New $1.6 Million Grant Will Investigate Nurse and Physician Communication

The study will focus on health IT’s effects on provider communication.

Dr. Milisa Manojlovich“Communication technology can increase or reduce adverse effects for patients depending on how nurses and physicians are using it,” says Milisa Manojlovich, PhD, RN, CCRN, a University of Michigan School of Nursing (UMSN) associate professor and member of U-M’s Institute for Healthcare Policy and Innovation. “Unfortunately, communication failures are one of the most common causes of adverse events for hospitalized patients, so it is very important to understand how communication technology is being used and how it can be improved.”
As the primary investigator on a new $1.6 million grant from the federal Agency for Healthcare Research and Quality (AHRQ), Dr. Manojlovich will investigate how communication technologies such as electronic health records, email, and pagers are being used and where common failures occur. “In general, as electronic communication has increased, the face-to-face communication between practitioners has decreased, and that has created occasions for crucial information to be passed incorrectly or not at all,” says Dr. Manojlovich.
Dr. Manojlovich and her colleagues will use a sequential mixed methods design including surveys, telephone interviews, observations, shadowing, and focus groups at hospitals across the country to learn how communication technologies, communication practices, and work relationships affect communication. The research team plans to use these results to make recommendations for design configurations that will improve the functionality of health IT.
“The work environment and policies are often not conducive to effective communication,” says Dr. Manojlovich. “For example, in a previous study [at a non-University of Michigan hospital], we observed physicians place a STAT order, meaning immediately, in the computer. However, they would not notify the nurse in any other way. The physicians were not aware that by hospital policy, nurses were only required to check the computer for orders every two hours. That meant that a STAT order sometimes went almost two hours before it was acknowledged and acted upon by the nurse,” she explains. “It is not about blame because both the doctor and nurse did their job properly according to policy.”
Dr. Manojlovich stresses that this study is designed to foster improved and positive interdisciplinary communication and team-based care. In keeping with AHRQ’s interest in health IT, this study will identify communication technologies that support mutual understanding of information between nurses and physicians. In addition, the researchers aim to recognize how problem recognition, identification, and diagnosis can occur more rapidly and accurately, possibly reducing risks to patient safety.
  • Julia Adler-Milstein, PhD, Assistant Professor of Information, University of Michigan School of Information.
  • Molly Harrod, PhD, Research Scientist at the VA Ann Arbor Center for Clinical Management Research
  • Timothy Hofer, MD, MSc, Professor of Medicine, University of Michigan Medical School and Research Scientist at the VA Ann Arbor Center for Clinical Management Research.
  • Sarah Krein, PhD, RN, Research Scientist at the VA Ann Arbor Center for Clinical Management Research and a Research Associate Professor, Department of Internal Medicine at the University of Michigan.
  • Sanjay Saint, MD, MPH, Professor of Internal Medicine at the University of Michigan and a Research Investigator at the Ann Arbor VA Center for Clinical Management Research.
  • Anne Sales, PhD, RN, Professor of Nursing, University School of Nursing and Research Scientist at the VA Ann Arbor Center for Clinical Management Research.
Research in this release is supported by AHRQ under grant number HS022305-01A1. The content is solely the responsibility of the authors and does not necessarily represent the official views of AHRQ.

Media Contact:

Mary Beth Lewis, University of Michigan School of Nursing, (734) 763-1682