Qualitative investigation of trace-based communication: how are traces conceptualised in healthcare teamwork?

Abstract

ObjectivesThis interview-based qualitative study aims to explore how healthcare providers conceptualise trace-based communication and considers its implications for how teams work. In the biological literature, trace-based communication refers to the non-verbal communication that is achieved by leaving ‘traces’ in the environment and other members sensing them and using them to drive their own behaviour. Trace-based communication is a key component of swam intelligence and has been described as a critical process that enables superorganisms to coordinate work and collectively adapt. This paper brings awareness to its existence in the context of healthcare teamwork.DesignInterview-based study using Constructivist Grounded Theory methodology.SettingThis study was conducted in multiple team contexts at one of Canada’s largest acute-care teaching hospitals.Participants25 clinicians from across professions and disciplines. Specialties included surgery, anesthesiology, psychiatry, internal medicine, geriatrics, neonatology, paramedics, nursing, intensive care, neurology and emergency medicine.InterventionNot relevant due to the qualitative nature of the study.Primary and secondary outcomeNot relevant due to the qualitative nature of the study.ResultsThe dataset was analysed using the sensitising concept of ‘traces’ from Swarm Intelligence. This study brought to light novel and unique elements of trace-based communication in the context of healthcare teamwork including focused intentionality, successful versus failed traces and the contextually bounded nature of the responses to traces. While participants initially felt ambivalent about the idea of using traces in their daily teamwork, they provided a variety of examples. Through these examples, participants revealed the multifaceted nature of the purposes of trace-based communication, including promoting efficiency, preventing mistakes and saving face.ConclusionsThis study demonstrated that clinicians pervasively use trace-based communication despite differences in opinion as to its implications for teamwork and safety. Other disciplines have taken up traces to promote collective adaptation. This should serve as inspiration to at least start exploring this phenomenon in healthcare.

Building Resilient Healthcare Teams: Insights from Analogy to the Social Biology of Ants, Honey Bees and Other Social Insects

“…Ants, termites and social bees may likewise use chemically complex pheromonal signals that can function to recruit others into mating aggregations, onto profitable food sources or towards new nesting sites [11]. We have demonstrated that healthcare teams regularly use multiple forms of communication, including trace objects and other forms of indirect communication [12]. Ophthalmoscopes, bedside charts, instrument trays, syringes, among other objects are, in a way, like pheromones; they can be used to passively communicate messages to team mates, much like how ants and other social insects can communicate with their nestmates.…”