Information exchange in the NICU: what sources of patient data do physicians prefer to use?

Background: There are significant gaps in understanding what sources of patient information physicians utilize in the Neonatal Intensive Care Unit (NICU). Objective: We conducted a qualitative study of physicians' self-report of information-seeking behaviors in the NICU of an academic medical center. Methods: The study used a survey design to assess resident and faculty physicians' perceptions of their utilization of written and verbal sources of patient information. Faculty and resident responses were compared by t-tests to assess how perceptions of information-seeking behavior might differ between these two groups. Results: Of the options listed in our survey, the three most commonly reported information sources were: (1) the bedside flowsheet; (2) conversations with resident physicians; and (3) conversations with nurses. Notes written by physicians-especiatty resident notes-were the least reported source of patient information. Conclusions: Physicians' preference to use verbal communication is consistent with prior studies. This study identifies that the bedside flowsheet is also an important source of information, while other written sources-especially resident notes-appear not to be utilized as frequently. Understanding why physicians use or fail to use different sources of patient information may shed light on ways to improve information exchange and reduce medical error in complex settings such as the NICU. (C) 2004 Elsevier Ireland Ltd. All rights reserved.