Interaction Beyond Boundaries, 2009.

New ways of collaboration between health care providers, i.e. physicians and nurses in hospital and the community health care need to be taken into account to meet the challenges in health care where more patients need post-hospital home health care (HHC). Despite great emphasis on clarifying what information should be exchanged between the organisations - existing information flow and content is characterized by mono-professional patterns. The implication is lack of information, inaccurate information, errors, and that the providers spend much time to receive adequate information. We have limited knowledge about the providers' reasoning when they produce and exchange information across organisations. In this project we aim to develop knowledge about hospital nurses' and doctors' production and exchange of information when they interact with colleagues in the community health care.

Four research questions are identified:
1. What criteria do health providers use in hospital care systems when they provide information about the patient's need for community care (CC) throughout the patient's stay, from admission to discharge?
2. How do health providers in CC evaluate the information received from their colleagues in hospital care systems about the patient's hospital stay?
3. How do health providers use the patient journal in the information exchange with CC during the patient's stay and what effect does the electronic patient journal system have on the information exchange?
4. What is the significance of the characteristics of the professions and organizations in the production and exchange of information?

Both interviews and questionnaires will be used through two phases. First, interviews will be conducted with health providers from the hospital and community care. The results of these interviews will be the basis for the development of a questionnaire. Second a representative selection of health providers of medical and surgical departments in general hospitals in Norway will be surveyed using this questionnaire.

为应对当前医疗保健领域的挑战——当下越来越多患者需要出院后家庭健康护理（HHC）——亟需构建涵盖医院医护人员与社区医疗工作者在内的医疗服务提供者间新型协作模式。尽管学界与业界已高度重视厘清不同机构间的信息交换范畴，但当前的信息流转模式与信息内容仍呈现出单专业导向的显著特征。由此引发的问题包括信息缺失、信息失准、操作差错，且医疗服务提供者需耗费大量时间才能获取足量的有效信息。目前，学界对医疗服务提供者跨机构开展信息生成与交换时的决策逻辑仍缺乏深入认知。本研究旨在探索医院护士与医师在与社区医疗同事开展协作时，其信息生成与交换的相关规律与内在机制。

本研究共设定四项研究问题：
1. 在患者从入院至出院的完整住院周期内，医院医疗系统的服务提供者在提供与患者社区护理（CC）需求相关的信息时，会依据哪些评判标准？
2. 社区护理（CC）的医疗服务提供者如何评估其从医院医疗系统同事处获取的、有关患者住院情况的相关信息？
3. 在患者住院期间，医疗服务提供者如何借助患者病历开展与社区护理（CC）的信息交换？电子患者病历系统对这类信息交换又会产生何种影响？
4. 专业属性与机构特征在信息生成与交换过程中具有何种重要意义？

本研究将通过两个阶段开展，同步采用访谈与问卷调查两种研究方法。第一阶段：对来自医院与社区医疗的服务提供者进行半结构化访谈，基于上述访谈结果开发专用调查问卷。第二阶段：采用该问卷对挪威综合医院内科与外科科室的代表性医护人员开展问卷调查。