Communication and Complexity: Negotiating Transitions in Critical Care

Chapter
Part of the Health Informatics book series (HI)

Abstract

There is considerable truth to the old adage that successful conversation will take you very far. Of course, the proposition is more complex when applied to the healthcare system. Hospital institutions are complex structures that use a multilayered approach and employ multiple modes of communication in caring for patients including paging systems, telephones, e-mail, fax, and face-to-face interactions [1]. It is reasonable to propose that electronic health records constitute another medium of communication although a decidedly less than optimal one at this point in time. However, the patient care process in ICU relies heavily on face-to-face verbal exchange [2]. It has been reported that clinicians devote 50—60 % of clinical time to talk in ICU settings.

References

  1. 1.
    Alvarez G, Coiera E. Interdisciplinary communication: an uncharted source of medical error? J Crit Care. 2006;21(3):236–42.PubMedCrossRefGoogle Scholar
  2. 2.
    Munir SK, Kay S. Simplifying the complexity surrounding ICU work processes–identifying the scope for information management in ICU settings. Int J Med Inform. 2005;74(7–8):643–56. PubMed PMID: 16023407.PubMedCrossRefGoogle Scholar
  3. 3.
    Coiera E. When conversation is better than computation. JAMA. 2000;7(3):277–86.Google Scholar
  4. 4.
    Cohen MD, Hilligoss PB. The published literature on handoffs in hospitals: deficiencies identified in an extensive review. Qual Saf Health Care. 2010;19(6):493–7.PubMedCrossRefGoogle Scholar
  5. 5.
    Bhasale AL, Miller GC, Reid SE, Britt HC. Analysing potential harm in Australian general practice: an incident-monitoring study. Med J Aust. 1998;169(2):73–6. PubMed PMID: 9700340.PubMedGoogle Scholar
  6. 6.
    Manser T. Teamwork and patient safety in dynamic domains of healthcare: a review of the literature. Acta Anaesthesiol Scand. 2009;53(2):143–51. PubMed PMID: 19032571.PubMedCrossRefGoogle Scholar
  7. 7.
    Wheelan SA, Burchill CN, Tilin F. The link between teamwork and patients’ outcomes in intensive care units. Am J Crit Care. 2003;12(6):527–34. PubMed PMID: 14619358.PubMedGoogle Scholar
  8. 8.
    Patel VL, Kaufman DR, Magder S. The road to excellence: the acquisition of expert performance in the arts and sciences, sports and games. In: Ericsson A, editor. The acquisition of medical expertise in complex dynamic decision-making environments. Hillsdale: Erlbaum; 1996. p. 127–65.Google Scholar
  9. 9.
    Ayse PG, Bradford DW, Priyadarshini RP, Pascale C, Peter JP. Human factors and ergonomics in intensive care units. In: Handbook of human factors and ergonomics in health care and patient safety. 2nd ed. Boca Raton (Florida): CRC Press; 2011. p. 693–708.Google Scholar
  10. 10.
    Carayon P, Smith MJ. Work organization and ergonomics. Appl Ergon. 2000;31(6):649–62. PubMed PMID: 11132049.PubMedCrossRefGoogle Scholar
  11. 11.
    Durso FT, Drews F. Health care, aviation, and ecosystems: a socio-natural systems perspective. Curr Dir Psychol Sci. 2010;19:71–5.CrossRefGoogle Scholar
  12. 12.
    Rouse WB. Health care as a complex adaptive system: implications for design and management. Bridge. 2008;38(1):17.Google Scholar
  13. 13.
    Lave J. Cognition in practice: mind, mathematics and culture in everyday life. Cambridge: Cambridge University Press; 1988.CrossRefGoogle Scholar
  14. 14.
    Clancey WJ. Scientific antecedents of situated cognition. In: Cambridge handbook of situated cognition. New York: Cambridge University Press; 2008. p. 11–34.CrossRefGoogle Scholar
  15. 15.
    Hutchins E. Cognition in the wild. Cambridge, MA: MIT Press; 1995. xviii, 381.Google Scholar
  16. 16.
    Horsky J, Kuperman GJ, Patel VL. Comprehensive analysis of a medication dosing error related to CPOE: a case report. JAMA. 2005;12:377–82.Google Scholar
  17. 17.
    Clark HH, Brennan SE. Grounding in communication. Perspect Soc Shar Cogn. 1991;13(1991):127–49.CrossRefGoogle Scholar
  18. 18.
    Clark HH, Schaefer EF. Contributing to discourse. Cogn Sci. 1989;13(2):259–94.CrossRefGoogle Scholar
  19. 19.
    Kecskes I, Zhang F. Activating, seeking, and creating common ground: a socio-cognitive approach. Pragmat Cogn. 2009;17(2):331–55.CrossRefGoogle Scholar
  20. 20.
    Kecskes I. Dueling contexts: a dynamic model of meaning. J Pragmat. 2008;40(3):385–406.CrossRefGoogle Scholar
  21. 21.
    Kecskes I. The paradox of communication-socio-cognitive approach to pragmatics. Pragmat Soc. 2010;1(1):50–73.CrossRefGoogle Scholar
  22. 22.
    Robert LW, Shawna JP, Emily SP. Handoffs and transitions of care. In: Handbook of human factors and ergonomics in health care and patient safety. 2nd ed. Boca Raton (Florida): CRC Press; 2011. p. 163–72.Google Scholar
  23. 23.
    Mistry KP, Jaggers J, Lodge AJ, Alton M, Mericle JM, Frush KS, et al. Using Six Sigma methodology to improve handoff communication in high-risk patients. 2008. 10 July 2011. Available from: http://www.ahrq.gov/downloads/pub/advances2/vol3/Advances-Mistry_114.pdf
  24. 24.
    Sutcliffe K, Lewton E, Rosenthal M. Communication failures: an insidious contributor to medical mishaps. Acad Med. 2004;79(2/February):186–94. PubMed PMID: doi: 10.1097/00001888-200402000-00019 Google Scholar

Copyright information

© Springer-Verlag London 2014

Authors and Affiliations

  • David R. Kaufman
    • 1
  • Joanna Abraham
    • 2
  • Lena Mamykina
    • 3
  1. 1.Department of Biomedical InformaticsArizona State UniversityScottsdaleUSA
  2. 2.Department of Biomedical and Health Information Sciences, College of Applied Health SciencesUniversity of IllinoisChicagoUSA
  3. 3.Department of Biomedical InformaticsColumbia UniversityNew YorkUSA

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