Patient-centered Perspectives of Communication and Handover between the Emergency Department and General Internal Medicine

Abstract

Effective communication among clinicians is critical for patient safety. This multi-site observational study analyzes inter-clinician communication and interaction with information technology, with a focus on the critical process of patient transfer from the Emergency Department to General Internal Medicine. The study provides insight into clinician workflow, evaluates current hospital communication systems, and identifies key issues affecting communication. It suggests opportunities for improvement: • extending the role of the electronic patient record, • rendering it available on a mobile platform, • developing an improved paging system. It also identifies design trade-offs to be negotiated: • synchronous communication vs. reducing interruptions, • notification of patient status vs. reducing interruptions, • portability vs. screen size of mobile devices, • speed vs. quality of handovers, • information privacy vs. accessibility. The results inform the potential development of an intervention meeting seven principles: interconnectivity, context awareness, accessibility, redundancy, user customization, security, and intuitive user interfaces.