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Objective: To review the research literature on the experiences of patients with communication disabilities in hospital according to the Generic Model of patient safety.Methods: In 2014 and 2015, we searched four scientific databases for studies with an aim or result relevant to safety of hospital patients with communication disabilities. The review included 27 studies.Results: A range of adverse event types were outlined in qualitative research. Little detail was provided about contributing or protective factors for safety incidents in hospital for these patients or the impact of the incidents on the patient or organisations involved.Conclusion: Further research addressing the safety of patients with communication disabilities is needed. Sufficient detail is required to identify the nature, timing, and detection of incidents; factors that contribute to or prevent adverse events; and detail the impact of the adverse events.Practice Implications: In order to provide safe and effective care to people with communication disabilities in hospital, a priority for health and disability services must be the design and evaluation of ecologically appropriate and evidence-based interventions to improve patient care, communication, and reduce the risk of costly and harmful patient safety incidents. [ABSTRACT FROM AUTHOR]

Abstract: Purpose: To identify the main concerns of a broad range of hospital staff about the implementation of a new Computerized Provider Order Entry (CPOE) system for medication management. Methods: The study was conducted in a large Australian teaching hospital using semi-structured interviews (n =20) and focus groups (six focus groups involving a total of 30 participants) from a broad section of health professionals including doctors, nurses, managers, pharmacists and senior health executives. Systematic concurrent analysis of the data was undertaken by a team of researchers. Results: We identified 20 recurrent themes related to nine areas of shared concern including work practices, software/hardware, relationships/communication, education and training, inexperienced staff and de-skilling. A higher level of analysis identified four interrelated constructs that highlight what people are concerned about: (1) Will it help? (2) Will it work? (3) Will we cope? (4) Will it impair existing interaction? Limitations: The research provides a snapshot overview of perceptions from a range of hospital personnel in the lead up to CPOE implementation. Generalizability is limited by the size of the sample and the contextual circumstances of the hospital being studied. Discussion: This work contributes valuable evidence about an often-neglected dimension in the evaluation of computer systems in hospitals, namely the pre-implementation concerns of staff. These pre-conceptions can have a significant effect on how technology is implemented and utilised. Acknowledging and addressing people''s concerns can contribute to the establishment of durable channels of negotiation and communication. Further research informed by the findings of this study will help advance this process. [Copyright &y& Elsevier]

Objective To determine physician perspectives about direct notification of normal and abnormal test results. Methods We conducted a cross-sectional survey at five clinical sites in the US and Australia. The US-based study was conducted via web-based survey of primary care physicians and specialists between July and October 2012. An identical paper-based survey was self-administered between June and September 2012 with specialists in Australia. Results Of 1417 physicians invited, 315 (22.2%) completed the survey. Two-thirds (65.3%) believed that patients should be directly notified of normal results, but only 21.3% were comfortable with direct notification of clinically significant abnormal results. Physicians were more likely to endorse direct notification of abnormal results if they believed it would reduce the number of patients lost to follow-up (OR = 4.98, 95%CI = 2.21–1.21) or if they had personally missed an abnormal test result (OR = 2.95, 95%CI = 1.44–6.02). Conversely, physicians were less likely to endorse if they believed that direct notification interfered with the practice of medicine (OR = 0.39, 95%CI = 0.20–0.74). Conclusion Physicians we surveyed generally favor direct notification of normal results but appear to have substantial concerns about direct notification of abnormal results. Practice implications Widespread use of direct notification should be accompanied by strategies to help patients manage test result abnormalities they receive. [ABSTRACT FROM AUTHOR]

Objectives: To investigate the communication processes involving test-related information in Australian Emergency Departments (EDs); specifically what and how ED clinicians communicate test-related information to patients, what patients know and understand about the provided information, and how patients view the potential to access their test-results electronically.Methods: We conducted face-to-face semi-structured interviews with clinicians (n = 26) and patients (n = 32) across three Australian EDs. Interviews were transcribed and analysed iteratively, following principles of qualitative content analysis and grounded theory.Results: Depending on various contextual (e.g. time pressures) and patient factors (e.g. perceived health literacy), ED clinicians provided, and patients recalled receiving, test-related information along a continuum, ranging from "no or limited" information to "specific" information. Many patients were confused about how to access their test-results. Patients welcomed the potential for future electronic access to results but viewed their individual health and/or computer literacy skills and knowledge as potential barriers.Conclusions: EDs are highly dynamic environments where contextual forces impinge on the amount and quality of test-related information that clinicians communicate to ED patients.Practice Implications: Systemic and patient factors need to be addressed to optimise the provision of test-related information in ED settings, improve patient understanding and foster patient empowerment. [ABSTRACT FROM AUTHOR]