The Agency for Healthcare Research and Quality has awarded researchers at the University of Michigan a $1.6 million grant to study the intricacies of physician-nurse communications in an effort to reduce adverse events.

Lead investigator Milisa Manojlovich will investigate 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,” Manojlovich said.

Manojlovich and her colleagues will use a sequential mixed methods design including 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. The research team plans to use these results to make recommendations for design configurations that will improve the functionality of health IT.

“The work environment and policies are often not conducive to effective communication,” Manojlovich said. For example, she said, in a previous study at a non-University of Michigan hospital, researchers observed physicians place a STAT order 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.

In keeping with AHRQ’s interest in health IT, this study will identify communication technologies that support mutual understanding of information between nurses and physicians. In addition, the researchers aim to recognize how problem recognition, identification, and diagnosis can occur more rapidly and accurately, possibly reducing risks to patient safety.

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