phases-of-illness paradigm better communication, better outcomesphases-of-illness模式更好的沟通,更好的结果.pdfVIP

Pamplin et al. Critical Care 2011, 15:309 /content/15/6/309 V I E W P O I N T Phases-of-illness paradigm: better communication, better outcomes 1 2 3 Jeremy C Pamplin* , Sarah J Murray and Kevin K Chung injuries and management mistakes account for tremen- Abstract dous costs in resources and dollars [4,5]. Communication failures are a signii cant contributor to Key to addressing this problem is the ‘divergence’ medical errors that harm patients. Critical care delivery among various team members as to what the priorities is a complex system of inter-professional work that is are for a patient’s care. ‘Communication failures are often distributed across time, space, and multiple disciplines. rooted in an internecine confl ict between team members Because health-care education and delivery remain about these priorities.’ For example: siloed by profession, we lack a shared framework Bedside nurse: ‘We haven’t done the rehab yet today.’ within which we discuss and subsequently optimize Attending physician: ‘Why?’ patient care. Furthermore, our disparate professional Bedside nurse: ‘We are waiting for ultrasound to come perspectives and interests often interfere with our up.’ ability to ef ectively prioritize individual care. It is Attending physician: ‘Let’s get [the patient] up now.’ important, therefore, to develop a cognitively shared h is dialog represents ‘a misunderstanding of intent fram