Communication as a sign of adaptation to a complex system: The case of robotic surgery

摘要

IntroductionAs investigations of medical accidents have revealed, communication is one of the factors that is most frequently associated with accidents.For instance, in anesthesia 25% of deaths are due to inadequate communication, which represents 39 % of reported medical errors (Arbous et al. 2001, Kluger et al. 2000).But, surprisingly, communication has not received much attention from researchers.Better training, better techniques, and better standards of equipment have been recommended in order to improve the patient's safety, but not much effort has been spent on communication training and tools, even though health care practitioners designate "improving communication" as an important corrective strategy (Kluger et al. op.cit.)During the past decade or so, there have been two important developments in medical care relevant to the study of communication in hospital: i) the increased specialization of medical sciences, which has increased the division and distribution of tasks among experts from different disciplines and, thus, the need for coordination and communication between healthcare providers.Today, a patient will very seldom visit only one hospital department and furthermore rarely sees only one physician during their stay.Multiple departments and professional skills are brought together in order to provide health services, but also to provide uninterrupted care around the clock.This specialization requires more and more information to be exchanged between departments as well as between individual operators who work cooperatively in hospitals in order to coordinate interventions both in time and space.Hospitals themselves have even become specialized, so that a patient may have to go to several hospitals and institutions to be properly taken care of (Nyssen 2006).This obviously raises the communication challenge at the inter-organization level.