Improving Clinical Communication and Collaboration Through Technology

Problem: Over the last 30 years, clinical communication methodologies in healthcare have evolved to become such disparate systems that they lead to confusion, wasted time, and clinician dissatisfaction. The Joint Commission (2016) reports up to 78% of sentinel events in hospitals are linked to communication failures, which have obvious implications for hospital systems in the quality and safety of their current communication systems. Context: The purpose of this project was to determine the effectiveness of implementing a unified clinical communication technology platform in an acute care hospital setting and to make recommendations from that implementation to the organization’s larger health system. Its purpose was also to determine if the creation of a clinical communication technology implementation guide for nurse leaders would positively impact future implementations of such platforms throughout the larger health system. Interventions: This project introduced smartphone communication technologies to inpatient nurses and other clinicians in a 352-bed hospital in California, which is part of a larger 39-hospital, multi-state system. Analysis was then performed by collecting data before and after implementation of the clinical communication platform. While not part of the original plan, elements of the platform were subsequently deployed to help with clinical communication during the height of the SARs CoV (COVID-19) pandemic, and this implementation was also analyzed for the project. The intention was also to determine if the creation of a clinically focused implementation guide for clinical leaders could positively impact the application of such a communication platform throughout the larger health system. Measures: Measures in this study included productivity, efficiency, quality of care, communication, and staff satisfaction with the newly implanted technology. Measurement regarding the usefulness of the implementation guide was gauged through the perceived satisfaction of nurse leaders who reviewed the guide and gave feedback. Results: Mixed results were realized from the implementation of this technology, but the work yielded valuable information for future implementations within the organization. Frontline staff and physician satisfaction with the whole platform was low, but leadership satisfaction with the elements implemented for COVID-19 was high. For the implementation guide, nurse leaders gave valuable feedback and determined it would be a highly useful document for facility implementation leads in the future. Conclusion: The implementation of new clinical communication technology and methodologies has the opportunity to improve productivity, efficiency, quality of care, communication, and staff satisfaction, but only if barriers to implementation are mitigated before, during, and immediately after go-live. A comprehensive implementation guide for nurse leaders can be the tool designed specifically to mitigate these barriers and prepare nurse leaders and facilities for the new technology and associated workflow changes that accompany the technology

Bounded by repertoires and roles : communication through multiple ICTs in a health care organization

Health care has become the largest employer in the United States, and health care organizations are looking to ICTs as a solution to facilitate interprofessional communication and patient care. Yet extant findings show mixed results on the efficacy of ICT use for coordination, and little is known about how health care professionals use their collection of ICTs, as opposed to a singular device, to communicate. Inspired by the theoretical underpinnings of communication media repertoires and boundary theory, this dissertation provides an empirical link between the use of multiple ICTs, that are both organizationally-issued and personally-owned, and the complexities of coordinating patient care. Drawing on qualitative data collected from observations, interviews, and focus groups at a pediatric hospital in the Southern U.S., this research investigates the communicative practices of different teams of allied health professionals—an underexplored population making up approximately 60% of the health care workforce. Differences in technological access, managerial expectations, and workflows emerged within and across the professional groups in the health care organization studied. The findings reveal how allied health professionals experienced repertoire misalignment, a situation where ICTs and routines of use clashed. Furthermore, many people were overloaded by learning which ICTs their colleagues used and how they used them— defined as communication load issues—which impeded the efficiency and quality of their work. This dissertation further shows how ICT repertoires are situated at the crossroad of multiple role boundaries, complicated by organizational rules and norms that were inconsistent across teams. These allied health professionals held strong professional identities, and they were asked—or required—to use personal mobile phones for work purposes. When organizational, professional, and personal boundaries were at odds, employees did not feel empowered to enact their ICTs in ways that privileged professionalism or personal preferences. Thus, although the use of ICT repertoires can facilitate communication within and across professional teams, this dissertation exposes how health care professionals’ work practices are being challenged and constrained by organizational demands for ICT repertoire useCommunication Studie

Quantifying Quality of Life

Describes technological methods and tools for objective and quantitative assessment of QoL Appraises technology-enabled methods for incorporating QoL measurements in medicine Highlights the success factors for adoption and scaling of technology-enabled methods This open access book presents the rise of technology-enabled methods and tools for objective, quantitative assessment of Quality of Life (QoL), while following the WHOQOL model. It is an in-depth resource describing and examining state-of-the-art, minimally obtrusive, ubiquitous technologies. Highlighting the required factors for adoption and scaling of technology-enabled methods and tools for QoL assessment, it also describes how these technologies can be leveraged for behavior change, disease prevention, health management and long-term QoL enhancement in populations at large. Quantifying Quality of Life: Incorporating Daily Life into Medicine fills a gap in the field of QoL by providing assessment methods, techniques and tools. These assessments differ from the current methods that are now mostly infrequent, subjective, qualitative, memory-based, context-poor and sparse. Therefore, it is an ideal resource for physicians, physicians in training, software and hardware developers, computer scientists, data scientists, behavioural scientists, entrepreneurs, healthcare leaders and administrators who are seeking an up-to-date resource on this subject

Wayfinding localized research practices through mobile technology

This dissertation presents wayfinding—the process of orienting oneself amid the myriad users, technologies, and digital spaces impacting any writing work—as a research methodology for contextualizing writing in mobile environments. Central to web design and non-web service design, wayfinding is an important addition to rhetoric and writing studies. First, it is descriptive: it observes and records first, showing how people go about tasks, and revealing relationships among people and their environments. Second, it helps when people get lost and then found. It records traces of the mental work people do to get unlost. Finding themselves, peoples’ maps help them both narrate the experience of finding their way as well as to recover their process by “reading over the map,” a process central to chapter 4. Third, wayfinding informs the scholarly representation of method, allowing for discussions of research to be grounded in a contextual, reflexive methodology of practice. We find ourselves, as scholars, amid the stories we tell to make sense of the fields of study we pursue and chapter 5 includes articulations of our scholarly wayfinding conversations. These stories describe how being self-conscious about using the design language of wayfinding will help keep rhetorical methodology in the forefront of our conversations about mobile writing and research practices

A Phenomenological Study of Teachers\u27 Lived Experiences with Cell Phones in the Classroom

The purpose of this phenomenological study was to discover high school teachers\u27 experiences with cell phones in the classrooms during instructional time at Quaker High School. The theory guiding this study is Jean Piaget\u27s constructivism theory, as it argues that knowledge is produced, and meaning is formed through the experiences of one\u27s physical or mental actions in their environment. The methodology for this dissertation includes a study design that utilizes a phenomenological study method and consists of thirteen teachers from various backgrounds and locations. The setting for the study is a high school in Pittsburgh, PA. The data collection and analysis approach includes semi-structured interviews, focus group interviews, and document analysis. The data were analyzed using coding methods consisting of initial coding and NVivo coding practices. The data were searched for patterns, insights, or concepts. The approaches high school teachers use for instructing students with cell phones during teaching periods were the focus of this dissertation. Notably, the findings illuminate how cell phone usage in classrooms impacts the scope of teachers\u27 autonomy in regulating such use and how it changes instructional methods. The research contributes to understanding how high school teachers navigate the challenges and opportunities presented by cell phones during instructional time

Mediated messages: constructions of intimate communication through the use of digital technologies, and the extent to which such encounters can be conceptualised as one-to-one performance

In the 21st Century a majority of the world’s population carry in their pockets devices that promise connection to others over distance. The instant connectivity offered by technologies of communication is somewhat of mixed blessing combining the allure of interaction and the threat of availability. Much of the advertising gloss for the technologies of communication – smartphones, video conferencing and social networks – relies on selling the idea of real human connection at a distance. This study sets out to explore the nature of mediated communications between individuals in the context of a perceived opposition that conceptualises technology as either distancing or enhancing what it is to be human. The research frames mediated interactions as one-to-one performance, an approach which encourages the unexpected and playful whist embracing vulnerability. In exploring the nature of the one-to-one performance scholars and audiences stress their experiences as personal, at times intense and certainly intimate. Here intimacy is engaged with as both a subconscious technological fluency as well as intrapersonal closeness, placing such interaction in the socio-cultural context of late capitalism. It is concluded that rather than technology enframing a commodified experience of the world, intimate interrelations are possible and inevitable. Chapter 1 serves as an introduction to the research question and contextualises the inquiry in regard to my own personal and professional background. Chapter 2 details relevant concepts, scholarship, performance practice and cultural context and serves to place the work in a lineage of other practice. Chapter 3 describes, documents and interrogates the research practice, including inspirations and experiments alongside the final works. Chapter 4 conceptualises the practice within a phenomenological framework, analysing contemporary communications technologies as part of an expanding perceptual toolset with which we co-shape our reality and placing technical infrastructure within a framework of late capitalism. The final chapter concludes the complimentary writing and clearly enumerates the findings

Quantifying Quality of Life

Describes technological methods and tools for objective and quantitative assessment of QoL Appraises technology-enabled methods for incorporating QoL measurements in medicine Highlights the success factors for adoption and scaling of technology-enabled methods This open access book presents the rise of technology-enabled methods and tools for objective, quantitative assessment of Quality of Life (QoL), while following the WHOQOL model. It is an in-depth resource describing and examining state-of-the-art, minimally obtrusive, ubiquitous technologies. Highlighting the required factors for adoption and scaling of technology-enabled methods and tools for QoL assessment, it also describes how these technologies can be leveraged for behavior change, disease prevention, health management and long-term QoL enhancement in populations at large. Quantifying Quality of Life: Incorporating Daily Life into Medicine fills a gap in the field of QoL by providing assessment methods, techniques and tools. These assessments differ from the current methods that are now mostly infrequent, subjective, qualitative, memory-based, context-poor and sparse. Therefore, it is an ideal resource for physicians, physicians in training, software and hardware developers, computer scientists, data scientists, behavioural scientists, entrepreneurs, healthcare leaders and administrators who are seeking an up-to-date resource on this subject

The mobile Internet report

Key ponts Material wealth creation / destruction should surpass earlier computing cycles. The mobile Internet cycle, the 5th cycle in 50 years, is just starting. Winners in each cycle often create more market capitalization than in the last. New winners emerge, some incumbents survive – or thrive – while many past winners falter. The mobile Internet is ramping faster than desktop Internet did, and we believe more users may connect to the Internet via mobile devices than desktop PCs within 5 years. Five IP-based products / services are growing / converging and providing the underpinnings for dramatic growth in mobile Internet usage – 3G adoption + social networking + video + VoIP + impressive mobile devices. Apple + Facebook platforms serving to raise the bar for how users connect / communicate – their respective ramps in user and developer engagement may be unprecedented. Decade-plus Internet usage / monetization ramps for mobile Internet in Japan plus desktop Internet in developed markets provide roadmaps for global ramp and monetization. Massive mobile data growth is driving transitions for carriers and equipment providers. Emerging markets have material potential for mobile Internet user growth. Low penetration of fixed-line telephone and already vibrant mobile value-added services mean that for many EM users and SMEs, the Internet will be mobile