TY - JOUR
T1 - Communication in emergency medicine
T2 - Implications for patient safety
AU - Eisenberg, Eric M.
AU - Murphy, Alexandra G.
AU - Sutcliffe, Kathleen
AU - Wears, Robert
AU - Schenkel, Stephen
AU - Perry, Shawna
AU - Vanaerhoef, Mary
N1 - Funding Information:
Eric M. Eisenberg (Ph.D., Michigan State University) is Professor and Chair of the Department of Communication at the University of South Florida. Alexandra Murphy (Ph.D., University of South Florida) is Associate Professor of Communication at DePaul University. Kathleen Sutcliffe (Ph.D., University of Texas at Austin) is Professor of Management at the University of Michigan. Robert Wears (M.D., Johns Hopkins University, M.S., FACEP) is Professor of Emergency Medicine, Shawna Perry (M.D., Case Western University) is Assistant Chair and Associate Professor of Emergency Medicine, and Mary Vanderhoef (M.S.N., ARNP, University of Florida) is a nurse at the University of Florida Health Center in Jacksonville, Florida. Stephen Schenkel (M.D., M.P.P., Harvard University) is Assistant Professor of Emergency Medicine at the University of Maryland Medical Center in Baltimore, Maryland. This study was funded by a generous grant from the National Patient Safety Foundation. Correspondence to Eric M. Eisenberg, Department of Communication, CIS 1040, University of South Florida, Tampa, FL 33620-7800, USA. Email: eisenber@cas.usf.edu
PY - 2005/12
Y1 - 2005/12
N2 - Emergency medicine is largely a communicative activity, and medical mishaps that occur in this context are too often the result of vulnerable communication processes. In this year-long qualitative study of two academic emergency departments, an interdisciplinary research team identified four such processes: triage, testing and evaluation, handoffs, and admitting. In each case, we found that narrative rationality (the patient's story) was consistently subjugated to technical rationality (actionable lists). Process changes are proposed to encourage caregivers to either reconsider their course of action or request additional contextual information. A heightened awareness of the bias for technical over narrative rationality and a better recognition of uncertainty in emergency medicine communication are important first steps toward anticipating potential failures and ensuring patient safety.
AB - Emergency medicine is largely a communicative activity, and medical mishaps that occur in this context are too often the result of vulnerable communication processes. In this year-long qualitative study of two academic emergency departments, an interdisciplinary research team identified four such processes: triage, testing and evaluation, handoffs, and admitting. In each case, we found that narrative rationality (the patient's story) was consistently subjugated to technical rationality (actionable lists). Process changes are proposed to encourage caregivers to either reconsider their course of action or request additional contextual information. A heightened awareness of the bias for technical over narrative rationality and a better recognition of uncertainty in emergency medicine communication are important first steps toward anticipating potential failures and ensuring patient safety.
KW - Emergency Medicine
KW - Handoffs
KW - Health Communication
KW - Patient Safety
KW - Qualitative Methods
UR - http://www.scopus.com/inward/record.url?scp=28244457871&partnerID=8YFLogxK
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U2 - 10.1080/03637750500322602
DO - 10.1080/03637750500322602
M3 - Article
AN - SCOPUS:28244457871
SN - 0363-7751
VL - 72
SP - 390
EP - 413
JO - Communication Monographs
JF - Communication Monographs
IS - 4
ER -