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Emergency Communication: Addressing the challenges in health care discourses and practices

Funding:
2007: $122,000
2008: $152,000
2009: $142,000

Project Member(s):
Diana Slade (Lead Researcher), Marie Manidis, Jeanette McGregor, Hermine Scheeres, Jane Stein-Parbury, Roger Dunston, Nicole Stanton, Eloise Chandler (University of Technology, Sydney), Christian Matthiessen(Hong Kong Polytechnic University), Maria Herke (Macquarie University).

The Emergency Communication Project consists of nine reports in total: one report for the emergency departments in each of the five hospitals, two executive summaries and this final report, which consists of two volumes—an executive summary and a full report that details the overall findings and summarises the hospital specific communication practices. We have attached the Executive summary (pdf, 2mb) and the full final report (pdf, 3mb).

Funding or Partner Organisation:
ACT Health
Australian Research Council (ARC Linkage Projects)
Northern Sydney Central Coast Area Health Service (North Sydney and Central Coast Area Health Service)
NSW Adult Migrant English Services (NSW ADULT MIGRANT ENGLISH SERVICE)
Royal North Shore Hospital (Division of Allied Health - NSCCH)
South Eastern Sydney and Illawarra Area Health Service (South Eastern Sydney and Illawarra Area Health Service Partnership Fund)
(UTS Contributions to ARC projects starting in 2007)

Year completed:
2011

Summary:
Ineffective communication has been identified as the major cause of critical incidents in public hospitals (NSW Health, 2005a). Critical incidents are adverse events leading to avoidable patient harm. This project, by examining spoken interactions between health-care practitioners and patients in hospital emergency departments identified and analysed causes of misunderstandings and breakdowns.

The Emergency Communication Project was conceived in response to the increasing realisation of the central role of communication in effective healthcare delivery, particularly in high stress contexts such as emergency departments. Over the last decade, as critical incidents have increased, growing attention has been paid to the relationship between communication (in particular, communication breakdowns) and patient safety. Our research presents a detailed picture of the critical importance of communication in the delivery of effective and patient-centred care, and provides a detailed analysis of the way in which communication occurs and, at times, fails. Failures in communication have consistently been identified as a major cause of critical incidents—that is, adverse events leading to avoidable patient harm.

Over the last three years, this project investigated communication between patients and clinicians (drs and nurses) in five representative emergency departments. It involved 1093 hours of observations, 150 interviews with key staff and patients and 82 patients recorded from triage to disposition. Only patients in triage categories 3 to 5 (i.e. initially assessed as non life-threatening) were approached for participation. Researchers recorded, analysed and described spoken interactions between clinicians and patients and identified the features of both successful and unsuccessful interactions. The project therefore represents one of the most comprehensive studies internationally on clinician–patient communication in hospitals.