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信息传递不畅:重症监护病房交接班沟通中的信息中断

Falling through the cracks: information breakdowns in critical care handoff communication.

作者信息

Abraham Joanna, Nguyen Vickie, Almoosa Khalid F, Patel Bela, Patel Vimla L

机构信息

Center for Cognitive Informatics and Decision Making, School of Biomedical Informatics, UTHealth, Houston, TX, USA.

出版信息

AMIA Annu Symp Proc. 2011;2011:28-37. Epub 2011 Oct 22.

Abstract

Handoffs have been recognized as a major healthcare challenge primarily due to the breakdowns in communication that occur during transitions in care. Consequently, they are characterized as being "remarkably haphazard". To investigate the information breakdowns in group handoff communication, we conducted a study at a large academic hospital in Texas. We used multifaceted qualitative methods such as observations, shadowing of care providers and their work activities, audio-recording of handoffs, and care provider interviews to examine the handoff communication workflow, with particular emphasis on investigating the sources of information breakdowns. Using a mixed inductive-deductive analysis approach, we identified two critical sources for information breakdowns - lack of standardization in handoff communication events and unsuccessful completion of pre-turnover coordination activities. We propose strategic solutions that can effectively help mitigate the handoff communication breakdowns.

摘要

交接已被公认为是主要的医疗保健挑战,主要原因是在护理转接过程中出现的沟通失误。因此,它们的特点是“非常随意”。为了调查团队交接沟通中的信息失误,我们在德克萨斯州的一家大型学术医院进行了一项研究。我们使用了多方面的定性方法,如观察、跟踪护理人员及其工作活动、交接过程的录音以及护理人员访谈,以检查交接沟通工作流程,特别强调调查信息失误的根源。使用归纳 - 演绎混合分析方法,我们确定了信息失误的两个关键根源——交接沟通事件缺乏标准化以及预交班协调活动未成功完成。我们提出了可以有效帮助减轻交接沟通失误的战略解决方案。

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