Pirnejad H, Niazkhani Z, Berg M, Bal R
Healthcare Governance, Institute of Health Policy and Management, Erasmus MC, Rotterdam, The Netherlands.
Methods Inf Med. 2008;47(4):336-45.
Intra-organizational communication is mostly interpersonal. Synchronous interruptive communication is recognized as a primary source of inefficiency and error in healthcare, and there is much potential for information and communication technology (ICT) to improve such communication. As recently suggested, however, due to communication failures ICT can also compound medical errors. In this paper we analyze factors that restrict the role of ICT in improving interpersonal healthcare communication and suggest solutions.
We critically analyzed the literature from a selection of diverse scientific disciplines. These were related to interpersonal communication, to the role and place of standardization and computerization in its improvement, and to reducing medical errors.
Four possible scenarios were defined on how ICT can serve healthcare communication. Two differing conceptual frameworks about communication in healthcare were discussed. Considering "information space" as a part of "communication space" allows the recognition and control of the source of the semantic gaps in conventional standardization and an enhancement of the role of ICT in improving intra-organizational communication. Moreover, cognitive, social, and organizational dimensions of complexity in interpersonal communication can be managed. Three approaches to control the variability in those dimensions and to promote the role of ICT in intra-organizational communication were discussed.
A multi-dimensional approach is required to promote the role of ICT in intra-organizational communication in healthcare. Parallel to conventional standardization, at least three dimensions need to be addressed: controlling the effect of the social context, developing standard information processing skills, and most importantly, controlling variations in care practices' performance.
组织内部沟通大多是人际沟通。同步干扰性沟通被认为是医疗保健中低效率和错误的主要来源，信息和通信技术（ICT）在改善此类沟通方面有很大潜力。然而，正如最近所指出的，由于沟通故障，ICT也可能加剧医疗错误。在本文中，我们分析了限制ICT在改善人际医疗保健沟通中作用的因素，并提出了解决方案。
我们对来自不同科学学科的文献进行了批判性分析。这些文献与人际沟通、标准化和计算机化在改善人际沟通中的作用和地位以及减少医疗错误有关。
定义了ICT如何服务于医疗保健沟通的四种可能情况。讨论了关于医疗保健沟通的两种不同概念框架。将“信息空间”视为“沟通空间”的一部分，有助于识别和控制传统标准化中语义差距的来源，并增强ICT在改善组织内部沟通中的作用。此外，可以管理人际沟通中复杂性的认知、社会和组织维度。讨论了控制这些维度中的变异性并促进ICT在组织内部沟通中作用的三种方法。
需要一种多维方法来促进ICT在医疗保健组织内部沟通中的作用。与传统标准化并行，至少需要解决三个维度的问题：控制社会背景的影响、培养标准信息处理技能，以及最重要 的是，控制护理实践表现中的变异性。
