A Qualitative Study of Physicians' Responses to Interruptions in Diagnostic Reasoning Caused by Frequent Handovers

• In Event: 68.030 - Qualitative Studies: Experiences and Practices of Health Professionals

Abstract

In modern teaching hospitals, physicians and patients experience significant discontinuity in relationships due to transitions of care. Many have studied handovers between physicians. None have explored what physicians do when responsibility for making the diagnosis is transitioned to another physician before the diagnosis is known. This paper reports on a qualitative, exploratory study investigating physicians’ responses to interruptions in diagnostic reasoning caused by handovers. In-depth, semi-structured interviews were conducted with eighteen participants. Using constructivist grounded theory and constant comparison, results showed that participants created habits for following up on patients, were motivated to learn of the outcomes of their decisions, and learned about outcomes through solitary and social information exchange. Results are discussed from the perspective of self-regulated learning.

Authors

• Judith L. Bowen, Oregon Health and Science University

• Jonathan Seth Ilgen, Harborview Medical Center

• David M. Irby, University of California - San Francisco

• Olle ten Cate, University Medical Center Utrecht

• Bridget Colleen O'Brien, University of California - San Francisco