Fitzpatrick Leslie-Anne D, Melnikas Andrea J, Weathers Michael, Kachnowski Stan W
Healthcare Innovation & Technology Lab.
J Healthc Inf Manag. 2008 Summer;22(3):34-41.
Organizational complexity and interruptive workflows present challenges to communication in clinical workspaces, compromising healthcare quality and cost, and potentially leading to negative patient outcomes. To understand how information communication technology (ICT) could be improved, we reviewed the literature on inter-clinician communication problems, impacts on clinical workflows, ICT usage and barriers to communication. Our search yielded more than 300 articles; 98 met our inclusion criteria. In general, we found that clinical communication tends to flow along synchronous channels and is highly interruptive. Both electronic and non-electronic solutions to communication problems have met with mixed results. Implementation failures have been linked to barriers to technology adoption, including such factors as age, gender and computer experience. More research is needed to understand how improved communication reduces adverse clinical events and healthcare costs. Cost-effective ICTs to improve communication efficiency and workflow patterns in healthcare settings have great potential to enhance quality of care and reduce medical costs.
组织复杂性和中断性工作流程给临床工作空间中的沟通带来了挑战,损害了医疗质量和成本,并可能导致负面的患者结果。为了了解如何改进信息通信技术(ICT),我们回顾了关于临床医生之间沟通问题、对临床工作流程的影响、ICT使用情况以及沟通障碍的文献。我们的检索产生了300多篇文章;98篇符合我们的纳入标准。总体而言,我们发现临床沟通倾向于通过同步渠道进行,且具有高度中断性。针对沟通问题的电子和非电子解决方案都取得了喜忧参半的结果。实施失败与技术采用障碍有关,包括年龄、性别和计算机经验等因素。需要更多的研究来了解改善沟通如何减少不良临床事件和医疗成本。具有成本效益的ICT在提高医疗环境中的沟通效率和工作流程模式方面具有巨大潜力,可提高护理质量并降低医疗成本。