A Qualitative Analysis of Shift Handoff Communication Practices Among Tele-ICU Clnicians.

Interprofessional Training and Communication Practices Among Clinicians in the Postoperative ICU Handoff

Hospitals have struggled for years regarding the handoff process of communicating patient information from one health care professional to another. Ineffective handoff communication is recognized as a serious patient safety risk within the health care community. It is essential to take communication into consideration when examining the safety of neonates who require immediate medical attention after birth; effective communication is vital for positive patient outcomes, especially with neonates in a delivery room setting. Teamwork and effective communication across the health care continuum are essential for providing efficient, quality care that leads to favorable patient outcomes. Interprofessional simulation and team training can benefit health care professionals by improving interprofessional competence, defined as one’s knowledge of other professionals including an understanding of their training and skillsets, and role clarity. Interprofessional teams that include members with specialization in obstetrics, gynecology, and neonatology have the potential to considerably benefit from training effective handoff and communication practices that would ensure the safety of the neonate upon birth. We must strive to provide the most comprehensive systematic, standardized, interprofessional handoff communication training sessions for such teams, through Graduate Medical Education and Continuing Medical Education that will meet the needs across the educational continuum.

Measuring content overlap during handoff communication using distributional semantics: An exploratory study

In the context of the Austrian Periodic Health Examination and on the basis of current evidence based medicine a systematic screening for prostate-specific antigen (PSA) is inadvisable. General practitioners (GPs) are expected to inform their patients about risks and benefits of screening before undergoing a PSA test. Ideally, this information corresponds to the model of informed decision making (IDM).The aim of this qualitative pilot-study is to explore factors, which gain insight into GPs' practice of counselling about the PSA test. This qualitative pilot study involves 5 focus groups with 30 GPs and 4 internists and in-depth interviews with 8 GPs. Both the discussions and the interviews were audio-taped, transcribed verbatim, and qualitatively analysed. Data were analysed by using typological analysis and qualitative content analysis as methodological approaches and by means of the software MAXqda. The results of the in-depth interviews show 2 groups of GPs which can be classified by frequency of performing a PSA test: (i) routine screeners, who recommend PSA testing to all patients of 50 years and older, and (ii) non-routine screeners, who inform the patients only if they formally wish it. In-depth interviews as well as focus groups reveal that risks and adverse effects are rarely reported in GP counselling. More often they discuss the potential benefit of the testing. They regard balanced information as unacceptable for both the GP and the patient. Influencing factors concerning the patient (cognitive and emotional demand, preference of the authoritarian doctor, discouraging), factors concerning the GP (own belief in the efficacy of PSA screening, lack of knowledge) and structural factors (lack of time, lack of remuneration) were detected. The results indicate a selective presentation of aspects of screening for prostate cancer within the GP practice of counselling, which seem to overvalue the benefits of the screening and undervalue the associated risks of the PSA test. It should be made clear that the aim - the implementation of informed decision making (IDM) within the context of counselling about PSA test - within the Austrian Periodic Health Examination has not yet been put into practice. Results show that it is necessary to improve GPs' practice of communication, for example, by integrating IDM into the context of GPs' continuous training.

Software Crowdsourcing (SW CS) is an emerging area in Software Engineering (SE). It has a dynamic nature in which problems are opened up to crowds of people through an open call to solve problems with the incentive of prizes for the best solutions. Although SW CS has been increasingly adopted in the software industry, many open issues are still to be elucidated. For instance, collaboration aspects are one of those issues. They impact communication and coordination practices. This study aims to identify barriers to collaboration in SW CS and communication practices that might help overcome these barriers. We identified the barriers and practices from a qualitative data analysis study considering an available literature review report. Our study contributes to the SE area by providing insights for researchers, tool designers, and managers that might help them to better understand collaboration issues and proposed solutions to solve them.

Public health threats (PHTs) influence how and in what ways managers communicate with employees. Employee resources and information during uncertain times has been noted as a reoccurring gap, especially as it relates to personal protective equipment (PPE). This study explored general and PPE-specific communication practices with 22 healthcare and emergency medical service (EMS) managers to support workers, particularly in the context of preparedness and response. Data collection occurred in two phases that involved interviews and small group discussions to identify, examine, and better frame and execute communication practices. Qualitative analysis was informed by the 4i FACT framework and the social ecological model (SEM) to identify relevant communication practices and intervention points within health delivery settings. Results elucidated perceived, effective leadership practices and interpersonal influences in the workplace. Tangible leadership communication practices were identified as important intervention points within the SEM, with a focus on proactive behaviors to procure necessary PPE and disseminate information. Participants emphasized one-on-one interactions with employees, and the use of trusted messengers to share health-related messages. They also highlighted the challenges of PPE shortages and the importance of access to resources across different job roles, organizations, and work settings. This study contributes insights into communication practices during a public health emergency, offering a nuanced understanding of managerial approaches, PPE-related communication, and the broader contextual factors influencing information dissemination. Further, the integration of frameworks like 4i FACT and SEM provides a structured perspective for future communication strategies, supporting tailored approaches across organizations.

Ineffective communication is the most frequently reported cause of sentinel events in U.S. hospitals. Examining hospital processes and systems of communication, and standardizing communication practices can reduce the risks to patients in the acute care environment. The purpose of this paper is to describe the use of an innovative, translating-research-into-practice model to generate and test a cost-effective, easy to use, best-practice protocol for nurse-to-nurse shift handoffs in a medium-sized magnet-designated community hospital in the United States. Roger's Diffusion of Innovations Theory was used as the overall framework for the translational model with Orlando's theory providing theoretical evidence for the best practice protocol. Using the first three steps of the model, methods included: (1) identifying clinical problems related to shift handoffs; (2) appraising and systematically evaluating the strength of theoretical, empirical, and clinical evidence; and (3) translating this evidence into a best-practice patient-centered, standardized protocol for nurse-to-nurse shift handoffs. Meaningful clinician participation in the development of a standardized, evidence-based, patient-centered approach to nurses' change-of-shift handoffs was achieved. Using the Collaborative Research Utilization Model can facilitate the integration of new knowledge both in the clinical and academic community.

A clinical shift handoff can be considered as a three-phase process, consisting of pre-handoff, handoff communication, and post-handoff. The majority of studies on clinical handoffs focused on the handoff communication. There is limited literature on how pre-handoff and post-handoff activities are conducted. This study aims to understand the handoff practice in a public hospital in Singapore from the three-phase process’ point of view, to identify potential problems that may occur in such a setting, and to discuss potential interventions to enhance clinical shift handoffs.

Sustainability of an Operating Room to Pediatric Postanesthesia Care Unit Handoff Tool

Deliberate practice of nurse handoff using simulation: A multi-site study.

This study employs the co-cultural theory of Mark Orbe to explore how women in Pakistani television drama Sinf-e-Ahan utilised various communication strategies. It employs qualitative content analysis to analyse how female characters, as representatives of co-culture group members in the drama, negotiate their status through communication and use various communication approaches, such as assimilation, accommodation, and separation, to achieve their preferred goals. The study has analysed the female characters of Sinf-e-Ahan and explored 23 episodes of the drama to extract specific dialogues and scenes, in which female characters use communication strategically as a response to conservative norms, societal oppression, and marginalisation due to the dominant group in society. Moreover, the research has focused on the dialogues and scenes of the drama for a co-cultural communicative analysis of the communicative experiences and practices of female characters in the dearth research has focused on the dialogues and scenes of the drama, for a co-cultural communicative analysis. The findings of the study reveal that the female characters in the drama, as representatives of cultural groups, employ nine distinct communication orientations and various communication practices in their encounters with the dominant group. This study concludes that despite their limited power, they use communication strategically as a response to the conservative norms of society and to achieve their preferred goals.

To identify the perceptions of emergency physicians (EPs) and hospitalists regarding interservice handoff communication as patients are transferred from the emergency department to the inpatient setting. Investigators conducted individual interviews with 12 physicians (six EPs and six hospitalists). Data evaluation consisted of using the steps of constant comparative, thematic analysis. Physicians perceived handoff communication as a gray zone characterized by ambiguity about patients' conditions and treatment. Two major themes emerged regarding the handoff gray zone. The first theme, poor communication practices and conflicting communication expectations, presented barriers that exacerbated physicians' information ambiguity. Specifically, handoffs consisting of insufficient information, incomplete data, omissions, and faulty information flow exacerbated gray zone problems and may negatively affect patient outcomes. EPs and hospitalists had different expectations about handoffs, and those expectations influenced their interactions in ways that may result in communication breakdowns. The second theme illustrated how poor handoff communication contributes to boarding-related patient safety threats for boarders and emergency department patients alike. Those interviewed talked about the systemic failures that lead to patient boarding and how poor handoffs exacerbated system flaws. Handoffs between EPs and hospitalists both reflect and contribute to the ambiguity inherent in emergency medicine. Poor handoffs, consisting of faulty communication behaviors and conflicting expectations for information, contribute to patient boarding conditions that can pose safety threats. Pragmatic conclusions are drawn regarding physician-physician communication in patient transfers, and recommendations are offered for medical education.

This article draws on the researcher’s training and experience as a certified intimacy coordinator to examine how labour from professional sex work to intimacy coordination necessitates nuanced approaches to consent. What I call consent work – practices of communication, negotiation, and boundary setting – supports bodily autonomy while guiding portrayals of intimacy and nudity in film, television, theatre, and erotic media. I begin by discussing intimacy coordinators’ communication and consent frameworks to create context for my ensuing investigation. Next, utilizing data from interviews with online sex workers, I explore their sophisticated personal and community-oriented harm reduction techniques that, without formal training, dovetail with those in the intimacy coordination industry. Continuing my qualitative analysis, I describe the ways in which my interlocutors’ use of knowledge from consensual BDSM reflects the breadth of practices that inform consent work while illuminating the links between kink and intimacy coordination. Finally, I unpack how consent models remain entangled within systems of inequality and exclusion while owing much to marginalized communities’ contributions to contemporary understandings of bodily autonomy. Overall, consent work and its capacious lineage contribute to the expanding literature on intimacy coordination and highlight the field’s under-researched intersections with adult content creation.

Providing care to cancer patients parenting minor children: A qualitative study on healthcare professionals' communication practice.

BackgroundEmergency department (ED) shift handoffs are potential sources of delay in care. We aimed to determine the impact that using standardized reporting tool and process may have on throughput metrics for patients undergoing a transition of care at shift change.MethodsWe performed a prospective, pre- and post-intervention quality improvement study from September 1 to November 30, 2015. A handoff procedure intervention, including a mandatory workshop and personnel training on a standard reporting system template, was implemented. The primary endpoint was patient length of stay (LOS). A comparative analysis of differences between patient LOS and various handoff communication methods were assessed pre- and post-intervention. Communication methods were entered a multivariable logistic regression model independently as risk factors for patient LOS.ResultsThe final analysis included 1,006 patients, with 327 comprising the pre-intervention and 679 comprising the post-intervention populations. Bedside rounding occurred 45% of the time without a standard reporting during pre-intervention and increased to 85% of the time with the use of a standard reporting system in the post-intervention period (P < 0.001). Provider time (provider-initiated care to patient care completed) in the pre-intervention period averaged 297 min, but decreased to 265 min in the post-intervention period (P < 0.001). After adjusting for other communication methods, the use of a standard reporting system during handoff was associated with shortened ED LOS (OR = 0.60, 95% CI 0.40 - 0.90, P < 0.05).ConclusionsStandard reporting system use during emergency physician handoffs at shift change improves ED throughput efficiency and is associated with shorter ED LOS.