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The Effect of Health Information Technology on Health Care Provider Communication: A Mixed-Method Protocol

BACKGROUND: Communication failures between physicians and nurses are one of the most common causes of adverse events for hospitalized patients, as well as a major root cause of all sentinel events. Communication technology (ie, the electronic medical record, computerized provider order entry, email,...

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Autores principales: Manojlovich, Milisa, Adler-Milstein, Julia, Harrod, Molly, Sales, Anne, Hofer, Timothy P, Saint, Sanjay, Krein, Sarah L
Formato: Online Artículo Texto
Lenguaje:English
Publicado: JMIR Publications Inc. 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4526935/
https://www.ncbi.nlm.nih.gov/pubmed/26068442
http://dx.doi.org/10.2196/resprot.4463
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author Manojlovich, Milisa
Adler-Milstein, Julia
Harrod, Molly
Sales, Anne
Hofer, Timothy P
Saint, Sanjay
Krein, Sarah L
author_facet Manojlovich, Milisa
Adler-Milstein, Julia
Harrod, Molly
Sales, Anne
Hofer, Timothy P
Saint, Sanjay
Krein, Sarah L
author_sort Manojlovich, Milisa
collection PubMed
description BACKGROUND: Communication failures between physicians and nurses are one of the most common causes of adverse events for hospitalized patients, as well as a major root cause of all sentinel events. Communication technology (ie, the electronic medical record, computerized provider order entry, email, and pagers), which is a component of health information technology (HIT), may help reduce some communication failures but increase others because of an inadequate understanding of how communication technology is used. Increasing use of health information and communication technologies is likely to affect communication between nurses and physicians. OBJECTIVE: The purpose of this study is to describe, in detail, how health information and communication technologies facilitate or hinder communication between nurses and physicians with the ultimate goal of identifying how we can optimize the use of these technologies to support effective communication. Effective communication is the process of developing shared understanding between communicators by establishing, testing, and maintaining relationships. Our theoretical model, based in communication and sociology theories, describes how health information and communication technologies affect communication through communication practices (ie, use of rich media; the location and availability of computers) and work relationships (ie, hierarchies and team stability). Therefore we seek to (1) identify the range of health information and communication technologies used in a national sample of medical-surgical acute care units, (2) describe communication practices and work relationships that may be influenced by health information and communication technologies in these same settings, and (3) explore how differences in health information and communication technologies, communication practices, and work relationships between physicians and nurses influence communication. METHODS: This 4-year study uses a sequential mixed-methods design, beginning with a quantitative survey followed by a two-part qualitative phase. Survey results from aim 1 will provide a detailed assessment of health information and communication technologies in use and help identify sites with variation in health information and communication technologies for the qualitative phase of the study. In aim 2, we will conduct telephone interviews with hospital personnel in up to 8 hospitals to gather in-depth information about communication practices and work relationships on medical-surgical units. In aim 3, we will collect data in 4 hospitals (selected from telephone interview results) via observation, shadowing, focus groups, and artifacts to learn how health information and communication technologies, communication practices, and work relationships affect communication. RESULTS: Results from aim 1 will be published in 2016. Results from aims 2 and 3 will be published in subsequent years. CONCLUSIONS: As the majority of US hospitals do not yet have HIT fully implemented, results from our study will inform future development and implementation of health information and communication technologies to support effective communication between nurses and physicians.
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spelling pubmed-45269352015-08-11 The Effect of Health Information Technology on Health Care Provider Communication: A Mixed-Method Protocol Manojlovich, Milisa Adler-Milstein, Julia Harrod, Molly Sales, Anne Hofer, Timothy P Saint, Sanjay Krein, Sarah L JMIR Res Protoc Protocol BACKGROUND: Communication failures between physicians and nurses are one of the most common causes of adverse events for hospitalized patients, as well as a major root cause of all sentinel events. Communication technology (ie, the electronic medical record, computerized provider order entry, email, and pagers), which is a component of health information technology (HIT), may help reduce some communication failures but increase others because of an inadequate understanding of how communication technology is used. Increasing use of health information and communication technologies is likely to affect communication between nurses and physicians. OBJECTIVE: The purpose of this study is to describe, in detail, how health information and communication technologies facilitate or hinder communication between nurses and physicians with the ultimate goal of identifying how we can optimize the use of these technologies to support effective communication. Effective communication is the process of developing shared understanding between communicators by establishing, testing, and maintaining relationships. Our theoretical model, based in communication and sociology theories, describes how health information and communication technologies affect communication through communication practices (ie, use of rich media; the location and availability of computers) and work relationships (ie, hierarchies and team stability). Therefore we seek to (1) identify the range of health information and communication technologies used in a national sample of medical-surgical acute care units, (2) describe communication practices and work relationships that may be influenced by health information and communication technologies in these same settings, and (3) explore how differences in health information and communication technologies, communication practices, and work relationships between physicians and nurses influence communication. METHODS: This 4-year study uses a sequential mixed-methods design, beginning with a quantitative survey followed by a two-part qualitative phase. Survey results from aim 1 will provide a detailed assessment of health information and communication technologies in use and help identify sites with variation in health information and communication technologies for the qualitative phase of the study. In aim 2, we will conduct telephone interviews with hospital personnel in up to 8 hospitals to gather in-depth information about communication practices and work relationships on medical-surgical units. In aim 3, we will collect data in 4 hospitals (selected from telephone interview results) via observation, shadowing, focus groups, and artifacts to learn how health information and communication technologies, communication practices, and work relationships affect communication. RESULTS: Results from aim 1 will be published in 2016. Results from aims 2 and 3 will be published in subsequent years. CONCLUSIONS: As the majority of US hospitals do not yet have HIT fully implemented, results from our study will inform future development and implementation of health information and communication technologies to support effective communication between nurses and physicians. JMIR Publications Inc. 2015-06-11 /pmc/articles/PMC4526935/ /pubmed/26068442 http://dx.doi.org/10.2196/resprot.4463 Text en ©Milisa Manojlovich, Julia Adler-Milstein, Molly Harrod, Anne Sales, Timothy P Hofer, Sanjay Saint, Sarah L Krein. Originally published in JMIR Research Protocols (http://www.researchprotocols.org), 11.06.2015. https://creativecommons.org/licenses/by/2.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0/ (https://creativecommons.org/licenses/by/2.0/) ), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR Research Protocols, is properly cited. The complete bibliographic information, a link to the original publication on http://www.researchprotocols.org, as well as this copyright and license information must be included.
spellingShingle Protocol
Manojlovich, Milisa
Adler-Milstein, Julia
Harrod, Molly
Sales, Anne
Hofer, Timothy P
Saint, Sanjay
Krein, Sarah L
The Effect of Health Information Technology on Health Care Provider Communication: A Mixed-Method Protocol
title The Effect of Health Information Technology on Health Care Provider Communication: A Mixed-Method Protocol
title_full The Effect of Health Information Technology on Health Care Provider Communication: A Mixed-Method Protocol
title_fullStr The Effect of Health Information Technology on Health Care Provider Communication: A Mixed-Method Protocol
title_full_unstemmed The Effect of Health Information Technology on Health Care Provider Communication: A Mixed-Method Protocol
title_short The Effect of Health Information Technology on Health Care Provider Communication: A Mixed-Method Protocol
title_sort effect of health information technology on health care provider communication: a mixed-method protocol
topic Protocol
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4526935/
https://www.ncbi.nlm.nih.gov/pubmed/26068442
http://dx.doi.org/10.2196/resprot.4463
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