Abstract

Objective: The aim of this study was to analyze clinical communication factors and interruptions and to develop clinician-clinician and clinician-computer knowledge representation models. Methods: An ICU observational study was combined with medical error reported cases to address the above questions. Researchers shadowed the ICU team, for 55 hours during patient rounds, to capture 6 main communication factors. Simultaneously, a systematic literature search was conducted to identify and extract reported medical error cases caused by clinical communication problem. The search included patient safety data banks, literature databases, newspaper, and reported lawsuits. Results: Out of 242 reported communication errors, 100 cases resulted in active errors while only 13 cases resulted in13 near misses; most of those errors were reported in journal articles (n = 302). As to the observation data, the most frequent communicator during ICU patient rounds was the Attending Physicians. The ratio of interruptions caused by clinicians to technology-aided devices was 3:1 per patient visit. The mean frequency of an Attending Physician interacting with a computer was once per patient visit. Analyzing data from both sources, two communication models representing the clinical communication framework were developed. Conclusion: Clinical communication is essential for effective health care delivery and for improved care outcomes. To further understand clinical communication, primary and secondary data were collected and analyzed and as a result, clinician-clinician and clinician-computer interaction models were

Keywords: Communication Models; Patient Safety; Intensive Care Unit; Medical Errors.