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Characterizing the Structure and Content of Nurse Handoffs: A Sequential Conversational Analysis Approach.

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Title: Characterizing the Structure and Content of Nurse Handoffs: A Sequential Conversational Analysis Approach.
Author(s): Abraham J; Kannampallil T; Brenner C; Lopez KD; Almoosa KF; Patel B; Patel VL
Subject(s): Care transitions Communication Communication errors Conversational analysis Intensive care Nurse handoffs Sequential analysis Shift report
Abstract: Effective communication during nurse handoffs is instrumental in ensuring safe and quality patient care. Much of the prior research on nurse handoffs has utilized retrospective methods such as interviews, surveys and questionnaires. While extremely useful, an in-depth understanding of the structure and content of conversations, and the inherent relationships within the content is paramount to designing effective nurse handoff interventions. In this paper, we present a methodological framework-Sequential Conversational Analysis (SCA)-a mixed-method approach that integrates qualitative conversational analysis with quantitative sequential pattern analysis. We describe the SCA approach and provide a detailed example as a proof of concept of its use for the analysis of nurse handoff communication in a medical intensive care unit. This novel approach allows us to characterize the conversational structure, clinical content, disruptions in the conversation, and the inherently phasic nature of nurse handoff communication. The characterization of communication patterns highlights the relationships underlying the verbal content of nurse handoffs with specific emphasis on: the interactive nature of conversation, relevance of role-based (incoming, outgoing) communication requirements, clinical content focus on critical patient-related events, and discussion of pending patient management tasks. We also discuss the applicability of the SCA approach as a method for providing in-depth understanding of the dynamics of communication in other settings and domains.
Issue Date: 2016-02
Publisher: Elsevier
Citation Info: Abraham, J., Kannampallil, T., Brenner, C., Lopez, K. D., Almoosa, K. F., Patel, B. and Patel, V. L.Characterizing the Structure and Content of Nurse Handoffs: A Sequential Conversational Analysis Approach. Journal of Biomedical Informatics. 2016. 59: 76-88. doi: 10.1016/j.jbi.2015.11.009.
Type: Article
Description: This is the author’s version of a work that was accepted for publication in Journal of Biomedical Informatics. Changes resulting from the publishing process, such as peer review, editing, corrections, structural formatting, and other quality control mechanisms may not be reflected in this document. Changes may have been made to this work since it was submitted for publication. A definitive version was subsequently published in Journal of Biomedical Informatics. 2016. 59: 76-88. 10.1016/j.jbi.2015.11.009.
ISSN: 1532-0464
Sponsor: This research was supported in part by a grant from the James S. McDonnell Foundation (Grant No. 220020152), and by a training fellowship from the Keck Center AHRQ Training Program in Patient Safety and Quality of the Gulf Coast Consortia (AHRQ Grant No. 1 T32 HS017586-02).
Date Available in INDIGO: 2017-03-16

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