To better understand the common information exchange errors teams make while working together, researchers from the School of Communication and Information are conducting a study investigating errors trauma teams make during emergency resuscitations of patients.
“We looked at how [trauma] teams communicate with each other, make decisions and transfer information,” said Aleksandra Sarcevic, School of Communication and Information research associate.
Dr. Randall Burd, of the Children’s National Medical Center in Washington, D.C., and Ivan Marsic, a University professor, initiated the project in 2004. It has since appeared in three published papers and was awarded a National Science Foundation award.
The U.S. Department of Health and Human Services reports the annual number of emergency room visits increased by one-third since last year, said Swati Govil, a School of Communication and Information media relations intern.
The biggest issue in trauma team communication is there are no strict rules regarding how information should be gathered in the field and then transferred, she said.
“Trauma teams usually use experience to develop their own way of collecting and reporting data, but that does not always work,” Sarcevic said.
With this increase in visitors to the emergency department, it is more critical to be on the lookout for possible medical mistakes, said Govil, a Rutgers College senior. Communication breakdowns can endanger the patient’s life.
Each patient requires a uniquely developed team, and there is no concrete system to ensure the transfer process goes completely smoothly, Burd said.
“[When a trauma emergency occurs], all of a sudden, there is a group of many different people working together, who do not usually work together,” he said.
Errors that trauma teams make can lead to adverse outcomes if they are severe, Sarcevic said.
Team members can easily forget or incorrectly remember an important piece of information while under the stress of trauma resuscitation, Sarcevic said. There are about 50 different types of information transferred by the teams, and it is only human that some are mistaken or forgotten.
The extent to which these mistakes affect the patient varies with each person, but they can definitely affect the care provided, she said.
“A lack of structure is what causes problems in communication,” Sarcevic said.
The team has published three papers on the topic so far, which were based on data collected from Robert Wood Johnson University Hospital, she said.
A new study began in September and will continue to examine team errors in more detail at the Children’s National Medical Center in Washington, D.C., Sarcevic said.
The team has almost unlimited access to live recording of resuscitations, which they did not have before, she said.
“We will produce richer and more detailed analyses than before without the time restrictions we faced before,” said Sarcevic, who will spend the next six months in Washington, D.C., working as a volunteer and gathering information from the trauma center at the Children’s National Medical Center.
“By completely blending into the environment as a worker and not an outside researcher, I’ll be able to examine the issue much more closely,” Sarcevic said.
The researchers are very happy with how well the hospitals responded to their study, she said.
“Without support from either hospital, we would be nowhere,” Sarcevic said. “Our studies are a product of a great collaboration between hospital personnel, doctors and researchers.”
The complexity of the problem makes finding a solution difficult, she said.
“Right now, we have to first gain a good understanding of where the problems are before we can propose solutions,” Sarcevic said.
Every trauma team functions differently, and there are too many variables to propose a single solution that will fix all the problems, she said.
The solutions will most likely range from very simple and straightforward to high-tech and futuristic, Sarcevic said.
“One solution might be as simple as a color-coding system, and another might be a computer that makes decisions, tracks activity and displays all information,” she said.
Solutions will take time and money to develop and test, but the team’s focus is on understanding the problem completely.
The award from the National Science Foundation will allow the group to expand and continue its study, Sarcevic said.
The grant money will allow the team to incorporate new elements and study the problem in greater detail, Burd said.
The three-year proposal written by Sarcevic will allow the researchers to thoroughly study and understand communication issues and begin to develop technology to solve these problems, he said.
“The next step in our research would be to implement our research in real-world settings,” he said.
The first year of the three-year proposal will be spent further understanding the problem, and the following two years will be devoted to setting up workshops to design and develop possible solutions, Sarcevic said.
This research will benefit health care researchers, doctors, nurses and other medical personnel, in addition to patients, Govil said.
“This research is one strong example of the impact Rutgers is making on the nation’s health and wellness,” she said.
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