Moving from information transfer to information exchange in health and health care

Lee, Renée Gravois; Garvin, Theresa

doi:10.1016/s0277-9536(02)00045-x

Cited by 197 publications

(178 citation statements)

References 30 publications

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“…38 There is increasing interest in moving away from the traditional 1-way transfer of information about a hospitalization toward a 2-way dialogue between hospitalist and primary care physician. 39 Preferences about how to do this will vary among physicians. One strategy might be to provide the PCP with the hospitalist's contact information and encouraging questions about the hospitalization.…”

Section: Improving Physician Information Transfer and Continuitymentioning

confidence: 99%

Promoting effective transitions of care at hospital discharge: A review of key issues for hospitalists

Kripalani

Jackson

Schnipper

et al. 2007

Journal of Hospital Medicine

676

632

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The period following discharge from the hospital is a vulnerable time for patients.About half of adults experience a medical error after hospital discharge, and 19%-23% suffer an adverse event, most commonly an adverse drug event. This article reviews several important challenges to providing high-quality care as patients leave the hospital. These include the discontinuity between hospitalists and primary care physicians, changes to the medication regimen, new self-care responsibilities that may stress available resources, and complex discharge instructions. We also discuss approaches to promoting more effective transitions of care,

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Section: Improving Physician Information Transfer and Continuitymentioning

confidence: 99%

Promoting effective transitions of care at hospital discharge: A review of key issues for hospitalists

Kripalani

Jackson

Schnipper

et al. 2007

Journal of Hospital Medicine

676

632

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“…Lee and Garvin have acknowledged this one-way information transfer as a pervasive pattern throughout health care practices that significantly limits effectiveness, 25 and have advocated for researchers, clinicians, and policy makers to practice two-way information exchange during patient/provider encounters. Incorporating planned two-way communication into handoff practices at care transitions is an important area for future research, particularly in rural care settings.…”

Section: Handoffs and The Direction Of Information Exchangementioning

confidence: 99%

Hip-Fracture Care in Rural Southwestern Ontario: An Ethnographic Study of Patient Transitions and Physiotherapy Handoffs

Johnson¹,

Forbes

Egan

et al. 2013

Physiotherapy Canada

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Purpose: To examine information exchange by physiotherapists during care handoffs of patients with hip fracture in a rural health care setting. Methods: This qualitative ethnographic study used observation and interviews of 11 networks of patients with hip fracture (n ¼ 11), family caregivers (n ¼ 8), and health care providers (n ¼ 24). Patients were followed from acute care through each subsequent care setting. Data were supplemented by health care records and policy documents. Results: Findings revealed that handoffs were less successful when information transfer was untimely or incomplete. Family caregivers experienced challenges in obtaining information required to facilitate the handoff, especially when direct contact with physiotherapists was not possible as a result of distance or other factors. Physiotherapists had to navigate multiple data sources to retrieve important information, and managed information gaps in various ways. Information flow was often unidirectional and suggested no further clinical accountability for the discharging physiotherapist. Conclusions: Providing information in a structured and timely fashion facilitated physiotherapy handoffs. Inadequate handoffs compromised continuity of care, delayed progress in rehabilitation, and resulted in families' missing information of vital importance to their caregiving role. A multi-directional exchange of information is needed between patients, families, and health care providers across care settings.Key Words: continuity of patient care; hip fractures; qualitative research; rural health services. RÉ SUMÉObjectif : Examiner l'é change d'information assuré par les physiothé rapeutes au cours des transferts du soin de patients qui ont subi une fracture de la hanche en contexte de soins de santé ruraux. Mé thodes : Cette é tude ethnographique qualitative reposait sur l'observation et des entrevues de 11 ré seaux de patients ayant subi une fracture de la hanche (n ¼ 11), d'aidants naturels (n ¼ 8) et de fournisseurs de soins de santé (n ¼ 24). Les patients ont é té suivis du service de soins actifs jusqu'à chaque contexte de soins subsé quent. Les dossiers de santé et des documents straté giques ont complé té les donné es. Ré sultats : Les constatations ont ré vé lé que les transferts é taient moins ré ussis lorsque le transfert de l'information é tait en retard ou incomplet. Les aidants naturels ont eu de la difficulté à obtenir l'information né cessaire pour faciliter le transfert, surtout lorsque la distance ou d'autres facteurs empê chaient de communiquer directement avec les physiothé rapeutes. Les physiothé rapeutes ont dû consulter de multiples sources de donné es pour extraire des renseignements importants et ont gé ré le manque d'information de diverses fac¸ons. L'information a souvent circulé de fac¸on unidirectionnelle, ce qui indique qu'un physiothé rapeute qui donne son congé au patient n'a plus d'autre obligation clinique. Conclusions : L'information fournie d'une fac¸on structuré e et à temps a facilité les transferts en phys...

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“…Most nutrition and health educational approaches also focus on the individual caregiver, and assume that as mothers receive new information about childcare, they will modify their behavior (Aubel, Toure, & Diagne, 2004;Lee & Garvin, 2003;Lupton, 1995;Yoder, 1997). Individual caregivers, usually assumed to be the biological mother, are often viewed as passive receptors of knowledge, with communication flows going in one direction from experts to lay people (Lee & Garvin, 2003). By focusing on mothers of reproductive age, nutrition education programs ignore the important role of the extended family and community in early child development.…”

Section: Child Nutrition and Health Education Modelsmentioning

confidence: 99%

“…By focusing on mothers of reproductive age, nutrition education programs ignore the important role of the extended family and community in early child development. This educational model also ignores the agency and knowledge of caregivers and their families, and their ability to adapt information to their own social context (Lee & Garvin, 2003). A review of nutrition education programs that use this social psychological model notes that this approach is ''seldom effective in the long term'' (Allen & Gillespie, 2001, 75).…”

Section: Child Nutrition and Health Education Modelsmentioning

confidence: 99%

“We Grandmothers Know Plenty”: Breastfeeding, complementary feeding and the multifaceted role of grandmothers in Malawi

Kerr

Dakishoni²,

Shumba³

et al. 2008

Social Science & Medicine

174

123

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This paper has two purposes: first of all, we examine grandmothers' role and views of child feeding practices in northern Malawi, and their influence on younger women's practices. Secondly, we consider the implications of these findings for health promotion activities and models of health education. Data were collected from semi-structured interviews, focus groups and a participatory workshop. Findings demonstrate that, to address child feeding practices which have an effect on nutrition, attention must be paid to the broader context that influences child nutrition, including extended family relations. Paternal grandmothers have a powerful and multifaceted role within the extended family in northern Malawi, both in terms of childcare and in other arenas such as agricultural practices and marital relations. Grandmothers often differ in their ideas about early child feeding from conventional Western medicine. Some practices have existed in the area at least since colonial times, and have strong cultural significance. Despite the important integrated role, older women have within households and communities in this part of Malawi, hospital personnel often have disparaging and paternalistic attitudes towards 'grannies' and their knowledge. Health education rarely involves grandmothers, and even if they are involved, their perspectives are not taken into consideration. Hospital staff often reject grandmother knowledge as part of a broader modernization paradigm which views 'traditional knowledge' as backward. Grandmothers view current child health conditions within a broader context of changing livelihood conditions and a high prevalence of HIV/ AIDS. The paper concludes by discussing the challenges of involving grandmothers in health education, and the difficulties of incorporating local knowledge into a medical system that largely rejects it.

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Moving from information transfer to information exchange in health and health care

Cited by 197 publications

References 30 publications

Promoting effective transitions of care at hospital discharge: A review of key issues for hospitalists

Promoting effective transitions of care at hospital discharge: A review of key issues for hospitalists

Hip-Fracture Care in Rural Southwestern Ontario: An Ethnographic Study of Patient Transitions and Physiotherapy Handoffs

“We Grandmothers Know Plenty”: Breastfeeding, complementary feeding and the multifaceted role of grandmothers in Malawi

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