Effective Communication Processes Research Articles

The safety at home study: an evidence base for policy and practice change.

This paper explores the policies and practices that are needed to improve the safety of home care in light of the most recent evidence about home care safety in Canada. Four areas for policy and practice change are addressed: 1) the promotion of effective communication processes in home care through cross-sector collaboration, case management and technology innovations; 2) screening for safety risk factors; 3) standardizing care processes, packaging and equipment; and 4) supporting family/caregivers and strengthening clients' ability to engage in therapeutic self-care. Evidence-based strategies for change are presented within the context of the evidence about home care safety issues.

The Anatomy of Primary Care and Mental Health Clinician Communication: A Quality Improvement Case Study

The high prevalence of comorbid physical and mental illnesses among veterans is well known. Therefore, ensuring effective communication between primary care (PC) and mental health (MH) clinicians in the Veterans Affairs (VA) health care system is essential. The VA's Patient Aligned Care Teams (PACT) initiative has further raised awareness of the need for communication between PC and MH. Improving such communication, however, has proven challenging. To qualitatively understand barriers to PC-MH communication in an academic community-based clinic by using continuous quality improvement (CQI) tools and then initiate a change strategy. An interdisciplinary quality improvement (QI) work group composed of 11 on-site PC and MH providers, administrators, and researchers identified communication barriers and facilitators using fishbone diagrams and process flow maps. The work group then verified and provided context for the diagram and flow maps through medical record review (32 patients who received both PC and MH care), interviews (6 stakeholders), and reports from four previously completed focus groups. Based on these findings and a previous systematic review of interventions to improve interspecialty communication, the team initiated plans for improvement. Key communication barriers included lack of effective standardized communication processes, practice style differences, and inadequate PC training in MH. Clinicians often accessed advice or formal consultation based on pre-existing across-discipline personal relationships. The work group identified collocated collaborative care, joint care planning, and joint case conferences as feasible, evidence-based interventions for improving communication. CQI tools enabled providers to systematically assess local communication barriers and facilitators and engaged stakeholders in developing possible solutions. A locally tailored CQI process focusing on communication helped initiate change strategies and ongoing improvement efforts.

Strategic alliances in higher education in Ecuador: the challenge of knowledge transfer and its effect on the learning curve

This paper examines the effect of knowledge transfer on the learning curve in higher education institutions involved in a strategic alliance. A qualitative inductive approach was used to analyze the case of a learning alliance between two higher education institutions. The authors found sufficient evidence, in the environment of universities in Ecuador, to support the idea that successful knowledge transfer processes between allied institutions have a positive effect on the learning curve of the institution that adopts the knowledge transferred in its initial stages. Furthermore, with the maturity of the relationship, this process of knowledge transfer becomes a two way exchange process that promotes the improvement of the institutions involved in the alliance. Key factors in the process of knowledge transfer are effective communication processes, social networks between institutions involved in alliance, motivation, absorptive capacity, rotating membership, and leadership of managers.

Board 526 - Technology Innovations Abstract Thoracotomy Task Trainer (Submission #501)

Introduction/Background Background: Simulation within the healthcare industry has become increasingly popular and has proven to be an effective tool1; however, it usually is associated with a high price tag.1,2 Thoracotomies are one of the most difficult surgeries to perform but are rare in occurrence and thus not performed frequently; therefore, skill level and self-efficacy tends to be low. A thoracotomy is an incision into the chest wall (i.e. thorax) and is performed in various situations including treatment or diagnosis of diseases, resuscitative, or emergency trauma to the chest.3 Practicing a thoracotomy in simulation often requires the use of either a cadaver or a fresh thorax, which is expensive, time consuming, and requires multiple stipulations (i.e. a room with proper ventilation, privacy regulations, transport laws, etc.). The creation of a Thoracotomy task trainer would eliminate these issues, be cost effective, and offer frequent training of a skill rarely practiced. Methods Objectives: Increase skill level and self-efficacy with residents;
Decrease the cost of training for thoracotomies; Create a low cost, reusable, mobile task trainer to increase competency; Develop effective communication between hospital staff during the procedure.

Methods: After developing and coordinating a previous thoracotomy training with over 40 general surgery residents and measuring outcomes, it was determined that although more costly than using a cadaver (approx. $2000), a fresh human thorax (approx. $5000) would be more beneficial, secondary to it being more realistic. Both the cadaver and thorax offer excellent training; consequently, they can only be used once. Additionally, feedback from residents who participated in past training indicated there was an obvious need for a cost effective, mobile, and reusable Thoracotomy task trainer. The cost to develop and construct the thoracotomy task trainer is approximately $200, while the cost to run one resident through the Thoracotomy task trainer is $5.

To do this, staff purchased (or find someone willing to donate) a used ALS SimMan by Laerdal)5 and carefully removed the mechanical parts from within the chest, making an open space. The idea is to then recreate a functioning chest wall with skin and ribs, as well as, a realistic substitute for a human heart; consisting of proper anatomy, fluid, and vasculature. Parts list included: ALS SimMan, cow ribs, pig pluck, IV and suction tubing, screws, zip ties, super glue, medium sized Tupperware to house pig pluck, zip lock bag, simulated blood, simulated human skin, and moulaged epigastric puncture wound. For training to be complete; a Thoracotomy Tray, pertinent medical instruments, and a subject matter expert are necessary. Results: Conclusion The thoracotomy task trainer is a cost effective, mobile, and reusable training tool. This innovative approach will allow each training center, hospital, healthcare facility the opportunity to build their own trainer, as well as, offering every resident the opportunity to perform this high stakes, low frequency procedure. Using this task trainer will amplify participants confidence, frequency of training, and skill level, while also helping to create an effective interdepartmental communication process throughout this procedure.5 All in all, the Thoracotomy task trainer is a low cost, highly efficient tool that can help save lives.

Smartphones as Multimodal Communication Devices to Facilitate Clinical Knowledge Processes: Randomized Controlled Trial

BackgroundDespite the widespread use and advancements of mobile technology that facilitate rich communication modes, there is little evidence demonstrating the value of smartphones for effective interclinician communication and knowledge processes.ObjectiveThe objective of this study was to determine the effects of different synchronous smartphone-based modes of communication, such as (1) speech only, (2) speech and images, and (3) speech, images, and image annotation (guided noticing) on the recall and transfer of visually and verbally represented medical knowledge.MethodsThe experiment was conducted from November 2011 to May 2012 at the University Hospital Basel (Switzerland) with 42 medical students in a master’s program. All participants analyzed a standardized case (a patient with a subcapital fracture of the fifth metacarpal bone) based on a radiological image, photographs of the hand, and textual descriptions, and were asked to consult a remote surgical specialist via a smartphone. Participants were randomly assigned to 3 experimental conditions/groups. In group 1, the specialist provided verbal explanations (speech only). In group 2, the specialist provided verbal explanations and displayed the radiological image and the photographs to the participants (speech and images). In group 3, the specialist provided verbal explanations, displayed the radiological image and the photographs, and annotated the radiological image by drawing structures/angle elements (speech, images, and image annotation). To assess knowledge recall, participants were asked to write brief summaries of the case (verbally represented knowledge) after the consultation and to re-analyze the diagnostic images (visually represented knowledge). To assess knowledge transfer, participants analyzed a similar case without specialist support.ResultsData analysis by ANOVA found that participants in groups 2 and 3 (images used) evaluated the support provided by the specialist as significantly more positive than group 1, the speech-only group (group 1: mean 4.08, SD 0.90; group 2: mean 4.73, SD 0.59; group 3: mean 4.93, SD 0.25; F 2,39=6.76, P=.003; partial η2=0.26, 1–β=.90). However, significant positive effects on the recall and transfer of visually represented medical knowledge were only observed when the smartphone-based communication involved the combination of speech, images, and image annotation (group 3). There were no significant positive effects on the recall and transfer of visually represented knowledge between group 1 (speech only) and group 2 (speech and images). No significant differences were observed between the groups regarding verbally represented medical knowledge.ConclusionsThe results show (1) the value of annotation functions for digital and mobile technology for interclinician communication and medical informatics, and (2) the use of guided noticing (the integration of speech, images, and image annotation) leads to significantly improved knowledge gains for visually represented knowledge. This is particularly valuable in situations involving complex visual subject matters, typical in clinical practice.

Competence-Based Communication Design in Factories

Purpose and problem. Today, business organisations are facing turbulent markets that are characterised by an increasing individualisation of products and customer specifications. This desire for individualisation leads to a growing number of complex tasks to fulfil requirements. Those tasks require very different competencies that exceed the competencies and the knowledge of a single person. As a result, many people within the company have to work together to meet the requirements of the market and the customer and to be able to react fast on changes. For that to happen, the employees need to exchange a lot of information efficiently. Additionally the need to communicate effectively increases while working together, so there has to be an environment that supports efficient and effective communication processes.

Explaining Successful Implementation of Logistics Information Technology (LIT): An empirical study

This paper aims to examine the factors influencing successful logistics information technology (LIT) among third-party logistics (3PL) service providers. Cross-sectional data from 136 Malaysian 3PL service providers were collected. Our findings indicate that the existence of technological capability, top management support, effective enterprise-wide communication and business process reengineering are pertinent. Nonetheless, the result demonstrate that firm size do not play a role in such initiative.

A Delphi Investigation into the Future of E-learning

The purpose of this study is to investigate the views and opinions of e-learning experts regarding the replacement of traditional education with e-learning settings and the advantages that the application of social and mobile technologies can bring to e- learning methods. The Delphi technique was chosen as a method of study. This technique is an efficient and effective group communication process designed to systematically elicit judgments from experts in their selected area of expertise. The 35 experts that participated in the study were asked to rate 16 statements according to what they think will probably happen (probability) and what they would like to see happen (desirability). Findings show that the majority of experts foresee as highly probable and highly desirable that the use of new technologies in e-learning will change current educational theories and methodologies and that e-learning instructors will have to acquire a new set of skills in order to succeed in the e-learning field. In addition, findings show that the majority of experts believe it is highly probable and highly desirable that social technologies may improve e-learning experience as they create an atmosphere of cooperation and easy interaction among users and that mobile technologies emphasize the convenience and flexibility of e-learning offered by the “anytime, anywhere” concept.

A Delphi investigation into future trends in e-learning in Israel

The purpose of this study is to investigate the views and opinions of e-learning experts regarding future trends in the e-learning arena. The Delphi technique was chosen as a method of study. This technique is an efficient and effective group communication process designed to systematically elicit judgments from experts in their selected area of expertise. The 35 experts who participated in this study were asked to rate 16 statements according to what they think will probably happen (probability) and what they would like to see happen (desirability). Findings show that participants believe that the use of new technologies will change current educational theories and methodologies and will have impact on instructor skills, effort, feedback, and interaction as well as on the process of learning assessment. Concerning the future of e-learning, participants view a future tendency toward the provision of full online degrees, yet they are skeptical, stating that the e-learning setting will not completely replace the frontal educational setting. Regarding the impact of social and mobile technologies on e-learning, experts seem to view the role of social and mobile technologies as facilitators in the transfer and sharing of information in e-learning settings.

Charting a course for collaboration: a multiteam perspective

The translation of medical research from bench-to-bedside often requires integrated input from multiple expert teams. These collectives can best be understood through the lens of multiteam systems theory. Team charters are a practical tool thought to facilitate team performance through the creation of explicit shared norms for behavior. We extend the current literature on team charters to the multiteam context and make three practical recommendations for multiteam charter content that could facilitate effective communication and leadership processes between teams.

Opportunities for improving risk communication during the permitting process for entomophagous biological control agents: a review of current systems

Concerns about potentially irreversible non-target impacts from the importation and release of entomophagous biological control agents (BCAs) have resulted in increasingly stringent national import requirements by National Plant Protection Organizations worldwide. However, there is a divergence of opinions among regulators, researchers, environmentalists, and the general public on ways to appropriately manage associated risks. Implementation of a comprehensive and effective risk communication process might narrow the opinion gaps. Results from a comprehensive survey conducted in the United States were used to describe communication habits of stakeholders involved in biological control and identify areas that are fundamental in an efficient process. In addition, this study critically reviews risk communication practices and how phytosanitary decisions are communicated in the permitting systems for entomophagous BCAs of several countries to identify risk communication tools used in an effective risk communication framework. The following barriers to efficient risk communication were identified: absence of a formalized risk communication process, undefined risk communication goals and target audiences, lack of credibility and objectivity of information sources, inefficiency of mode of distribution of messages, insufficient public participation, and lack of transparency of decision making processes. This paper suggests the creation and/or enhancement of modes of distribution of risk messages to increase coverage, understanding, and guidance. For instance, messages should be presented in different formats such as internet, brochures, and newspapers. Surveys, public meetings, and trainings/workshops are tools that can be used to characterize stakeholders’ diversity and develop risk messages specific to the targeted audience. Implementation of a participatory decision making process will increase stakeholder involvement and trust in the risk management plan. Development of practical mechanisms, such as public hearings will increase all stakeholders’ involvement in the risk assessment process. A clear framework describing how public comments will be incorporated in the decision making process should be implemented. Finally, to ensure a streamlined risk communication process, there must be consistency in the messages disseminated by federal, state, and local agencies.

Ethical dilemmas in decision making at limits of neonatal viability

The survival rate for extremely preterm infants has improved over the last two decades. Although the incidence of such births is about 2%, the impact of preterm birth on these infants, their families, health-care providers, and society is profound. The birth of an extremely low birth weight (ELBW) and early gestational age infant poses complex medical, social, and ethical challenges to the family and health-care professionals. Survivors have an increased risk of chronic medical problems and disability. It is difficult to make decisions while trying to provide optimal medical care to the infant and supporting the family when delivery occurs at the threshold of viability because outcome at that time is highly unpredictable. Such decisions may have lifelong consequences for those involved.An individualized prognostic strategy appears to be the most appropriate approach. While keeping the patient’s best interest as the primary objective, the goal is to reach, through a process of effective communication between the parents and physicians, a consensual decision that respects the parents’ wishes and promotes physician beneficence.

Histerectomia: aspectos psicossociais e processos de enfrentamento

O objetivo deste estudo foi investigar os aspectos psicossociais e as construções de enfrentamento da cirurgia de histerectomia. Tratou-se de estudo de coorte, longitudinal, envolvendo 10 mulheres, com média de idade de 44 anos, baixa escolaridade e renda, atendidas em um hospital municipal do Estado da Paraíba. Utilizou-se a Escala de Modo de Enfrentamento de Problemas (EMEP) e entrevistas semiestruturadas realizados na maternidade e nas residências, no intervalo entre o pré-cirúrgico e no sexto mês do pós-operatório. Para análise dos resultados, utilizou-se estatística descritiva e bivariada e a técnica de análise de conteúdo. Os resultados indicaram a variabilidade das estratégias de enfrentamento, com predomínio na busca de práticas religiosas, seguido de focado no problema. Os discursos evidenciam receio pela perda da feminilidade e mobilização de sentimentos de temor quanto à cirurgia. Os resultados fornecem subsídios para a intervenção psicológica, enfatizando processos de comunicação mais efetivos entre profissionais de saúde e pacientes.

Key Role of Social Work in Effective Communication and Conflict Resolution Process: Medical Orders for Life-Sustaining Treatment (MOLST) Program in New York and Shared Medical Decision Making at the End of Life

In this article, the authors review the development of the Medical Orders for Life-Sustaining Treatment (MOLST) Program and recent landmark legislation in New York State in the context of advance care planning and shared medical decision making at the end of life. Social workers are central health care professionals in working with patients, families, practitioners, health care agents, and surrogates in the health systems and in the communication and conflict resolution process that is integral to health care decision making. The critical importance of ethics and end-of-life training and education for social workers is also addressed. Data from a pilot study evaluating interdisciplinary ethics training on legal and ethical content in communication and conflict resolution skills in health care decision making are reported. Recommendations are made for research on education and training of social workers, and investigation of the role and influence of systems in shaping social work involvement in end-of-life and palliative care.

HIP Fracture Patients and Clopidogrel

HIP Fracture Patients and Clopidogrel

The Faculty Evaluation Process: The First Step In Fostering Professional Development In An Online University

The presentation will trace the experiences of two program directors from Walden University and their examination of issues involved with faculty assessment. Their experiences were used to create a simple but effective and workable model for faculty assessment and development. Once a presentation of how data were obtained, and analyzed, to create an effective communication process, the specifics of how faculty members were engaged in the collegial methods to ensure a workable professional development process will be described. The experiences of the directors in working with assessment will be utilized as they demonstrate how they regularly conduct an interactive evaluation process, involving the audience in using the model created at Walden in the Richard W. Riley College of Education and Leadership. This model was developed using various metrics, such as student course evaluations, faculty self-assessments, checklists of activity, adherence to rubrics, etc. The entire process begins with the premise that collegial interactions will provide the most sustainable changes. The process concludes with the implementation of online professional development in response to the collected data.

Considerações sobre o escopo de um processo de avaliação da sustentabilidade do turismo

A lot has been discussed about the need for tourism to develop in a sustainable way. However, for it to transcend discourse and be made effective into practice, it is necessary the presence of guidelines that indicate which aspects should be evaluated, for it is only through evaluation that one will find if the expected results were achieved. From that finding, arises an unavoidable question: what to evaluate? That questioning is, although fundamental to the operationalization of the sustainable tourism concept, still little discussed. The following article has the goal of suggesting and discussing a minimal content proposal to be observed in the scope of any tourism sustainability evaluation process. As a conclusion, it is suggested that, for it to achieve it's purposes, a tourism sector sustainability evaluation process shall: i) adopt a vision about sustainable development; ii) establish a effective communication process with the stakeholders; iii) be able to provide relevant information to the decision making process; iv) contemplate public participation; v) be able to adapt to new circumstances.

Acquisition Of Language And Communication Skills As Essential Developmental Ingredients For Children With Visual Impairments

Early acquisition of language and communication skills enhances and promotes effective communication and interactive processes among children who are visually impaired. These children require communication power for them to function effectively in spoken words among sighted persons. Acquisition of listening skills afford blind road users to move safely on the road .It is common knowledge that Nigerian roads are not only badly constructed but lack necessary signs and visual signals. In this article, language and communication skills were emphasized as essential tools to be acquired early enough in life for a visually impaired person to function effectively in the global village where Information Communication Technology (ICT) makes information and communication easy and accessible too. This article discussed some ITC equipment which makes learning not only accessible to the blind but also affordable .With IT facilities in place, learning can easily be brought to the doorstep of the visually impaired learner in form of distance learning, geographical location notwithstanding. African Journal for the Psychological Study of Social Issues Vol. 11 (1&2) 2008: pp. 220-227

Redefining accountability in health care: managing the plurality of medical interests

Conflict in health service delivery is common. It is often attributed to disputes between clinicians and patients or their families about treatment decisions and is particularly common in intensive care units (ICUs), in the form of ;futility disputes' between families and medical clinicians about decisions to terminate the active treatment of a dying family member. More common, but less prominent in the literature, is conflict within the medical profession about patient care goals and treatment. We contend that managing the plurality of medical interests is essential in achieving a more managed and positive experience for patients and families of the care they receive, and for achieving standards of quality and resource use. From an ethnographic study undertaken in a large ICU in Sydney, Australia, we found that the knowledge and practice differences of multiple medical decision-makers generated conflict, inconsistency of practice and subjectivity of decision-making that impeded coherent clinical decision-making and integrated patient care planning, coordination and care review. Improving patients' and families' experience of care requires medical clinicians and medical managers to accept responsibility for institutionalizing effective communication and decision-making processes within clinical networks and between clinical and managerial domains. Thus, strategies to improve patient care will need to extend beyond the medical profession to incorporate administrative management. We conclude that restructuring communication and decision-making processes is imperative to achieve clinical accountability in the workplace and systems accountability in the organization.

Knowledge Management Systems for Emergency Preparedness

This article is about the design and implementation of an information system, using Wiki technology to improve the emergency preparedness efforts of the Claremont University Consortium. For some organizations, as in this case, responding to a crisis situation is done within a consortium environment. Managing knowledge across the various entities involved in such efforts is critical. This includes having the right set of information that is timely and relevant and that is governed by an effective communication process. This study suggests that Wiki technology might be useful to support knowledge management in the context of emergency preparedness within organizations. However, issues such as training in the use of a system(s), a knowledge-sharing culture among entities involved in emergency preparedness, and a fit between task and technology/system must be there in order to support emergency preparedness activities that are given such structures.