Thursday, June 03, 2010

Information Transmission in Organizations

This sounds like the title of some research project that might be published in a business journal, but what I want to talk about is simply some observations that have emerged in stark detail as I have practiced medicine for the last 30 years.

Neurology is a specialty that is obviously an area that most doctors and nurses struggled with in their training. This is not meant to be a derogatory statement, since I can easily recall that when I first tried to learn neuroanatomy I was rather convinced that there was too much to learn, and that it was all quite beyond my capabilities.

As you complete training in a field quite foreign to other health care workers, you become a kind of source of information that seems mysterious, and you become a font that people come to for enlightenment about various neurologic illnesses. If that weren't enough, I also did a fellowship in neuromuscular diseases, which can be a bit of black box for many neurologists, let alone those without some degree of comfort about neurologic diseases.

So now we finally get to the point suggested by the title. An individual person, let's say a nurse on a particular unit on a particular shift, wants to know some details about some condition. I can certainly expound on some subject, for example the various features of, expectations of, treatments for, a condition like Guillain-Barré syndrome, but this is a cul-de-sac conversation. It's not marked down somewhere, not entered in any notes, not passed on to other nurses, maybe not even well-assimilated by the nurse I'm talking to. And so it's like dumping my time into a hole, where it disappears.

Tomorrow, another nurse wants the same information. Do I deliver my time into another hole? The only practical thing for me is to find some spot in between, which I'm afraid probably comes across as being reticent to explain things, maybe withholding information, not being as explanatory as I can be. It might be easy enough to try the "Google is your friend" approach in some palatable way, but I know quite well that this will be the source of a lot of misinformation and noninformation for esoteric topics.

It's a major dilemma, and I don't think that most hospital organizations either understand it or have any investment in doing something about it.