Royse Lisa, Nolan Nathanial, Hoffman Kimberly
Department of Orthopaedic Surgery, University of Missouri School of Medicine, Columbia, MO, USA.
Division of Infectious Diseases, Washington University School of Medicine, St. Louis, MO, USA.
J Multidiscip Healthc. 2020 Nov 17;13:1583-1593. doi: 10.2147/JMDH.S273746. eCollection 2020.
The complexity of modern medicine requires high-performance teamwork to ensure quality care. Teams rely on communication patterns that are replicable and efficient. The purpose of this observational study was to characterize communication dynamics among interprofessional team members during a team huddle. The study aimed to (a) characterize communication within structured huddles on an inpatient medicine unit by evaluating who talked and to whom and what types of communication took place during each interaction and (b) explore participants' perceptions of the huddles.
We used a sociogram to diagram direct observations of the structure and patterns of group interaction. Through the sociogram, we documented the flow and frequency of team members information exchange, questions, and requests. We conducted two follow-up focus groups-one with residents and one with nurses.
The most frequent type of interaction observed was information exchange: nurse to resident (28.3%) and resident to nurse (47%). Both residents and nurses asked questions: nurse to resident (7.4%) and resident to nurse (14.2%). Nurses made more requests of residents (2.8%) than vice versa (0.3%). Four themes emerged from focus group analysis, including the huddle promotes (1) a better-informed team, (2) relationship building, (3) communication process efficiencies, and (4) logistical challenges.
Sociograms can serve as a novel tool to characterize what actually happens during information exchange at the point of care and identify the nature of communication among team members. Daily huddles among team members involved in the frontline of patient care provides an opportunity to share information, requests, and questions and update shared mental models to meet team objectives.
现代医学的复杂性要求高效的团队协作以确保高质量的护理。团队依赖可复制且高效的沟通模式。这项观察性研究的目的是描述跨专业团队成员在团队碰头会期间的沟通动态。该研究旨在：（a）通过评估在每次互动中谁与谁交谈以及发生了何种类型的沟通，来描述住院内科病房结构化碰头会中的沟通情况；（b）探究参与者对碰头会的看法。
我们使用社会关系图来直观呈现对小组互动结构和模式的直接观察结果。通过社会关系图，我们记录了团队成员信息交流、问题及请求的流动和频率。我们进行了两次后续焦点小组讨论，一次是与住院医师，另一次是与护士。
观察到的最常见互动类型是信息交流：护士与住院医师之间（28.3%）以及住院医师与护士之间（47%）。住院医师和护士都提出了问题：护士向住院医师提问（7.4%）以及住院医师向护士提问（14.2%）。护士向住院医师提出的请求（2.8%）比住院医师向护士提出的请求（0.3%）更多。焦点小组分析得出了四个主题，包括碰头会促进了（1）信息更灵通的团队，（2）关系建立，（3）沟通流程效率，以及（4）后勤挑战。
社会关系图可作为一种新颖的工具，用于描述在护理现场信息交流期间实际发生的情况，并识别团队成员之间沟通的性质。参与患者护理一线工作的团队成员每日进行碰头会，为分享信息、请求和问题以及更新共享心智模型以实现团队目标提供了机会。
