Selling patients and other metaphors: a discourse analysis of the interpretive frames that shape emergency department admission handoffs.

摘要: Abstract This paper reports a discourse analysis of the language doctors used as they talked about and engaged in patient handoffs between emergency department (ED) various inpatient services at one highly specialized academic tertiary teaching referral hospital Midwest United States. Although interest handoff improvement has grown considerably recent years, progress been hampered, perhaps part, because widely but limiting conceptual model an information transmission. The purpose study reported here is to analyze way make sense interactions, including uncovering interpretive frames use, order provide empirical findings expand models handoff. All data were drawn from two-year ethnographic (2009–2011) include semi-structured interviews ( n  = 48), non-participant observations (349 h), recorded telephone conversations  = 48). A total eighty-six individuals participated, resident attending ED, internal medicine surgical services, well administrators. Findings are organized around four metaphors used: sales, sports games, packaging, teamwork. Each metaphor, turn, reveals underlying frame that appears be influenced by organizational social structures shape possibilities for action perceive. are: persuasion, competition, expectation matching, collaboration. Taken together, these highlight complex, socially interactive nature basis grounding enriching guides research practice efforts.