Hospitalists' perceptions of communication and how they navigate communication challenges in the hospital setting
Burleson, Debra Dobbins
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Medical rhetoricians within the field of Technical Communication understand the important interdisciplinary role of rhetoric and medical discourse, and they have applied this knowledge to patient narratives, disease treatment and management, end of life treatment, as well as health education. This dissertation adds to the body of literature that has reported about medical communication challenges. Researchers have deliberated the hospitalist model and extended the debate about the need for the profession. What is unique about this study is that there is very little, if any, research about hospitalists’ perceptions of communication and the impact that the hospitalist profession has made on communication within the medical setting. The study examines hospitalists’ perceptions of communication regarding patients and patient families, other medical personnel, and written communication such as the H&Ps, progress notes, and discharge summaries. Through interviews with hospitalists, nurse practitioner hospitalists, and medical personnel who work with hospitalists as well as observations of hospitalists’ group sessions, this case study reports on hospitalists perceptions of effective and ineffective communication as well as trust and relationship challenges that they face since the profession was implemented in 1996. The results of this study show that continuity of care, especially regarding handoffs of information, is insufficient. It is also interesting that many hospitalists elect to exchange information face to face instead of reading the patients’ electronic medical records. This preference for face-to-face communication could potentially impede continuity of care when important information is not documented. This study also found that communication is greatly impacted by trust. Trust influences communication with patients and patient families, medical decisions and collaborations with other medical personnel, and how medical information is documented.