Characterizing the Structure and Content of Nurse Handoffs: A Sequential Conversational Analysis Approach.

Effective communication during nurse handoffs is instrumental in ensuring safe and quality patient care. Much of the prior research on nurse handoffs has utilized retrospective methods such as interviews, surveys and questionnaires. While extremely useful, an in-depth understanding of the structure and content of conversations, and the inherent relationships within the content is paramount to designing effective nurse handoff interventions. In this paper, we present a methodological framework-Sequential Conversational Analysis (SCA)-a mixed-method approach that integrates qualitative conversational analysis with quantitative sequential pattern analysis. We describe the SCA approach and provide a detailed example as a proof of concept of its use for the analysis of nurse handoff communication in a medical intensive care unit. This novel approach allows us to characterize the conversational structure, clinical content, disruptions in the conversation, and the inherently phasic nature of nurse handoff communication. The characterization of communication patterns highlights the relationships underlying the verbal content of nurse handoffs with specific emphasis on: the interactive nature of conversation, relevance of role-based (incoming, outgoing) communication requirements, clinical content focus on critical patient-related events, and discussion of pending patient management tasks. We also discuss the applicability of the SCA approach as a method for providing in-depth understanding of the dynamics of communication in other settings and domains

Preserving data privacy and security in Australian my health record system: A quality health care implication

Australian My Health Record (MyHR) system must enable efficient availability of meaningful, accurate, complete and up-to-date health data. However, the major challenge must be to ensure the security of the clinical information of the MyHR. The foremost question that remains unanswered is ‘are current information security settings adequate to protect MyHR?’. To build an adequate security setup and increase the uptake of the MyHR system, it is imperative to show the MyHR is safe to use. In addressing this issue and implementing the adoption of the initiative, we determine and systematically analyse the existing threats to the system. We assess strengths of various solutions against possible threats and discuss the development and implementation process of the proposed model

Integrating organisation of healthcare services, workers' wellbeing, and quality of care:An introduction to the system-based perspective of healthy healthcare

The current chapter introduces Healthy Healthcare, an integrated perspective involving quality of care, workers' wellbeing, and organisation of healthcare services, for a system-based understanding of healthcare practice. Healthy Healthcare is based on three main conditions, herein termed pillars, of healthcare delivery: (a) quality of care; (b) workers' wellbeing; and (c) organisation of healthcare. This perspective is important to develop research approaches and to incorporate evidence-based practice and knowledge into Healthy Healthcare. The current volume provides perspectives on Healthy Healthcare based on research from different disciplines and different countries. This chapter introduces Healthy Healthcare with a brief presentation of the modern context of healthcare practice and a description and explanation of the system. It concludes with a brief outline of the volume's contents.</p