Annals of Emergency Medicine
Volume 53, Issue 6 , Pages 711-712 , June 2009

Beyond “Communication Failure”

  • Emily S. Patterson, PhD

      Affiliations

    • Veteran's Association, Cincinnati, OH, and The Ohio State University, Columbus, OH
    • Corresponding Author InformationAddress for correspondence: Emily Patterson, PhD, 210 Baker Systems, 1971 Neil Ave, Columbus, OH 43210; 614-688-3938, fax 614-292-7852
    • ,
  • Robert L. Wears, MD, MS

      Affiliations

    • Department of Emergency Medicine, University of Florida, Jacksonville, FL, and Clinical Safety Research Unit, Imperial College, London, UK

References 

  1. Joint Commission. 2007 National patient safety goals. http://www.jointcommission.org/PatientSafety/NationalPatientSafetyGoals/07_hap_cah_npsgs.htmAccessed March 18, 2007
  2. Haig KM, Sutton S, Whittington J. SBAR: a shared mental model for improving communication between clinicians. Jt Comm J Qual Patient Saf. 2006;32:167–175
  3. Fairbanks RJ, Bisantz AM, Sunm M. Emergency department communication links and patterns. Ann Emerg Med. 2007;50:396–406
  4. Woloshynowych M, Davis R, Brown R, et al. Communication patterns in a UK emergency department. Ann Emerg Med. 2007;50:407–413
  5. Coiera EW, Jayasuriya RA, Hardy J, et al. Communication loads on clinical staff in the emergency department. Med J Aust. 2002;176:415–418
  6. Spencer R, Coiera E, Logan P. Variation in communication loads on clinical staff in the emergency department. Ann Emerg Med. 2004;44:268–273
  7. Hollingsworth JC, Chisholm CD, Giles BK, et al. How do physicians and nurses spend their time in the emergency department?. Ann Emerg Med. 1998;31:87–91
  8. Horwitz LI, Meredith T, Schuur JD, et al. Dropping the baton: a qualitative analysis of failures during the transition from emergency department to inpatient care. Ann Emerg Med. 2009;53:701–710
  9. Cook RI, Render M, Woods DD. Gaps in the continuity of care and progress on patient safety. BMJ. 2000;320:791–794
  10. Rasmussen J. The role of error in organizing behaviour. Ergonomics. 1990;33:1185–1190
  11. Rasmussen J. The role of error in organizing behaviour. Qual Saf Health Care. 2003;12:377–383
  12. Hollnagel E. Human error: trick or treat. In:  Durso FT,  Nickerson RS,  Dumais ST, et al. editor. Handbook of Applied Cognition. 2nd ed.. Chichester, UK: John Wiley & Sons; 2007;p. 219–238
  13. Wears RL. The error of counting “errors.”. Ann Emerg Med. 2008;52:502–503
  14. Letsky M, Warner N, Fiore SM, et al. Macrocognition in complex team problem solving. Proceedings of the 12th International Command and Control Research and Technology symposium, Newport, RI; 2007 http://www.dodccrp.org/events/12th_ICCRTS/CD/html/papers/239.pdfAccessed June 11, 2008
  15. Malone TW, Crowston K. What Is Coordination Theory and How Can It Help Design Cooperative Work Systems? (Proceedings of the 1990 ACM Conference on Computer-Supported Cooperative Work). Los Angeles, CA: ACM; 1990;
  16. Ostrom E, Walker J. Trust and Reciprocity: Interdisciplinary Lessons From Experimental Research. New York, NY: Russell Sage Foundation; 2003;
  17. Coiera EW. When conversation is better than computation. J Am Med Inform Assoc. 2000;7:277–286
  18. Parker J, Coiera E. Improving clinical communication: a view from psychology. J Am Med Inform Assoc. 2000;7:453–461
  19. Eisenberg E. The social construction of healthcare teams. In:  Nemeth CP editors. Improving Healthcare Team Communication: Building on Lessons From Aviation and Aerospace. Aldershot, UK: Ashgate; 2008;p. 9–20
  20. Bruner J. The narrative construction of reality. Critical Inquiry. 1991;18:1–21

 Supervising editor: Michael L. Callaham, MD

 Funding and support: By Annals policy, all authors are required to disclose any and all commercial, financial, and other relationships in any way related to the subject of this article that might create any potential conflict of interest. The authors have stated that no such relationships exist. See the Manuscript Submission Agreement in this issue for examples of specific conflicts covered by this statement.

 Publication date: Available online August 22, 2008.

 Earn CME Credit: Continuing Medical Education is available for this article at: www.ACEP-EMedHome.com.

 Reprints not available from the authors.

PII: S0196-0644(08)01498-4

doi: 10.1016/j.annemergmed.2008.07.014

Annals of Emergency Medicine
Volume 53, Issue 6 , Pages 711-712 , June 2009

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