The Influence of Information Technology on Multi-professional Communication during a Patient Handoff

Persistent Link:
http://hdl.handle.net/10150/194331
Title:
The Influence of Information Technology on Multi-professional Communication during a Patient Handoff
Author:
Benham-Hutchins, Mary Margaret
Issue Date:
2008
Publisher:
The University of Arizona.
Rights:
Copyright © is held by the author. Digital access to this material is made possible by the University Libraries, University of Arizona. Further transmission, reproduction or presentation (such as public display or performance) of protected items is prohibited except with permission of the author.
Abstract:
Little is known about the communication principles necessary for the design and implementation of health information technology (HIT) that supports the needs of healthcare providers from multiple professions. The purpose of this descriptive, exploratory research was to examine the patterns and methods of communication used by nurses, physicians, social workers, respiratory therapists, and pharmacists to share patient information during a patient handoff between units. The principles of complexity science were used as a theoretical framework and an original model of the healthcare organization consisting of embedded complex adaptive systems is presented.Five patient handoffs from the emergency department to participating inpatient units were included in the study. Providers responsible for the care of patients during the designated handoffs were identified through observation and snowball sampling and asked to complete a survey asking whom they communicated with and how. Social Network Analysis was used to map, analyze, and compare the communication patterns used by healthcare providers. Inferential statistics and thematic content analysis were used to examine provider characteristics and satisfaction with the quality of information available.The multi-professional collaborative patterns that emerged revealed the simultaneous use of both synchronous and asynchronous communication methods. HIT was shown to play a major role in the coordination process. Centrality and centralization measures identified that there is no one particular professional group dominating communication and hierarchy metrics indicate a unidirectional communication flow with tiers of dominant providers filtering information to providers on the lower tiers. These patterns suggest that the coordination of patient care during a handoff is a complex process that is the domain of more than one professional group.Satisfaction with the quality of available information was higher for providers working in the ED compared to the admitting units. Verbal communication was preferred by most participants despite difficulties identifying or contacting providers in other units. This study provides a foundation for future research that examines how communication principles that reflect the needs of multiple providers can be incorporated into healthcare provider workflow and HIT design.
Type:
text; Electronic Dissertation
Keywords:
nursing; informatics; social network analysis; communication; interdisciplinary; collaboration
Degree Name:
PhD
Degree Level:
doctoral
Degree Program:
Nursing; Graduate College
Degree Grantor:
University of Arizona
Advisor:
Effken, Judith A.
Committee Chair:
Effken, Judith A.

Full metadata record

DC FieldValue Language
dc.language.isoENen_US
dc.titleThe Influence of Information Technology on Multi-professional Communication during a Patient Handoffen_US
dc.creatorBenham-Hutchins, Mary Margareten_US
dc.contributor.authorBenham-Hutchins, Mary Margareten_US
dc.date.issued2008en_US
dc.publisherThe University of Arizona.en_US
dc.rightsCopyright © is held by the author. Digital access to this material is made possible by the University Libraries, University of Arizona. Further transmission, reproduction or presentation (such as public display or performance) of protected items is prohibited except with permission of the author.en_US
dc.description.abstractLittle is known about the communication principles necessary for the design and implementation of health information technology (HIT) that supports the needs of healthcare providers from multiple professions. The purpose of this descriptive, exploratory research was to examine the patterns and methods of communication used by nurses, physicians, social workers, respiratory therapists, and pharmacists to share patient information during a patient handoff between units. The principles of complexity science were used as a theoretical framework and an original model of the healthcare organization consisting of embedded complex adaptive systems is presented.Five patient handoffs from the emergency department to participating inpatient units were included in the study. Providers responsible for the care of patients during the designated handoffs were identified through observation and snowball sampling and asked to complete a survey asking whom they communicated with and how. Social Network Analysis was used to map, analyze, and compare the communication patterns used by healthcare providers. Inferential statistics and thematic content analysis were used to examine provider characteristics and satisfaction with the quality of information available.The multi-professional collaborative patterns that emerged revealed the simultaneous use of both synchronous and asynchronous communication methods. HIT was shown to play a major role in the coordination process. Centrality and centralization measures identified that there is no one particular professional group dominating communication and hierarchy metrics indicate a unidirectional communication flow with tiers of dominant providers filtering information to providers on the lower tiers. These patterns suggest that the coordination of patient care during a handoff is a complex process that is the domain of more than one professional group.Satisfaction with the quality of available information was higher for providers working in the ED compared to the admitting units. Verbal communication was preferred by most participants despite difficulties identifying or contacting providers in other units. This study provides a foundation for future research that examines how communication principles that reflect the needs of multiple providers can be incorporated into healthcare provider workflow and HIT design.en_US
dc.typetexten_US
dc.typeElectronic Dissertationen_US
dc.subjectnursingen_US
dc.subjectinformaticsen_US
dc.subjectsocial network analysisen_US
dc.subjectcommunicationen_US
dc.subjectinterdisciplinaryen_US
dc.subjectcollaborationen_US
thesis.degree.namePhDen_US
thesis.degree.leveldoctoralen_US
thesis.degree.disciplineNursingen_US
thesis.degree.disciplineGraduate Collegeen_US
thesis.degree.grantorUniversity of Arizonaen_US
dc.contributor.advisorEffken, Judith A.en_US
dc.contributor.chairEffken, Judith A.en_US
dc.contributor.committeememberVerran, Joyce A.en_US
dc.contributor.committeememberReed, Pamela G.en_US
dc.contributor.committeememberMcEwan, Marylyn M.en_US
dc.identifier.proquest2622en_US
dc.identifier.oclc659749608en_US
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