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Promoting Speaking Up Through Interprofessional Identity Triggers in a Mixed-Profession Simulation Scenario: Two Group Double-Blinded Pre-Test-Only Design.

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Medical handovers: tacit consensus on interaction.

Paulien Harms1,2, Ninke Stukker3, Tom Koole4,5

  • 1Department of Critical Care, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands. p.harms@rug.nl.

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PubMed
Summary
This summary is machine-generated.

Incoming physicians can improve patient safety by actively participating in patient handovers. This study identifies specific communication points within the handover process where their input is most effective and expected, enhancing clinical practice.

Keywords:
CommunicationDiscourse analysisHandoverPatient safetyQuality improvement

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Area of Science:

  • Medical Communication
  • Discourse Analysis
  • Healthcare Quality Improvement

Background:

  • Patient handovers are critical for preventing medical errors.
  • Existing recommendations for incoming physician participation are often abstract.
  • Lack of specific guidance hinders effective integration of incoming physicians.

Purpose of the Study:

  • To identify specific interactional moments for incoming physician involvement in handovers.
  • To apply discourse theory and methods to analyze handover communication.
  • To provide concrete guidance for enhancing incoming physician participation.

Main Methods:

  • Analysis of 12 simulated ICU resident physician handovers.
  • Utilized genre theory and conversation analysis.
  • Identified communication "moves" within the handover genre.

Main Results:

  • Specific handover "moves" (tasks, focus points, questions, consultation) invite incoming physician participation.
  • The "clinical situation" move is less accessible due to outgoing physician control.
  • Four other moves show monologic patterns, not anticipating incoming input.

Conclusions:

  • Medical professionals have implicit, genre-specific rules for participation timing.
  • Discourse analysis reveals tacit rules for effective handover communication.
  • Findings can inform training to align participation recommendations with clinical practice conventions.