Cognition, Technology & Work

, Volume 16, Issue 1, pp 47–57

Exploring similarities and differences in teamwork across diverse healthcare contexts using communication analysis

  • Avi Parush
  • Chelsea Kramer
  • Tara Foster-Hunt
  • Alicia McMullan
  • Kathryn Momtahan
Original Article

Abstract

Teamwork is prevalent in many work contexts. This study explored the similarities and differences in teamwork processes across different healthcare work contexts with the aim of assessing knowledge transfer feasibility. The research approach was to aggregate team communication analyses from four healthcare contexts to uncover teamwork similarities and differences. The four healthcare contexts included two handoffs and two surgery contexts. The communication analysis segmented communication into meaningful sequences. It categorized utterances into content categories and verbal behaviors. There were a few similar content categories across the four contexts. A clear information structure emerged in the two handoff contexts. In addition, there were more dialogues and requests in the surgeries compared to more reports in the handoffs. The content similarities suggest that some knowledge is transferable among the contexts. However, the differences in communication patterns reflect fundamental differences between handoff and surgery contexts in some teamwork processes. This research demonstrated that using communication analysis can uncover similarities and differences in team cognition and teamwork processes across work contexts. This in turn can help determine what knowledge and methods pertaining to team training, procedures, and technology are transferable across the contexts.

Keywords

Teamwork Handoffs Surgeries Information sharing Coordination Collaboration Verbal behaviors Healthcare 

References

  1. Apker J, Mallak LA, Applegate EB, Gibson SC, Ham JJ, Johnson NA, Street RL (2010) Exploring emergency physician–hospitalist handoff interactions: development of the Handoff communication assessment. Ann Emerg Med 55(2):161–170CrossRefGoogle Scholar
  2. Awad S, Fagan S, Bellows C, Albo D, Green-Rashad B, De La Garza M, Berger D (2005) Bridging the communication gap in the operating room with medical team training. Am J Surg 190(5):770–774CrossRefGoogle Scholar
  3. Baker DP, Day R, Salas E (2006) Teamwork as an essential component of high-reliability organizations. Health Res Educ Trust 41(4):1576–1598Google Scholar
  4. Ball LJ, Ormerod TC (2000) Putting ethnography to work: the case for a cognitive ethnography of design. Int J Human Comput Stud 53:147–168CrossRefGoogle Scholar
  5. Behara R, Wears RL, Perry SJ, Eisenberg E, Murphy L, Vanderhoef M, Shapiro M, Beach C, Croskerry P, Cosby K (2005) Conceptual framework for the safety of handovers. In: Henriksen K (ed) Advances in patient safety. Agency for Healthcare Research and Quality/Department of Defense, Rockville, pp 309–321Google Scholar
  6. Bowers CA, Jentsch F, Salas E, Braun CC (1998) Analyzing communication sequences for team training needs assessment. Hum Factors 40:672–679CrossRefGoogle Scholar
  7. Brannick MT, Prince C (1997) An overview of team performance measurement. In: Brannick MT, Salas E, Prince C (eds) Team Performance assessment and measurement. Erlbaum, Mahwah, pp 3–16Google Scholar
  8. Cooke NJ, Gorman JC, Kiekel PA (2008) Communication as team-level cognitive processing. In: Letsky M, Warner N, Fiore S, Smith CAP (eds) Macrocognition in teams: theories and methodologies. Ashgate Publishing Ltd, Hants, pp 51–64Google Scholar
  9. Creswell JW (2007) Qualitative inquiry and research design: Choosing among five approaches, 2nd edn. Sage Publications, Thousand OaksGoogle Scholar
  10. Davies JM (2005) Team communication in the operating room. Acta Anaesthesiol Scand 49:898–901CrossRefGoogle Scholar
  11. Dickinson TL, McIntyre RM (1997) A conceptual framework for teamwork measurement. In: Brannick MT, Salas E, Prince C (eds) Team performance assessment and measurement. Lawrence Erlbaum Associates, Mahwah, pp 19–43Google Scholar
  12. Dowding D (2001) Examining the effects that manipulating information given in the change of shift report has on nurses’ care planning ability. J Adv Nurs 33(6):836–846CrossRefGoogle Scholar
  13. Durso FT, Crutchfield JM, Harvey CM (2007) The cooperative shift change: an illustration using air traffic control. Theoret Issues Ergonom Sci 8(3):213–232CrossRefGoogle Scholar
  14. Ellingson LL (2002) Communication, collaboration, and teamwork among health care professionals. Commun Res Trends 21(3):1–21Google Scholar
  15. Fischer U, Orasanu J (1999) Say it again, Sam! Effective communication strategies to mitigate pilot errors. In: The Proceedings of the 10th international symposium on Aviation psychologyGoogle Scholar
  16. Foster-Hunt T (2009) Information flow in change of shift patient handoffs in a pediatric intensive care unit. Unpublished MA thesis, Department of Psychology, Carleton University, Ottawa, Ontario, CanadaGoogle Scholar
  17. Frankel A, Gardner R, Maynard L, Kelly A (2007) Using the communication and teamwork skills (CATS) assessment to measure health care team performance. Jt Comm J Qual Patient Safe 33(9):549–558Google Scholar
  18. Gorman JC, Cooke NJ, Pedersen HP, Connor OO, Dejoode JA (2005) Coordinated awareness of situation by teams (CAST): measuring team situation awareness of a communication glitch. In: Proceedings of the human factors and ergonomics society 49th annual meeting. Santa Monica, CA:HFES, pp. 274–277Google Scholar
  19. Gorman JC, Cooke NJ, Winner JL (2006) Measuring team situation awareness in decentralized command and control systems. Ergonomics 49:1312–1325CrossRefGoogle Scholar
  20. Grusenmeyer C (1995) Shared functional representation in cooperative tasks: the example of shift changeover. Int J Human Factors Manufact 5:163–176CrossRefGoogle Scholar
  21. Hammersly M, Atkinson P (1995) Ethnography: principles in practice, 2nd edn. Routledge, LondonGoogle Scholar
  22. Hazlehurst B, McMullen CK, Gorman N (2007) Distributed cognition in the heart room: how situation awareness arises from coordinated communications during cardiac surgery. J Biomed Inform 40:539–551CrossRefGoogle Scholar
  23. Heath C, Luff P (1991) Collaborative activity and technological design: task coordination in London underground control rooms. In: Proceedings of the ECSCW 91. Kluwer Academic Publishers, pp 65–80Google Scholar
  24. Horwitz LI, Meredith T, Schuur JD, Shah NR, Kulkarni R, Grace Y (2009) Dropping the baton: a qualitative analysis of failures during the transition from emergency department to inpatient care. Ann Emerg Med 53(6):701–710CrossRefGoogle Scholar
  25. Joint Commission on Accreditation of Healthcare Organizations (2004) Sentinel event statistics, June 29, Available at: http://www.jcaho.org/accredited+organizations/ambulatory+care/sentinel+events/sentinel+event+statistics.htm
  26. Kozlowski SWJ, Bell BS (2003) Work groups and teams in organizations. In: Borman WC, Ilgen DR, Klimoski RJ (eds) Handbook of psychology (vol 12): industrial and organizational psychology. Wiley, New York City, pp 333–375Google Scholar
  27. Kramer C (2009) Situation awareness indicators, mental models, and teamwork in the OR. Unpublished MA thesis, Department of Psychology, Carleton University, Ottawa, Ontario, CanadaGoogle Scholar
  28. Kramer C, Parush A, Brandigampola S, Momtahan K (2010) Analysis of cross-professional communication in thoracic operating rooms. In: Duffy VG (ed) Advances in human factors and ergonomics in healthcare. CRC Press, USA, pp 307–316Google Scholar
  29. Leonard M, Graham S, Bonacum D (2004) The human factor: the critical importance of effective teamwork and communication in providing safe care. Qual Saf Health Care 13(Suppl 1):i85–i90Google Scholar
  30. Lingard L, Albert M, Levinson W (2008) Grounded theory, mixed methods, and action research. Br Med J (Clinical research ed.) 337:a567. doi:10.1136/bmj.39602.690162.47
  31. Manser T (2009) Teamwork and patient safety in dynamic domains of healthcare: a review of the literature. Acta Anaesthesiol Scand 53(2):143–151CrossRefGoogle Scholar
  32. McBurney DH (2001) Research methods, 5th edn. Wadsworth Thomson Learning, Belmont, USAGoogle Scholar
  33. McMullan A (2010) Communication in patient care handoffs and implications to safety. Unpublished MA thesis, Department of Psychology, Carleton University, Ottawa, Ontario, CanadaGoogle Scholar
  34. Mohammed S, Dumville BC (2001) Team mental models in a team knowledge framework: expanding theory and measurement across disciplinary boundaries. J Organ Behav Special Issue Shared Cognit 22(2):89–106Google Scholar
  35. Nemeth CP, Kowalsky J, Brandwijk M, O’Connor MF, Nunnally ME, Klock PA, Cook RI (2005) Distributed cognition: how hand-off communication actually works. Anesthesiology 103:A1289Google Scholar
  36. Nunnally ME, Bitan Y, Nemeth CP, O’Connor MF, Cook RI (2005) Failure in context: linking observed behavior to cognition, tasks, and adverse events. Anesthesiology 103:A1296CrossRefGoogle Scholar
  37. O’Byrne WT, Weavind L, Selby J (2008) The science and economics of improving clinical communication. Anesthesiology Clin 26:729–744CrossRefGoogle Scholar
  38. Orasanu J (1994) Shared problem models and flight crew performance. In: Johnston N, McDonald N, Fuller R (eds) Aviation psychology in practice. Ashgate, Aldershot, pp 255–285Google Scholar
  39. Parker J, Coiera E (2000) Improving clinical communication. J Am Med Inf Assoc 7(5):453–461CrossRefGoogle Scholar
  40. Parush A, Momtahan K, Foster-Hunt T, Kramer C, Holm C, Nathan H (2008) Critical information flow analysis in the cardiac operating room. In: Proceedings of the International System Safety Conference 2008 (August 2008, Vancouver, BC, Canada)Google Scholar
  41. Parush A, Momtahan K, Foster-Hunt T, Kramer C, Hunter A, Nathan H (2009) A communication analysis methodology for developing cardiac operating room team-oriented displays. In: Proceedings of the annual human factors and ergonomics society conference, October 2009, pp. 728–732Google Scholar
  42. Parush A, Simoneau Y, Foster-Hunt T, Thomas M, Rashotte J (2010) The use of resources during shift hand-offs in a pediatric intensive care unit. In: Proceedings of the 54th annual human factors and ergonomics society conference, pp. 962–966 (5)Google Scholar
  43. Parush A, Kramer C, Foster-Hunt T, Momtahan K, Hunter A, Sohmer B (2011) Communication and team situation awareness in the OR: implications for augmentative information display. J Biomed Inform 44(3):477–485. doi:10.1016/j.jbi.2010.04.002 Google Scholar
  44. Patel VL, Zhang J, Yoskowitz NA, Green R, Sayan OR (2008) Translational cognition for decision support in critical care environments: a review. J Biomed Inform 41(3):413–431Google Scholar
  45. Pomerantz A, Fehr BJ (1997) Conversation analysis: An approach to the study of social action as sense making practices. In: van Dijk TA (ed) Discourse as social interaction. SAGE Publications, Thousand Oaks, pp 64–91Google Scholar
  46. Reddy MC, Spence PR (2008) Collaborative information seeking: a field study of a multidisciplinary patient care system. Inf Process Manage 44:244–255Google Scholar
  47. Reddy M, Pratt W, Dourish P, Shabot MM (2003) Sociotechnical requirements analysis for clinical systems. Methods Inf Med 42:437–444Google Scholar
  48. Salas E, Cannon-Bowers JA (2000) The anatomy of team training. In: Tobias S, Fletcher JD (eds) Training and retraining: a handbook for business, industry, government, and the military. Macmillan, New York, pp 312–335Google Scholar
  49. Salas E, Dickinson TL, Converse SA, Tannenbaum SI (1992) Toward an understanding of team performance and training. In: Swezey RW, Salas E (eds) Teams: their training and performance. Ablex, Norwood, pp 3–29Google Scholar
  50. Salas E, Prince C, Baker PD, Shrestha L (1995) Situation awareness in team performance. Hum Factors 37(1):123–136CrossRefGoogle Scholar
  51. Schegloff EA (1987) Analyzing single episodes of interaction: an exercise in conversation analysis. Soc Psychol Q 50(2):101–114CrossRefGoogle Scholar
  52. Schramm W (1954) How communication works. In: Schramm W (ed) The process and effects of mass communication. University of Illinois Press, Illinois, p 3Google Scholar
  53. Shabnam U, Sevdalis N, Healey A, Darzi A, Vincent C (2006) Teamwork in the operating theatre: cohesion or confusion? J Eval Clin Pract 12(2):182–189CrossRefGoogle Scholar
  54. Sonnenwald DH, Pierce LG (2000) Information behavior in dynamic group work contexts: interwoven situation awareness, dense social networks and contested collaboration in command and control. Inf Process Manage 36:461–479CrossRefGoogle Scholar
  55. Yeager S (2005) Interdisciplinary collaboration: the heart and soul of health care. Crit Care Nurs 17:143–148Google Scholar

Copyright information

© Springer-Verlag London Limited 2012

Authors and Affiliations

  • Avi Parush
    • 1
  • Chelsea Kramer
    • 2
  • Tara Foster-Hunt
    • 3
  • Alicia McMullan
    • 4
  • Kathryn Momtahan
    • 5
  1. 1.Carleton UniversityOttawaCanada
  2. 2.CAE Professional ServicesOttawaCanada
  3. 3.Canadian Department of National DefenseOttawaCanada
  4. 4.University of OttawaOttawaCanada
  5. 5.The Ottawa HospitalOttawaCanada

Personalised recommendations