Analysis of communication patterns in critical care environments

Abstract

Efficient and effective communication processes are critical for patient health and safety. Communication processes for patient admission within the UVa Surgical and Trauma Intensive Care Unit (SICU) vary depending on situational factors. Trauma personnel in the SICU are also involved in patient admission to the Operating Room (OR). In order to better understand communication patterns and identify inefficiencies and variation, an analysis of the patient admission processes from the Emergency Department (ED) to the OR and ED to SICU is performed. To identify potential inefficiencies within patient admission, key sub-processes with high variability were identified. Process models were constructed to depict the current practices of each step and the associated communication patterns between stakeholders. Interviews, surveys, and focus groups were also conducted with trauma personnel to gauge opinions on the patient admission processes and to collect estimated waiting times at each step in the processes. Based on findings from interviews, process completion times were compiled and analyzed using Hurwicz Alpha Criterion. Results of the study indicate that communication processes with consults and the bed center, both located outside of the SICU, are variable and inconsistent. This variability in communication is a result of a lack of situational awareness and procedures external to the SICU.