Centre for Innovation in Complex Care, University Health Network , Toronto, Ontario, Canada, M5G 2C4;
Appl Clin Inform. 2012 Feb 1;3(1):38-51. doi: 10.4338/ACI-2011-11-RA-0067. Print 2012.
Clinical communication is recognized as a major source of errors in hospitals. The lack of documentation of communication, especially among verbal interactions, often creates hindrances and impedes improvement efforts. By providing smartphones to residents and encouraging nurses to communicate with residents by email shifted much of the communication to emails which permitted analysis of content.
Description on the interprofessional email communication between doctors and nurses occurring on the general internal medicine wards at two academic hospitals.
A prospective analysis of email communications between doctors and nurses.
34 out of the 67 residents who were on the general medicine clinical teaching units consented to allow analysis of their emails over a 6 month period.
Statistical tabulations were performed on the volume and frequency of communications as well the response time of messages. Two physicians coded the content of randomly selected emails for urgency, emotion, language, type of interaction, and subject content.
A total of 13,717 emails were available for analysis. Among the emails from nurses, 39.1% were requests for a call back, 18.9% were requests for a response by email and the remaining 42.0% indicated no response was required from physicians. For the messages requesting a response by email, only 50% received an email response. Email responses had a median response time of 2.3 minutes. Content analysis revealed that messages were predominantly non-urgent. The two most frequent purposes for communications were to convey information (91%) and to request action by the physician (36%).
A smartphone-based email system facilitated the description and content analysis of a large amount of email communication between physicians and nurses. Our findings provide a picture of the communication between physicians, nurses and other healthcare professionals. This work may help inform the further development of information and communications technology that can improve clinical communication.
临床沟通被认为是医院错误的主要来源。沟通记录的缺乏，尤其是口头互动的沟通记录缺乏，往往会造成障碍，并阻碍改进工作。为住院医师配备智能手机，并鼓励护士通过电子邮件与住院医师沟通，这使得大部分沟通都通过电子邮件进行，从而使内容分析成为可能。
描述在两所学术医院的普通内科病房中医生和护士之间的跨专业电子邮件沟通。
对医生和护士之间电子邮件沟通的前瞻性分析。
在普通内科临床教学单元的 67 名住院医师中，有 34 名同意在 6 个月的时间内允许分析他们的电子邮件。
对沟通的数量和频率以及消息的回复时间进行了统计制表。两位医生对随机选择的电子邮件的内容进行编码，以确定其紧急程度、情绪、语言、交互类型和主题内容。
共可分析 13717 封电子邮件。在护士发来的电子邮件中，39.1%是要求回电的，18.9%是要求通过电子邮件回复的，其余 42.0%表示不需要医生回复。对于要求通过电子邮件回复的邮件，只有 50%收到了电子邮件回复。电子邮件的回复中位数时间为 2.3 分钟。内容分析显示，邮件主要是非紧急的。沟通的两个最常见目的是传达信息（91%）和要求医生采取行动（36%）。
基于智能手机的电子邮件系统促进了对大量医生和护士之间电子邮件沟通的描述和内容分析。我们的研究结果提供了医生、护士和其他医疗保健专业人员之间沟通的情况。这项工作可以帮助进一步开发可以改善临床沟通的信息和通信技术。
