Table 1.
ICU Planned and unplanned information exchange activities
| Nurses’ report | Residents’ sign-out | ICU interdisciplinary morning rounds | Updates | Neurosurgery rounds | Charge nurse rounds | Disposition rounds | Medical rounds | |
|---|---|---|---|---|---|---|---|---|
| Communication Type | Planned, verbal | Planned, verbal | Planned, verbal | Unplanned, verbal | Planned, verbal | Planned, documented | Planned, verbal | Planned, verbal |
| Participants | Night-shift nurse & day-shift nurse | Night-shift resident & day-shift resident | Neurology attending, fellow & residents; staff nurse; pharmacist; medical & nursing students (respiratory therapist intermittently) | Any clinician | Neurosurgery attending & resident, neurology attending & fellow, charge nurse | Charge nurse and, individually, the nurse for each patient | Charge nurse, social worker, & neurology fellow | Neurology attending, fellow, & residents |
| Frequency/Timing | 7 am & 7 pm | 7 am & about 6 pm | 7:30 am until 10:30–12 pm | Anytime needed | Between 8–11 am | About 6 am & about 6 pm | Between 9–11 am | About 5 pm |
| Approximate | 15–30 minutes/one patient | 15–30 minutes/all of resident’s patients | 3–4.5 hours/all ICU patients | Typically 30 seconds to 15 minutes/one patient | 10–15 minutes/all ICU patients | Less than 1 minute/one patient | 15–30 minutes/all ICU patients | 30 minutes/all ICU patients |
| Artifacts | Personal notes* | Personal notes* | EHR; personal notes* | EHR; pager; personal notes* | Personal notes* | Personal notes* & charge nurse paper note | Personal notes* & charge nurse paper note | Personal notes* |
EHR= electronic health record, *Personal notes = paper-based to-do list, paper-based vital-signs flow-sheet and printed information from EHR (NOTE: there was not a ‘typical’ type of ‘personal notes’ used by any of the clinicians during these information exchange activities)