Surgery. 2003;133:614–21.PubMedCrossRefGoogle Scholar
  16. 16.
    Gandhi TK, Kachalia A, Thomas EJ, et al. Missed and delayed diagnoses in the ambulatory setting: a study of closed malpractice claims. Ann Intern Med. 2006;145:488–96.PubMedCrossRefGoogle Scholar
  17. 17.
    Kachalia A, Gandhi TK, Puopolo AL, et al. Missed and delayed diagnoses in the emergency department: a study of closed malpractice claims from 4 liability insurers. Ann Emerg Med. 2007;49:196–205.PubMedCrossRefGoogle Scholar
  18. 18.
    Philibert I. Use of strategies from high-reliability organisations to the patient hand-off by resident physicians: practical implications. Qual Saf Health Care. 2009;18:261–6.PubMedCrossRefGoogle Scholar
  19. 19.
    Borowitz SM, Waggoner-Fountain LA, Bass EJ, Sledd RM. Adequacy of information transferred at resident sign-out (inhospital handover of care): a prospective survey. Qual Saf Health Care. 2008;17:6–10.PubMedCrossRefGoogle Scholar
  20. 20.
    Catchpole K, Sellers R, Goldman A, McCulloch P, Hignett S. Patient handovers within the hospital: translating knowledge from motor racing to healthcare. Qual Saf Health Care. 2010;19:318–22.PubMedCrossRefGoogle Scholar
  21. 21.
    Lamond D. The information content of the nurse change of shift report: a comparative study. J Adv Nurs. 2000;31:794–804.PubMedCrossRefGoogle Scholar
  22. 22.
    Fassett MJ, Hannan TJ, Robertson IK, Bollipo SJ, Fassett RG. A national survey of medical morning handover report in Australian hospitals. Med J Aust. 2007;187:164–5.PubMedGoogle Scholar
  23. 23.
    Solet DJ, Norvell JM, Rutan GH, Frankel RM. Lost in translation: challenges and opportunities in physician-to-physician communication during patient handoffs. Acad Med. 2005;80:1094–9.PubMedCrossRefGoogle Scholar
  24. 24.
    Chaboyer W, McMurray A, Wallis M. Bedside nursing handover: a case study. Int J Nurs Pract. 2010;16:27–34.PubMedCrossRefGoogle Scholar
  25. 25.
    Odell A. Communication theory and the shift handover report. Br J Nurs. 1996;5:1323–6.PubMedGoogle Scholar
  26. 26.
    Miller A, Scheinkestel C, Limpus A, Joseph M, Karnik A, Venkatesh B. Uni- and interdisciplinary effects on round and handover content in intensive care units. Hum Factors. 2009;51:339–53.PubMedCrossRefGoogle Scholar
  27. 27.
    Bhabra G, Mackeith S, Monteiro P, Pothier DD. An experimental comparison of handover methods. Ann R Coll Surg Engl. 2007;89:298–300.PubMedCentralPubMedCrossRefGoogle Scholar
  28. 28.
    Accreditation C. Required organizational practices. Ottawa: Accreditation Canada; 2009.Google Scholar
  29. 29.
    Haig KM, Sutton S, Whittington J. SBAR: a shared mental model for improving communication between clinicians. Jt Comm J Qual Patient Saf. 2006;32:167–75.PubMedGoogle Scholar
  30. 30.
    Riesenberg LA, Leitzsch J, Little BW. Systematic review of handoff mnemonics literature. Am J Med Qual. 2009;24:196–204.PubMedCrossRefGoogle Scholar
  31. 31.
    Ilan R, LeBaron CD, Christianson MK, Heyland DK, Day A, Cohen MD. Handover patterns: an observational study of critical care physicians. BMC Health Serv Res. 2012;12:11.PubMedCentralPubMedCrossRefGoogle Scholar
  32. 32.
    Van Eaton EG, Horvath KD, Lober WB, Rossini AJ, Pellegrini CA. A randomized, controlled trial evaluating the impact of a computerized rounding and sign-out system on continuity of care and resident work hours. J Am Coll Surg. 2005;200:538–45.PubMedCrossRefGoogle Scholar
  33. 33.
    Anderson J, Shroff D, Curtis A, et al. The Veterans Affairs shift change physician-to-physician handoff project. Jt Comm J Qual Patient Saf. 2010;36:62–71.PubMedGoogle Scholar
  34. 34.
    Petersen LA, Orav EJ, Teich JM, O’Neil AC, Brennan TA. Using a computerized sign-out program to improve continuity of inpatient care and prevent adverse events. Jt Comm J Qual Improv. 1998;24:77–87.PubMedGoogle Scholar
  35. 35.
    Ash JS, Sittig DF, Campbell EM, Guappone KP, Dykstra RH. Some unintended consequences of clinical decision support systems. AMIA Annu Symp Proc. 2007:26–30.Google Scholar
  36. 36.
    Cheney C, Ramsdell JW. Effect of medical records’ checklists on implementation of periodic health measures. Am J Med. 1987;83:129–36.PubMedCrossRefGoogle Scholar
  37. 37.
    Institute for Safe Medication Practices. ISMPs guidelines for standard order sets; 2011.Google Scholar
  38. 38.
    Hicks RW, Nelson J, Santell JP. Medication errors associated with preprinted orders. USP Drug Saf Rev Syst. 2004;148:pHSE28.Google Scholar
  39. 39.
    Brown P. Politeness: some universals in language usage. Cambridge: Cambridge University Press; 1987.Google Scholar
  40. 40.
    Westli HK, Johnsen BH, Eid J, Rasten I, Brattebo G. Teamwork skills, shared mental models, and performance in simulated trauma teams: an independent group design. Scand J Trauma Resusc Emerg Med. 2010;18:47.PubMedCentralPubMedCrossRefGoogle Scholar
  41. 41.
    Barshi I. The effects of mental representation on performance in a navigation task. ProQuest Dissertations and Theses, University of Colorado at Boulder, 1998, p. 93.Google Scholar
  42. 42.
    Snook SA. Friendly fire: the accidental shootdown of U.S. Black Hawks over Northern Iraq. New Jersey: Princeton University Press; 2000.Google Scholar

Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  1. 1.Department of Critical Care MedicineSunnybrook Health Sciences CentreTorontoCanada
  2. 2.Interdepartmental Division of Critical Care MedicineUniversity of TorontoTorontoCanada

Personalised recommendations