Hospital Communications - Need for a New Theoretical Approach
-
Upload
arunkeepan -
Category
Documents
-
view
231 -
download
2
description
Transcript of Hospital Communications - Need for a New Theoretical Approach
![Page 1: Hospital Communications - Need for a New Theoretical Approach](https://reader036.fdocuments.in/reader036/viewer/2022070312/553a9b674a7959d8258b4597/html5/thumbnails/1.jpg)
1
SUMMARIZING THE THEORETICAL FOUNDATION FOR HOSPITAL COMMUNICATION RESEARCH
Arun Keepanasseril
![Page 2: Hospital Communications - Need for a New Theoretical Approach](https://reader036.fdocuments.in/reader036/viewer/2022070312/553a9b674a7959d8258b4597/html5/thumbnails/2.jpg)
2
![Page 3: Hospital Communications - Need for a New Theoretical Approach](https://reader036.fdocuments.in/reader036/viewer/2022070312/553a9b674a7959d8258b4597/html5/thumbnails/3.jpg)
3
![Page 4: Hospital Communications - Need for a New Theoretical Approach](https://reader036.fdocuments.in/reader036/viewer/2022070312/553a9b674a7959d8258b4597/html5/thumbnails/4.jpg)
4
Trivial mistakes may trigger large accidents
![Page 5: Hospital Communications - Need for a New Theoretical Approach](https://reader036.fdocuments.in/reader036/viewer/2022070312/553a9b674a7959d8258b4597/html5/thumbnails/5.jpg)
5
Thomas Farrinor-the Careless Baker
![Page 6: Hospital Communications - Need for a New Theoretical Approach](https://reader036.fdocuments.in/reader036/viewer/2022070312/553a9b674a7959d8258b4597/html5/thumbnails/6.jpg)
6
Accidents are multifactorial in origin
Common factor - Failure to communicate
![Page 7: Hospital Communications - Need for a New Theoretical Approach](https://reader036.fdocuments.in/reader036/viewer/2022070312/553a9b674a7959d8258b4597/html5/thumbnails/7.jpg)
7
Dangerous hospitals
![Page 8: Hospital Communications - Need for a New Theoretical Approach](https://reader036.fdocuments.in/reader036/viewer/2022070312/553a9b674a7959d8258b4597/html5/thumbnails/8.jpg)
8
Medical Error Data
•Harvard Medical Practice Studies - I and II -“there is a substantial amount of injury to patients from medical management”
•Utah & Colorado studies -1992Brennan TA, Leape LL, Laird N et al. Incidence of adverse events and negligence in hospitalized patients: results of the Harvard Medical Practice Study I. Qual Saf Health Care.
2004;13(2):145-151.
![Page 9: Hospital Communications - Need for a New Theoretical Approach](https://reader036.fdocuments.in/reader036/viewer/2022070312/553a9b674a7959d8258b4597/html5/thumbnails/9.jpg)
9
IOM Report
•“Healthcare in United States is not as safe as it should be and can be”
•‘44000-98000’ deaths- often repeated data.
Institute Of Medicine. To Err Is Human: Building a Safer Health System. National Academies Press. 1999;1-312.
![Page 10: Hospital Communications - Need for a New Theoretical Approach](https://reader036.fdocuments.in/reader036/viewer/2022070312/553a9b674a7959d8258b4597/html5/thumbnails/10.jpg)
10
Canadian Data
•AE in 7.5% of all hospital admissions.
•36% preventable.
Baker GR, Norton PG, Flintoft V et al. The Canadian Adverse Events Study: the incidence of adverse events among hospital patients in Canada. CMAJ . 2004;170(11):1678-1686.
![Page 11: Hospital Communications - Need for a New Theoretical Approach](https://reader036.fdocuments.in/reader036/viewer/2022070312/553a9b674a7959d8258b4597/html5/thumbnails/11.jpg)
11
Canadian Data
•‘9250-23750’ preventable deaths
![Page 12: Hospital Communications - Need for a New Theoretical Approach](https://reader036.fdocuments.in/reader036/viewer/2022070312/553a9b674a7959d8258b4597/html5/thumbnails/12.jpg)
12
Medication Management Ford CD, Killebrew J, Fugitt P, Jacobsen J, Prystas EM. Study of medication errors on a community hospital oncology ward. J Oncol Pract.
2006;2(4):149-154.
![Page 13: Hospital Communications - Need for a New Theoretical Approach](https://reader036.fdocuments.in/reader036/viewer/2022070312/553a9b674a7959d8258b4597/html5/thumbnails/13.jpg)
13
Handover / HandoffKripalani S. What have we learned about safe hand overs? Web M&M. 2011.
Joint Commission. Sentinel Event Data-Root Causes by Event Type 2004-Fourth Quarter 2010. 2011.
![Page 14: Hospital Communications - Need for a New Theoretical Approach](https://reader036.fdocuments.in/reader036/viewer/2022070312/553a9b674a7959d8258b4597/html5/thumbnails/14.jpg)
14
The Response
•Training - Six Sigma, CRM,SBAR.
•Technology - Cell phones, pagers, smart phones, tablet computers,EMR.
![Page 15: Hospital Communications - Need for a New Theoretical Approach](https://reader036.fdocuments.in/reader036/viewer/2022070312/553a9b674a7959d8258b4597/html5/thumbnails/15.jpg)
15
Statistical Summary of Commercial Jet Airplane Accidents 1959-2011.Available at http://www.boeing.com/news/techissues/pdf/statsum.pdf
![Page 16: Hospital Communications - Need for a New Theoretical Approach](https://reader036.fdocuments.in/reader036/viewer/2022070312/553a9b674a7959d8258b4597/html5/thumbnails/16.jpg)
16
Aim• Collect communication theories, models, frameworks that
have been used in basic science and applied science domains such as cognitive psychology, human factors engineering, organizational behavior, sociology, and communication sciences as well as other HROs like aviation, nuclear power generation and defense that may be applied to healthcare.
• Summarize the knowledge determined in the first 2 objectives and make suggestions for future research in inter professional hospital communication using ICTs.
• To conduct a case study of a reported instance of faulty communication in a hospital in the light of the theories and models contained in this review.1
6
![Page 17: Hospital Communications - Need for a New Theoretical Approach](https://reader036.fdocuments.in/reader036/viewer/2022070312/553a9b674a7959d8258b4597/html5/thumbnails/17.jpg)
17
Methods
•Scoping review.
•Most effective when a highly specific body of literature does not exist.
Danielle L, Heather Colquhoun Kelly K O'Brien. Scoping studies: advancing the methodology. Implement Sci. 2010;5:69.
![Page 18: Hospital Communications - Need for a New Theoretical Approach](https://reader036.fdocuments.in/reader036/viewer/2022070312/553a9b674a7959d8258b4597/html5/thumbnails/18.jpg)
18
Search Diagram
![Page 19: Hospital Communications - Need for a New Theoretical Approach](https://reader036.fdocuments.in/reader036/viewer/2022070312/553a9b674a7959d8258b4597/html5/thumbnails/19.jpg)
19
List of Databases Systematically Searched
![Page 20: Hospital Communications - Need for a New Theoretical Approach](https://reader036.fdocuments.in/reader036/viewer/2022070312/553a9b674a7959d8258b4597/html5/thumbnails/20.jpg)
20
•Ovid MEDLINE (1948-2011 Oct)
•EMBASE
•Psycarticles (1806- Oct 2011)
•OVID Health and Psychosocial Instruments
•IEEE
•Engineering Village
•CINAHL
•Business Source Complete
•Military and Intelligence database20
![Page 21: Hospital Communications - Need for a New Theoretical Approach](https://reader036.fdocuments.in/reader036/viewer/2022070312/553a9b674a7959d8258b4597/html5/thumbnails/21.jpg)
21
List of Databases and Sources Hand Searched
![Page 22: Hospital Communications - Need for a New Theoretical Approach](https://reader036.fdocuments.in/reader036/viewer/2022070312/553a9b674a7959d8258b4597/html5/thumbnails/22.jpg)
22
•Scholar's Portal
•Business Source Complete
•The International Journal of Aviation Psychology
•Google Scholar
•Proquest
•International Journal of Human-Computer Interaction
•Tayler and Francis
•Science Direct
•OVID Health and Psychosocial Instruments
•Cognitive Systems Research
•Leadership in Health Services
•ACM Special interest group - HCI
•Computer Supported Cooperative Work
•Cognition, Technology & Work
•Journal of Loss Prevention
•Computers in Human Behavior
•Social Science & Medicine
•Human Resource Management Review
•International Emergency Nursing
•Nursing Times Research
•Journal of Communication Management
•International Journal of Nursing Studies
•Campus-Wide Information Systems
•Journal of Managerial Psychology
•Wilson Web
•Corporate Communications: An International Journal
•Journal of Clinical Psychology in Medical Settings.
•Multicultural Education & Technology Journal
•International Journal of Operations & Production Management
•Business Process Management Journal
22
![Page 23: Hospital Communications - Need for a New Theoretical Approach](https://reader036.fdocuments.in/reader036/viewer/2022070312/553a9b674a7959d8258b4597/html5/thumbnails/23.jpg)
23
List of Theories Identified in the Review
![Page 24: Hospital Communications - Need for a New Theoretical Approach](https://reader036.fdocuments.in/reader036/viewer/2022070312/553a9b674a7959d8258b4597/html5/thumbnails/24.jpg)
24
•Information theory
•Systems theory
•Socio-technical theory
•Taylor’s theory of organizational communication
•Humanistic communication theory
•Communication accommodation theory
•Convergence theory
•Network theory
•Likert’s four system’s theory
•Uncertainty reduction theory
•Wicked problems theory
•Task artifact cycle
•Chaos theory
•Risk communication theory
![Page 25: Hospital Communications - Need for a New Theoretical Approach](https://reader036.fdocuments.in/reader036/viewer/2022070312/553a9b674a7959d8258b4597/html5/thumbnails/25.jpg)
25
List of Models Identified in the Review
![Page 26: Hospital Communications - Need for a New Theoretical Approach](https://reader036.fdocuments.in/reader036/viewer/2022070312/553a9b674a7959d8258b4597/html5/thumbnails/26.jpg)
26
•Limited capacity model
•Wicken’s staged model
•Socio-technical theory
•Shannon – Weaver’s model
•Linear model
•Mechanical model
•Psychological model
•Interactional and Transactional model
•Systemic interaction model
•Uncertainty reduction theory
•Schein’s cultural model
•Andersch, Staats and Bostom model26
![Page 27: Hospital Communications - Need for a New Theoretical Approach](https://reader036.fdocuments.in/reader036/viewer/2022070312/553a9b674a7959d8258b4597/html5/thumbnails/27.jpg)
27
List of Methods for Communication Analysis Identified in the Review
![Page 28: Hospital Communications - Need for a New Theoretical Approach](https://reader036.fdocuments.in/reader036/viewer/2022070312/553a9b674a7959d8258b4597/html5/thumbnails/28.jpg)
28
•Cognitive work analysis
•Computer-based linguistic method of text analysis
•Sentence completeness analysis method
•Social network analysis
•Communication And Teamwork Skills Assessment
•C3TRACE (Command, Control, and Communication Techniques for Reliable Assessment
•Case based reasoning (CBR)
•Cognitive archeology
•CREAM-based communication error analysis method (CEAM) communication
![Page 29: Hospital Communications - Need for a New Theoretical Approach](https://reader036.fdocuments.in/reader036/viewer/2022070312/553a9b674a7959d8258b4597/html5/thumbnails/29.jpg)
29
Case study
![Page 30: Hospital Communications - Need for a New Theoretical Approach](https://reader036.fdocuments.in/reader036/viewer/2022070312/553a9b674a7959d8258b4597/html5/thumbnails/30.jpg)
30
•A 20-month-old boy in ICU following a Fontan surgical procedure.
•Respiratory distress in the first post op evening
•On call ICU attending .
•Surgeon orders ECG
•ECG result communicated to surgeon(admitting doc).
•RP communicates with ICU-A for rest of night.
•Child suffers cardiac arrest in the morning, dies.
![Page 31: Hospital Communications - Need for a New Theoretical Approach](https://reader036.fdocuments.in/reader036/viewer/2022070312/553a9b674a7959d8258b4597/html5/thumbnails/31.jpg)
31
•Solo vs Teamwork
•Team composition.
•Goal-Exemplary care delivery [within the confines].
•Caring for patients with multiple conditions is a complex process
•Diverse and large quantity of data
Initial considerations
![Page 32: Hospital Communications - Need for a New Theoretical Approach](https://reader036.fdocuments.in/reader036/viewer/2022070312/553a9b674a7959d8258b4597/html5/thumbnails/32.jpg)
32
System Theory Considerations
•Hospital - System
•Diff units - Sub systems.
•Objects and attributes.
•Interrelationships.
•Need to clearly identify the anchoring unit.
![Page 33: Hospital Communications - Need for a New Theoretical Approach](https://reader036.fdocuments.in/reader036/viewer/2022070312/553a9b674a7959d8258b4597/html5/thumbnails/33.jpg)
33
System theory considerationscontd
•Loss of clarity of anchor role in the case.
•lack of awareness of how to ensure effective team communication when multiple attending physicians were involved in caring for the child.
![Page 34: Hospital Communications - Need for a New Theoretical Approach](https://reader036.fdocuments.in/reader036/viewer/2022070312/553a9b674a7959d8258b4597/html5/thumbnails/34.jpg)
34
Information theory
•Information about the child’s condition was present in the system but was not transmitted to all concerned.
•High entropy.
![Page 35: Hospital Communications - Need for a New Theoretical Approach](https://reader036.fdocuments.in/reader036/viewer/2022070312/553a9b674a7959d8258b4597/html5/thumbnails/35.jpg)
35
Network Theory
•Absolute Vs Distributed information.
•Failure of distribution policy.
![Page 36: Hospital Communications - Need for a New Theoretical Approach](https://reader036.fdocuments.in/reader036/viewer/2022070312/553a9b674a7959d8258b4597/html5/thumbnails/36.jpg)
36
Convergence Theory, Cultural Model
•Collision b/w artifacts, behaviors, and espoused values of each each group of professionals.
•High level of convergence
![Page 37: Hospital Communications - Need for a New Theoretical Approach](https://reader036.fdocuments.in/reader036/viewer/2022070312/553a9b674a7959d8258b4597/html5/thumbnails/37.jpg)
37
•H-H-S Framework.
Proposed Analysis
![Page 38: Hospital Communications - Need for a New Theoretical Approach](https://reader036.fdocuments.in/reader036/viewer/2022070312/553a9b674a7959d8258b4597/html5/thumbnails/38.jpg)
38
H-H-S Framework
•Extends the conventional framework for human–human communication analysis to include the information processed by the technical system.
•Analyze team communication in depth, including the ‘shifting’ phenomenon that results from system information processing.
![Page 39: Hospital Communications - Need for a New Theoretical Approach](https://reader036.fdocuments.in/reader036/viewer/2022070312/553a9b674a7959d8258b4597/html5/thumbnails/39.jpg)
39
Information flow pattern A
![Page 40: Hospital Communications - Need for a New Theoretical Approach](https://reader036.fdocuments.in/reader036/viewer/2022070312/553a9b674a7959d8258b4597/html5/thumbnails/40.jpg)
40
Information pattern B
![Page 41: Hospital Communications - Need for a New Theoretical Approach](https://reader036.fdocuments.in/reader036/viewer/2022070312/553a9b674a7959d8258b4597/html5/thumbnails/41.jpg)
41
Steps in analysis
•Creating chronology of events
•Creating transcript of conversation b/w team members.
•Creating info flow diagram
•HHS tool
![Page 42: Hospital Communications - Need for a New Theoretical Approach](https://reader036.fdocuments.in/reader036/viewer/2022070312/553a9b674a7959d8258b4597/html5/thumbnails/42.jpg)
![Page 43: Hospital Communications - Need for a New Theoretical Approach](https://reader036.fdocuments.in/reader036/viewer/2022070312/553a9b674a7959d8258b4597/html5/thumbnails/43.jpg)
![Page 44: Hospital Communications - Need for a New Theoretical Approach](https://reader036.fdocuments.in/reader036/viewer/2022070312/553a9b674a7959d8258b4597/html5/thumbnails/44.jpg)
![Page 45: Hospital Communications - Need for a New Theoretical Approach](https://reader036.fdocuments.in/reader036/viewer/2022070312/553a9b674a7959d8258b4597/html5/thumbnails/45.jpg)
![Page 46: Hospital Communications - Need for a New Theoretical Approach](https://reader036.fdocuments.in/reader036/viewer/2022070312/553a9b674a7959d8258b4597/html5/thumbnails/46.jpg)
![Page 47: Hospital Communications - Need for a New Theoretical Approach](https://reader036.fdocuments.in/reader036/viewer/2022070312/553a9b674a7959d8258b4597/html5/thumbnails/47.jpg)
![Page 48: Hospital Communications - Need for a New Theoretical Approach](https://reader036.fdocuments.in/reader036/viewer/2022070312/553a9b674a7959d8258b4597/html5/thumbnails/48.jpg)
![Page 49: Hospital Communications - Need for a New Theoretical Approach](https://reader036.fdocuments.in/reader036/viewer/2022070312/553a9b674a7959d8258b4597/html5/thumbnails/49.jpg)
![Page 50: Hospital Communications - Need for a New Theoretical Approach](https://reader036.fdocuments.in/reader036/viewer/2022070312/553a9b674a7959d8258b4597/html5/thumbnails/50.jpg)
![Page 51: Hospital Communications - Need for a New Theoretical Approach](https://reader036.fdocuments.in/reader036/viewer/2022070312/553a9b674a7959d8258b4597/html5/thumbnails/51.jpg)
![Page 52: Hospital Communications - Need for a New Theoretical Approach](https://reader036.fdocuments.in/reader036/viewer/2022070312/553a9b674a7959d8258b4597/html5/thumbnails/52.jpg)
![Page 53: Hospital Communications - Need for a New Theoretical Approach](https://reader036.fdocuments.in/reader036/viewer/2022070312/553a9b674a7959d8258b4597/html5/thumbnails/53.jpg)
![Page 54: Hospital Communications - Need for a New Theoretical Approach](https://reader036.fdocuments.in/reader036/viewer/2022070312/553a9b674a7959d8258b4597/html5/thumbnails/54.jpg)
![Page 55: Hospital Communications - Need for a New Theoretical Approach](https://reader036.fdocuments.in/reader036/viewer/2022070312/553a9b674a7959d8258b4597/html5/thumbnails/55.jpg)
![Page 56: Hospital Communications - Need for a New Theoretical Approach](https://reader036.fdocuments.in/reader036/viewer/2022070312/553a9b674a7959d8258b4597/html5/thumbnails/56.jpg)
Resident 1Resident 1
Cardiology Cardiology FellowFellow Nurse 1Nurse 1
Nurse 1INurse 1I
SurgeonSurgeon
ICU ICU attendingattending
![Page 57: Hospital Communications - Need for a New Theoretical Approach](https://reader036.fdocuments.in/reader036/viewer/2022070312/553a9b674a7959d8258b4597/html5/thumbnails/57.jpg)
57
Cardiology Cardiology FellowFellow Nurse 1Nurse 1
Nurse 1INurse 1I
SurgeonSurgeon
ICU ICU attendingattendingResident 1Resident 1
EMEMRR
![Page 58: Hospital Communications - Need for a New Theoretical Approach](https://reader036.fdocuments.in/reader036/viewer/2022070312/553a9b674a7959d8258b4597/html5/thumbnails/58.jpg)
58
![Page 59: Hospital Communications - Need for a New Theoretical Approach](https://reader036.fdocuments.in/reader036/viewer/2022070312/553a9b674a7959d8258b4597/html5/thumbnails/59.jpg)
59
Conclusion•Adopt theories and models to hospital
communication research, modifying existing theories and models to suit the unique requirements of hospitals or by developing a strategy to design them de-novo.
•Identified 14 theories, 12 models and 12 communication analysis methods.
•Needs to ascertain their application in healthcare