van Leijen-Zeelenberg Janneke E, van Raak Arno J A, Duimel-Peeters Inge G P, Kroese Mariëlle E A L, Brink Peter R G, Vrijhoef Hubertus J M
Department of Health Services Research, School for Public Health and Primary Care (CAPHRI) , Maastricht University, Maastricht , The Netherlands .
J Interprof Care. 2015;29(4):320-30. doi: 10.3109/13561820.2014.1003802. Epub 2015 Jan 23.
Although communication failures between professionals in acute care delivery occur, explanations for these failures remain unclear. We aim to gain a deeper understanding of interprofessional communication failures by assessing two different explanations for them. A multiple case study containing six cases (i.e. acute care chains) was carried out in which semi-structured interviews, physical artifacts and archival records were used for data collection. Data were entered into matrices and the pattern-matching technique was used to examine the two complementary propositions. Based on the level of standardization and integration present in the acute care chains, the six acute care chains could be divided into two categories of care processes, with the care chains equally distributed among the categories. Failures in communication occurred in both groups. Communication routines were embedded within organizations and descriptions of communication routines in the entire acute care chain could not be found. Based on the results, failures in communication could not exclusively be explained by literature on process typology. Literature on organizational routines was useful to explain the occurrence of communication failures in the acute care chains. Organizational routines can be seen as repetitive action patterns and play an important role in organizations, as most processes are carried out by means of routines. The results of this study imply that it is useful to further explore the role of organizational routines on interprofessional communication in acute care chains to develop a solution for failures in handover practices.
尽管在急性护理服务中专业人员之间会出现沟通失误,但这些失误的原因仍不明确。我们旨在通过评估两种不同的解释来更深入地理解跨专业沟通失误。我们开展了一项包含六个案例(即急性护理链)的多案例研究,其中使用半结构化访谈、实物制品和档案记录来收集数据。数据被录入矩阵,并采用模式匹配技术来检验两个互补命题。根据急性护理链中标准化和整合的程度,这六个急性护理链可分为两类护理流程,且护理链在两类中平均分布。两组均出现了沟通失误。沟通惯例嵌入在组织内部,且在整个急性护理链中找不到沟通惯例的描述。基于研究结果,沟通失误不能仅由流程类型学的文献来解释。关于组织惯例的文献有助于解释急性护理链中沟通失误的发生。组织惯例可被视为重复性行动模式,在组织中发挥着重要作用,因为大多数流程都是通过惯例来执行的。本研究结果表明,进一步探讨组织惯例在急性护理链跨专业沟通中的作用,以开发解决交接班实践失误的方案是有益的。