Analysis of an Information System between the Nursing Service and the Dietary Departments

The analysis of an information system between the nursing service and the dietary departments of a 390 bed hospital was conducted at the East Tennessee Baptist Hospital. This study was to identify, classify, and record the frequency of the most common written and verbal communication problems occurring between the nursing service and the dietary departments.

Interviews were held with forty nursing and dietary personnel. The interviews were utilized for the identification of communication forms and problems between these departments. The problems identified in the interviews, literature research, and experience were factors used in the development of a coding system for recording and classifying telephone messages and problems which occurred in the nursing units.

Communication forms identified by the interviews were analyzed by Flow Process Charts. The elements considered in the Flow Charts were transportation, inspection and operation, delay, storage, and destroyed. Forms were handled four to twenty-four times from the origination to storage or destruction.

Telephone communications were recorded and then coded by a Problem Check List for two nonconsecutive weeks. The same Problem Check List was utilized for five nonconsecutive days on the nursing units for identification of communication problems between nursing and dietary.

The communication problems identified between nursing and dietary were classified as to timing of information, incorrect information, incomplete information, patient complaints, and duplication of information. Seventeen or 37.8 percent of the coded messages were classified as timing of information; twelve or 26.7 percent: incomplete information; fourteen or 31.1 percent incorrect information; one or 2.2 percent duplication of information; and one or 2.2 percent patient complaints.

Some recommendations include inservice meetings for improving the completeness and accuracy of information on all communication forms, and discussion of problems with supervisors and employees. Better communication and understanding between levels of personnel could be accomplished through supervisors taking more responsibility in communicating to employees under their jurisdiction. Tile exchange of departmental observations could-be helpful in understanding and solving problems related to diet prescriptions in both nursing and dietary departments. Staff meetings with physicians to explain the functions and problems of timing of patient admittance in relation to nursing service and dietary departments could be helpful.

It is also recommended that dietary, nursing, and administration investigate several of the automated or computer type information systems that provide continuous up-to-date information. These types of computer systems could possibly help to eliminate some of the forms used to communicate information, perhaps decrease the number of employees needed to process the forms, and increase the accuracy of the information handled. Communication that provides complete, accurate, and timely information is necessary for both nursing and dietary to order and dispense a correct diet prescription to the patient.