Popovici Ilinca, Morita Plinio P, Doran Diane, Lapinsky Stephen, Morra Dante, Shier Ashleigh, Wu Robert, Cafazzo Joseph A
Institute of Biomaterials and Biomedical Engineering, Faculty of Medicine, University of Toronto, Toronto, ON, Canada Centre for Global eHealth Innovation, University Health Network, Toronto, ON, Canada M5G 2C4.
Centre for Global eHealth Innovation, University Health Network, Toronto, ON, Canada M5G 2C4.
Int J Qual Health Care. 2015 Jun;27(3):183-8. doi: 10.1093/intqhc/mzv016. Epub 2015 Apr 7.
To gain insights into how technological communication tools impact effective communication among clinicians, which is critical for patient safety.
This multi-site observational study analyzes inter-clinician communication and interaction with information technology, with a focus on the critical process of patient transfer from the Emergency Department to General Internal Medicine.
Mount Sinai Hospital, Sunnybrook Health Sciences Centre and Toronto General Hospital.
At least five ED and general internal medicine nurses and physicians directly involved in patient transfers were observed on separate occasions at each institution.
N/A.
N/A.
The study provides insight into clinician workflow, evaluates current hospital communication systems and identifies key issues affecting communication: interruptions, issues with numeric pagers, lack of integrated communication tools, lack of awareness of consultation status, inefficiencies related to the paper chart, unintuitive user interfaces, mixed use of electronic and paper systems and lack of up-to-date contact information. It also identifies design trade-offs to be negotiated: synchronous communication vs. reducing interruptions, notification of patient status vs. reducing interruptions and speed vs. quality of handovers.
The issues listed should be considered in the design of new technology for hospital communications.
深入了解技术通信工具如何影响临床医生之间的有效沟通，而这对患者安全至关重要。
这项多中心观察性研究分析了临床医生之间的沟通以及与信息技术的交互，重点关注患者从急诊科转至普通内科这一关键过程。
西奈山医院、森尼布鲁克健康科学中心和多伦多综合医院。
在每家机构的不同时间，观察了至少五名直接参与患者转运的急诊科和普通内科护士及医生。
无。
无。
该研究深入了解了临床医生的工作流程，评估了当前医院的通信系统，并确定了影响沟通的关键问题：中断、数字传呼机问题、缺乏集成通信工具、对会诊状态缺乏了解、纸质病历相关的低效率、不直观的用户界面、电子和纸质系统的混合使用以及缺乏最新的联系信息。它还确定了需要权衡的设计问题：同步通信与减少中断、患者状态通知与减少中断以及交接速度与质量。
在设计医院通信新技术时应考虑所列问题。
