Facilitators and barriers to the use of a structured hand-off: a pediatric hospital exploratory case study |
| |
| Authors: | Rebecca Purtell Megan E Cullinan Heather E Canary |
| |
| Institution: | 1. Department of Pediatrics, School of Medicine, University of Utah, Salt Lake City, UT, USArebecca.purtell@hsc.utah.edu;3. Department of Communication, University of Utah, Salt Lake City, UT, USA;4. School of Communication, San Diego State University, San Diego, CA, USA |
| |
| Abstract: | Competent communication practices among healthcare providers are a key factor in maintaining patient safety during transfers of patient care. Research shows that the majority of errors in patient care are related to communication problems, and a majority occur during patient hand-offs. This project is a qualitative study exploring the facilitators and barriers of structured hand-off at a pediatric hospital. Our data analysis indicates that while the hand-off process is facilitated by structure, clarity, and adequate time, it is hindered by lack of time, distractions, human factors, and a number of social and organizational factors that complicate physicians’ roles. Using structurating activity theory (SAT) to frame findings, analysis points to a structural tension between worker autonomy and organizational control as the primary cause of poor adherence to structured hand-off among pediatric residents. We draw on constructs of SAT to identify practical strategies for managing this contradiction at a system level. |
| |
| Keywords: | Adherence barriers facilitators health communication patient hand-off resistance structurating activity theory |
|
|
