Exploring role dialectics in inter-service admission handoffs: a qualitative analysis of physician communication

Julie Apker*, Jennifer Ptacek, Christopher B Beach, Robert Wears

*Corresponding author for this work

Research output: Contribution to journalArticle

6 Scopus citations

Abstract

Admission handoffs between emergency physicians (EPs) and internal medicine/hospitalist physicians (IMHPs), a frequently occurring form of patient transfer, remain understudied despite their importance to care continuity. Handoffs function as more than simple information transfer; they require a repertoire of interpersonal skills to accomplish tasks and develop professional relationships. Relational Dialectics Theory (RDT), a perspective that asserts social life consists of oppositional and unified discourses present in personal relationships, frames the current study. We use role dialectics to more fully understand the contradictions that emerge from the competing discourses of physician roles. Data were collected from six focus groups consisting of residents and attending physicians working at a large, urban, academic medical center in the Midwest United States. Using a grounded, constant-comparative approach, analysis of transcripts reveals that these physicians encounter two key role dialectics during handoffs: autonomy–collaboration and uncertainty–certainty. Interventions for physicians and hospital decision-makers are recommended.

Original languageEnglish (US)
Pages (from-to)399-414
Number of pages16
JournalJournal of Applied Communication Research
Volume44
Issue number4
DOIs
StatePublished - Oct 1 2016

Keywords

  • Physician communication
  • care transitions
  • emergency medicine
  • handoffs
  • inpatient medicine

ASJC Scopus subject areas

  • Language and Linguistics
  • Communication

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