The University of Michigan School of Nursing announced Associate Professor and member of U-Ms Institute for Healthcare Policy and Innovation Milisa Manojlovich, PhD, RN, CCRN, is the primary investigator on a new $1.6 million grant from the federal Agency for Healthcare Research and Quality to study communication between nurses and physicians. Manojlovich and her colleagues will use methods such as surveys, telephone interviews, observations, shadowing and focus groups at hospitals across the country to learn how communication technologies, communication practices and work relationships affect communication, according to a news release. The research team plans to use these results to make recommendations for design configurations to improve the functionality of health IT.
Communication technology can increase or reduce adverse effects for patients depending on how nurses and physicians are using it, Manojlovich said in a news release. Unfortunately, communication failures are one of the most common causes of adverse events for hospitalized patients, so it is very important to understand how communication technology is being used and how it can be improved.
Manojlovich and co-investigators will research how communication technologies such as electronic health records, email and pagers are being used and where common failures occur. In general, as electronic communication has increased, the face-to-face communication between practitioners has decreased, and that has created occasions for crucial information to be passed incorrectly or not at all, she said in the release.
The work environment and policies are often not conducive to effective communication, Manojlovich said. For example, in a previous study, we observed physicians place a STAT order, meaning immediately, in the computer. However, they would not notify the nurse in any other way. The physicians were not aware that by hospital policy, nurses were only required to check the computer for orders every two hours. That meant that a STAT order sometimes went almost two hours before it was acknowledged and acted upon by the nurse. It is not about blame because both the doctor and nurse did their job properly according to policy, but this communication failure can have serious implications for the patient.
Manojlovich stressed this study is designed to foster improved and positive interdisciplinary communication and team-based care. In keeping with AHRQs interest in health IT, this study will identify communication technologies that support mutual understanding of information between nurses and physicians, according to the release. In addition, the researchers aim is to determine how problem recognition, identification and diagnosis can occur more rapidly and accurately, possibly reducing risks to patient safety.
Co-investigators include Julia Adler-Milstein, PhD, assistant professor of information, U-M School of Information; Molly Harrod, PhD, research scientist, VA Ann Arbor Center for Clinical Management Research; Timothy Hofer, MD, MSc, professor of medicine, U-M Medical School and research scientist, VA Ann Arbor Center for Clinical Management Research; Sarah Krein, PhD, RN, research scientist, VA Ann Arbor Center for Clinical Management Research and research associate professor, department of internal medicine, U-M; Sanjay Saint, MD, MPH, professor of internal medicine, U-M and research investigator, Ann Arbor VA Center for Clinical Management Research; and Anne Sales, PhD, RN, professor of nursing, U-M School of Nursing and research scientist at the VA Ann Arbor Center for Clinical Management Research.