(Communication behaviour in a hospital setting: an observational study)
Despite the fact that healthcare seems to suffer from enormous inefficiencies because of poor communication infrastructures, little work has been done to assess communication systems. In this week's BMJ, Coiera and Tombs report a small communication study of 10 healthcare workers in Frenchay Hospital, Bristol. The authors found that the patterns of communication in this setting were extremely interruptive, which seemed to contribute to inefficiency in work practice.
Coiera and Tombs note that medical staff generated twice as many interruptions (by telephone and paging systems) than they actually received themselves. This seemed to be because staff had a tendency to seek information from colleagues rather than refer to printed materials and they were often unsure of who was responsible for which specific role. Frequently staff interpreted the meaning of calls from the paging system based on insufficient information and this along with complex communication patterns, could lead to inefficiencies.
The authors conclude that staff need to change their communication behaviour patterns, and that some form of training would be beneficial. Staff are highly mobile during their working day, communication technology (such as voicemail, email and mobile telephones) could help with contacting these "moving targets". They also suggest that a role based database (along the lines of the Yellow Pages) might be useful when ascertaining the ëright person for the job'. Some form of call screening may also be beneficial.
Dr Enrico Coiera, Senior Project Manager, Hewlett-Packard Laboratories, Bristol firstname.lastname@example.org