Intra-organizational Communication in Healthcare

Abstract

Summary Objectives: Intra-organizational communication is mostly interpersonal. Synchronous interruptive communication is recognized as aprimary source of inefficiency anderror in healthcare, and there is much potential for information and communication technology (ICT) to improve such communication. As recently suggested, however, due to communication failures ICT can also compound medical errors. In this paper we analyze factors that restrict the role of ICT in improving interpersonal healthcare communication and suggest solutions. Methods: We critically analyzed the literature from a selection of diverse scientific disciplines. These were related to interpersonal communication, tothe role and place of standardization and computerization in its improvement, and to reducing medical errors. Results: Four possible scenarios were defined on how ICT can serve healthcare communication. Two differing conceptual frameworks about communication in health-care were discussed. Considering “information space” as apart of “communication space ” allows the recognition and control of the source of the semantic gaps in conventional standardization and an enhancement of the role of ICT in improving intra-organizational communication. Moreover, cognitive, social, and organizational dimensions of complexity in interpersonal communication can be managed. Three approaches to control the variability in those dimensions and to promote therole of ICT in intra-organizational communication were discussed. Conclusion: A multi-dimensional approach is required to promote the role of ICT in intra-organizational communication in healthcare. Parallel to conventional standardization, atleast three dimensions need to be addressed: controlling the effect of the social context, developing standard information processing skills, and most importantly, controlling variations in care practices’ performance.

Contextual Barriers to Communication Between Physicians and Nurses About Appropriate Catheter Use

“…We placed results within a conceptual framework that describes communication space by focusing on how information and communication technology (ICT) can be used to enhance communication in healthcare. 13 Pirnejad maintains that in addition to a communicator, information, and the medium needed to transmit information, three other concepts are equally as important to achieving communication objectives: organizational, cognitive, and social complexity.…”

“…According to Pirnejad's communication space framework, organizational complexity arises from time and resource constraints imposed by an organization that require healthcare personnel to coordinate their activities with each other to deliver care. 13 Within this complexity, urgent problems must be addressed and unforeseen conflicts resolved, requiring frequent negotiation and adjustment of workflow patterns to meet evolving patient care needs. We found that the workflow misalignment between nurses and physicians, as well as between different physician specialties, contributed to barriers to communication about catheters during rounds.…”

“…The cognitive load required for communicators to convey and understand a message also contributes to the complexity of interpersonal communication. 13 Adding to that complexity in this setting was the use of a wide variety of communication channels (e.g., verbal, nonverbal) and media (e.g., paper, EMR, pagers) through which healthcare professionals communicated. We found several communication barriers related to cognitive complexity: (1) some reliance on paper in an organization that had an EMR, (2) training and usability issues with the EMR, and (3) pager usage that added to cognitive load.…”

Étudier la communication organisationnelle et santé des organisations de santé au health organizing

“…Il ne s'agit pas uniquement des savoirs qui ont rapport à la profession médicale, mais aussi et surtout de savoir-faire communicationnel qui s'actualise dans les pratiques quotidiennes et les échanges informels Lacoste, 2001). Les TIC en tant qu'outils de stockage et de transmission de données jouent un rôle important dans la constitution et le partage des savoirs et compétences collectifs, et contribuent ainsi au processus d'apprentissage organisationnel, tout en transformant les formes et les modes de collaboration Benghozi, 2001 ;Bouzon, 2004 ;Pirnejad et al, 2008 ;Robey et Boudreau, 1999 ;Safran et al, 1998 ;Vitacca et al, 2009). Les auteurs s'entendent pour dire que les TIC encouragent à la fois la décentralisation (grâce aux outils permettant le travail à distance, comme le courrier électronique et le dossier patient électronique, DPE) et l'intégration (les systèmes informatisés exigent une rationalisation plus accrue et un contrôle plus rigoureux des processus de la création de l'information, de la transmission et de la rétroaction).…”

“…L'intégration des TIC au sein des organisations de santé représente un autre facteur susceptible d'altérer la distribution des rôles, transformer les identités professionnelles et questionner la nature et le sens du travail des acteurs (Alasad, 2002). La question centrale est celle de la distribution du travail entre les acteurs humains et les acteurs technologiques, et de la place de ces derniers au sein des équipes de travail (Pirnejad et al, 2008 ;Safran et al, 1998). L'augmentation de compétences individuelles de certains acteurs grâce à l'utilisation des TIC peut conduire, d'un côté, « à la suppression de certaines tâches, puis de certains métiers » au sein des organisations (Benghozi, 2001, p. 8) Grosjean, 2004 ;Lacoste, 2001 ;Raveyre et Ughetto, 2003 ;Schweyer et al, 2004).…”