Transferring Patient Care: Patterns of Synchronous Bidisciplinary Communication Between Physicians and Nurses During Handoffs in a Critical Care Unit

Purpose: The transfer of patient care from one health care worker to another involves communication in high-pressure contexts that are often vulnerable to error. This research project captured current practices for handoffs during the critical care stage of surgical recovery in a hospital setting. The objective was to characterize information flowduring transfer and identify patterns of communication between nurses and physicians. Design and Methods: Observations were used to document communication exchanges. The data were analyzed qualitatively according to the types of information exchanged and verbal behavior types. Findings: Reporting and questions were the most common verbal behaviors, and retrospective medical information was the focus of information exchange. The communication was highly interactive when discussing patient status and future care plans. Nurses proactively asked questions to capture a large proportion of the information they needed. Conclusions: Findings reflect positive and constructive patterns of communication during handoffs in the observed hospital unit

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

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