The Art of Effective Handoff Communication Among Medical and Surgery Residents

2021 ◽  
pp. 155534342110182
Author(s):  
Nicholas A. Rattray ◽  
Mindy E. Flanagan ◽  
Laura G. Militello ◽  
Paul Barach ◽  
Richard M. Frankel
Keyword(s):  
Complex Adaptive Systems ◽  
Adaptive Systems ◽  
Cognitive Task ◽  
Adverse Outcomes ◽  
Communication Behaviors ◽  
Medical Centers ◽  
Complex Adaptive ◽  
Resident Handoffs ◽  
Multiple Residents ◽  
Relevant Factors

End-of-shift handoffs occur when physicians transfer care responsibilities from one shift to another. Typically viewed as a straightforward exchange of information, we argue that several contextually relevant factors shape the communication behaviors of outgoing and incoming residents during handoffs. Digital recordings and transcripts of resident handoffs in medicine and surgery were made at three VA Medical Centers. They were triangulated with cognitive task interviews that elicited residents’ reconstructions of their work practices. Analyses revealed clear distinctions among “day-to-night,” “night-to-day,” and “double handoffs” that involve transitions between day and night teams. Although residents preferred handing off in dedicated, quiet spaces, few (16%) occurred in such settings; 28% contained significant interruptions. The quality handoff artifacts (notes and forms) influenced interactions, especially in cases where multiple residents from different teams were involved, requiring incoming residents to adjust “on the fly.” This study demonstrated that there are multiple contextual factors that affect, and are affected by, handoff interactions. The findings suggest that handoffs are less like the delivery of a telegram (unidirectional) and more like complex adaptive systems (products of interactional co-construction). Teaching communication practices based on interaction complexity may reduce errors and adverse outcomes for hospitalized patients.

Theories of Communication Networks

2003 ◽  
Author(s):  
Peter R. Monge ◽  
Noshir Contractor
Keyword(s):  
Communication Networks ◽  
Computer Simulations ◽  
Complex Adaptive Systems ◽  
Adaptive Systems ◽  
Cross Sectional ◽  
Network Decomposition ◽  
Network Computer ◽  
Social Theories ◽  
Complex Adaptive ◽  
Almost All

To date, most network research contains one or more of five major problems. First, it tends to be atheoretical, ignoring the various social theories that contain network implications. Second, it explores single levels of analysis rather than the multiple levels out of which most networks are comprised. Third, network analysis has employed very little the insights from contemporary complex systems analysis and computer simulations. Foruth, it typically uses descriptive rather than inferential statistics, thus robbing it of the ability to make claims about the larger universe of networks. Finally, almost all the research is static and cross-sectional rather than dynamic. Theories of Communication Networks presents solutions to all five problems. The authors develop a multitheoretical model that relates different social science theories with different network properties. This model is multilevel, providing a network decomposition that applies the various social theories to all network levels: individuals, dyads, triples, groups, and the entire network. The book then establishes a model from the perspective of complex adaptive systems and demonstrates how to use Blanche, an agent-based network computer simulation environment, to generate and test network theories and hypotheses. It presents recent developments in network statistical analysis, the p* family, which provides a basis for valid multilevel statistical inferences regarding networks. Finally, it shows how to relate communication networks to other networks, thus providing the basis in conjunction with computer simulations to study the emergence of dynamic organizational networks.

The crucial roles of the artificial information systems web in intelligent human organizations

2003 ◽  
Vol 22 (3) ◽  
pp. 115-124
Author(s):  
Liang Thow Yick
Keyword(s):  
Information Systems ◽  
Complex Adaptive Systems ◽  
Adaptive Systems ◽  
Collective Intelligence ◽  
Physical Structure ◽  
Current Status ◽  
Human Beings ◽  
Intelligent Structure ◽  
Complex Adaptive ◽  
Human Thinking

Human organizations with human beings as interacting agents are complex adaptive systems. Such organizations continuously consume information, make decisions, and evolve with the changing environment. In this respect, all human organizations including businesses must enhance their collective intelligence in order to learn faster and compete more effectively. Thus, adopting an intelligent structure is vital to all businesses as the world moves deeper into the knowledge economy. The paradigmatic shift in thinking, structure, management and operation requires all intelligent human organizations to be designed around intelligence. An intelligent structure encompasses an orgmind, an intangible deep component, as well as a physical component. At the physical structure perspective, being able to identify, design and develop an artificial information systems network that synchronizes well with the orgmind is critical. The connectivity of the organization, and the manner in which it behaves, communicates and collaborates, depend on the effectiveness of its information systems network and its orgmind. The orgmind which is at least the collection of all the interacting human thinking systems must be fully aware of both the internal and external environments. Inevitably, in the new economy, intelligent human organizations must be equipped with a well-integrated intelligent information network which functions similarly to the nervous system in biological beings. This study examines the current status of artificial information systems and their networks in businesses with respect to the above concepts.

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