Hospital Handoffs as Multifunctional Situated Routines: Implications for Researchers and Administrators

Hilligoss, Brian; Cohen, Michael D.

doi:10.1108/s1474-8231(2011)0000011008

Cited by 40 publications

(53 citation statements)

References 111 publications

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“…Therefore, whilst customization is critical, some form of standardization is also important to make the work process efficient. This contrasts with professions such as law, in which there are relatively few client relationships (Smets Morris & Greenwood 2012;Bednarek, Burke, Jarzabkowski & Smets forthcoming), but resonates with medical professionals whose routines help to efficiently cope with high patient volumes (Gawande, 2010;Hilligoss & Cohen, 2011;Morgan et al, 2014).…”

Section: Contributionsmentioning

confidence: 76%

The Influence of Routine Interdependence and Skillful Accomplishment on the Coordination of Standardizing and Customizing

2015

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This is the accepted version of the paper.This version of the publication may differ from the final published version. Permanent repository link 1 THE INFLUENCE OF ROUTINE INTERDEPENDENCE AND SKILLFUL ACCOMPLISHMENT ON THE COORDINATION OF STANDARDIZING AND CUSTOMIZING ABSTRACTThis paper advances understanding of the coordination of interdependence between multiple intersecting routines and its influence on the balancing of coexisting ostensive patterns. Building on a professional service routine -the deal appraisal routine -and its intersections with four related routines, we develop a dynamic framework that explains the coordination of standardization and flexibility in four ways. First, intersecting routines have shifting salience in the performance of a focal routine, and this shifting salience is enacted through professional skill and judgment. Second, each intersection amplifies pressure towards one or the other ostensive pattern thus introducing dynamism into the balancing of competing ostensive patterns. Third, professionals skillfully acknowledge these pressures from intersecting routines to orient towards one ostensive pattern and then reorient the performance of the routine towards the opposite ostensive pattern. Fourth, this balancing act, which we theorize as reciprocal task interdependence, occurs within the moment of performing each task, so providing a highly dynamic understanding of the association between routine interdependence and the coordination of coexisting ostensive patterns.

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Section: Contributionsmentioning

confidence: 76%

The Influence of Routine Interdependence and Skillful Accomplishment on the Coordination of Standardizing and Customizing

2015

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“…Despite widespread awareness of the negative consequences of poor communication in handoffs and transitions of care, little research has identified best practices. 7,48,49 Authors such as Hilligoss and Cohen 50 and Horowitz and colleagues 51 suggest that education for effective handoffs incorporate direct observation and feedback or handoff behaviors, use of reflective practice as a way to inculcate vigilance, and attention to differences in handoff types (for example, within-unit handoffs [between trainees who are largely known to one another] and betweenunit transfers of care [between trainees or attending physicians who are strangers to one another]). We are developing a handover tool for residents and attending physicians 7 have reviewed the literature on handoffs in a number of high reliability industries and concluded that faceto-face handoffs have the highest accuracy and reliability.…”

Section: Discussionmentioning

confidence: 99%

Crossing the Communication Chasm: Challenges and Opportunities in Transitions of Care from the Hospital to the Primary Care Clinic

Rattray

Sico

Cox

et al. 2017

The Joint Commission Journal on Quality and Patient Safety

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Background: Transitions of care from specialty and acute settings to primary care abound. Compared to the continuity in end-of-shift handoffs, care transitions involve provider communication between practices and facilities with their own cultures and bureaucracies. Using the transition from acute care to outpatient primary care for stroke/transient ischemic attack (TIA) patients as a case study, this qualitative research explored communication practices and institutional arrangements among clinical providers responsible for longitudinal management of hypertension.

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“…Namely, healthcare workers recognized the precautions, policies, and safety procedures and acknowledged their rationale, but failed to put them into practice [28]. Moreover, there seems to be fundamental miscalibration of how much content standardization and content ordering is desirable or even possible [19,[29][30][31].…”

Section: Focus Characteristics Advantages Drawbacksmentioning

confidence: 99%

“…For example, while standardization views such events as handover, or medication administration as vulnerable points of care that can pose threats to patient safety, the resilience approach recognizes that these crucial encounters provide an important "audit-point" essential for potential recovery from failure [14,30,33,35,36]. Communication at the handover can also furnish new perspectives on a patient's situation as a result of the outgoing party's renewed attention to it while preparing for the handover, or of the incoming party's "fresh perspective and a rested mind" [29]. By examining the assumptions underlying actions, a process Patterson and colleagues call "collaborative cross-checking," errors can be caught and their effects minimized [37].…”

Section: Focus Characteristics Advantages Drawbacksmentioning

confidence: 99%

From Standardization to Resilience: How Day-To-Day Life in Healthcare Organizations Shapes Safety

Drach‐Zahavy

Somech²

2014

Occup Med Health Aff

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This paper focuses on the working strategies nurses develop and employ in their day-to-day routine in an attempt to identify "red alerts" which enable them to maintain patient safety despite the load and interruptions characterizing their work environment. Based on insights gained from three studies (focusing on nurses' medication administration, use of protective measures and transferring information during handover) we develop a theoretical model that describes how understanding aspects of the day-to-day life in healthcare organizations, and the system of meaning that guides everyday life, can inform our understanding of workplace safety. The model illustrates how the chaotic, turbulent, and complex environment characterizing the nurses' workplace prevents them from fully complying with the declared safety goals practices and procedures. Yet even under these near-impossible circumstances, the nurses' main mission is to maintain patients' safety. Embracing a resilience strategy allows nurses to actively prevent something bad from happening or becoming worse, and to repair something bad once it has occurred, which of course contribute to patient's safety. Otherwise, nurses might rely on an implicit theories strategy, limiting the likelihood that they will discover their misperceptions, thereby putting patients' safety at risk. The model further describes how each of these two strategies is reinforced by positive feedback loops on the individual, ward, and organizational levels. Practical implications for managers include work practices that can encourage nurses' resilience by creating a work environment of professionalism, mindfulness and awareness of errors.

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Hospital Handoffs as Multifunctional Situated Routines: Implications for Researchers and Administrators

Cited by 40 publications

References 111 publications

The Influence of Routine Interdependence and Skillful Accomplishment on the Coordination of Standardizing and Customizing

The Influence of Routine Interdependence and Skillful Accomplishment on the Coordination of Standardizing and Customizing

Crossing the Communication Chasm: Challenges and Opportunities in Transitions of Care from the Hospital to the Primary Care Clinic

From Standardization to Resilience: How Day-To-Day Life in Healthcare Organizations Shapes Safety

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