Diana Slade is Professor of Applied Linguistics. She is currently doing half time at the Department of English at Hong Kong Polytechnic University (PolyU) and half time at UTS. From 1998-2004 she was Associate Dean, Teaching and Learning in the Faculty of Education at UTS and before that she was Head of the Department of Language and Literacy at UTS. She was Chair of the UTS Teaching and Learning Committee as well as Deputy Chair of Academic Board from 1999 to 2008. Before joining UTS, in 1990, she was a lecturer on the MA program in Applied Linguistics in the linguistics Department, Sydney University for five years.With Christian Matthiessen, Diana convened the 1st International Roundtable and Symposium on Healthcare Communication at PolyU from 14–16 March 2011. The Symposium and Roundtable brought together national and international researchers and practitioners from a range of clinical and academic disciplines to explore issues relating to healthcare communication.Diana is also an Executive Committee member of The International Charter for Human Values in Healthcare, a collaborative effort involving people, countries, organizations and institutions around the world working together to restore core human values to healthcare.
Can supervise: YES
The description of spoken English; healthcare communication, discourse analysis, systemic functional linguistics, culture and communication in the workplace.Diana has over 30 years experience in researching, teaching and publishing in applied linguistics, linguistics and organisational communication. Her major research focus is on developing and extending theoretical work in these three areas, with a particular focus on the analysis and description of spoken English. Her PhD (Linguistics) and following book—Analysing Casual Conversation (with Suzanne Eggins, Equinox, 1997/2005) developed a systematic model for the analysis and description of spoken English and was shortlisted for the British Association of Applied Linguistics Book Award, 1998. Diana’s other major publications include Conversation: from Description to Pedagogy (with Thornbury, Scott 2006, Cambridge University Press), and Communicating in Hospital Emergency Departments (with Manidis M, Mcgregor J, Scheeres H, Stein-Parbury J, Dunston R, Stanton, N, Chandler E, Matthiessen C, Herke M. 2011). She has earned over $7 million in research income (cash and in-kind; including two significant grants from the Australian Research Council) and recently has led research in a number of different health care contexts, in both Australia and Hong Kong.She is currently lead investigator on an Australian Research Council (ARC) grant (2010–2014) on Effective communication in clinical handover (ECHHo) a three year national project across 4 states of Australia. As part of this project handovers in four different states have been/will be audio and many video recorded. Detailed language analysis of the communicative dimensions of the handovers will be undertaken. Before this she was the first chief investigator on an ARC Linkage (2007–2010) entitled Emergency Communication: Addressing the challenges in health care discourses and practices. The research involved 1093 hours of observations, 150 interviews with key staff and patients and 82 patients recorded from triage to disposition. It therefore represents one of the most comprehensive studies internationally on clinician–patient communication.Diana is currently also the lead researcher (with Christian Matthiessen) on qualitative research projects with Tuen Mun Hospital funded by Hong Kong Polytechnic University. These research projects involving a team of PolyU academics, has three senior medical clinicians from the New Territories West Cluster as Co-Is and has involved surveying all the clinicians in the Accident and Emergency Department; interviewing key clinicians and management and audio-recording patients from triage to disposition. Diana is invited to talk around the world on different aspects of the health communication research and has presented (with different team members) over 25 papers over the last two years at conferences and seminars in the USA, Australia, Hong Kong, China, Europe and UK (see below).
- The description of spoken English
- Discourse analysis
- Workplace communication and culture
- Healthcare communication
Slade, D & Mattiessen, C 2018, The Texture of Casual Conversation: A Multidimensional Interpretation, Equinox, United Kingdom.
Over the last three decades there has been an ever-increasing interest in the analysis of spoken interaction. Work on casual conversation, which for a time was found to present virtually insuperable problems to the analyst, has now come to occupy as prominent a place as institutional interactions. Many approaches to casual conversation have been partial, and the author's own seminal publication with Suzanne Eggins, Analysing Casual Conversation(1997) was a milestone in demonstrating the value of locating the analysis in a broad framework that was inspired by Halliday's Systemic Functional Linguistics. In this new book Slade amplifies and extends that earlier work, presenting original case material and expanding on her claim that the 'chunks' of genre-based analysis need to be supplemented by the concept of 'chat.' She presents a framework and the tools for describing the dynamics of both the macro and the micro structure of conversation as it creates and recreates social relations. All those whose interests lie in understanding how language works in casual conversation, whether in linguistics sociolinguistics, educational linguistics or cultural studies, will find this an essential read.
This book gives valuable insights into the features of effective and ineffective clinical handovers in a variety of common hospital context.
Slade, DM, Manidis, M, McGregor, J, Scheeres, H, Chandler, E, Stein-Parbury, J, Dunston, R, Herke, M & Matthiessen, CM 2015, Communicating in Hospital Emergency Departments, Springer, Heidelberg New York Dordrecht London.View/Download from: UTS OPUS or Publisher's site
Analysing Casual Conversation develops a systematic model for the analysis and description of casual conversation in English.
Cope, W., Pauwels, A., Slade, D.M., Brosnan, D. & Neil, D. 1994, Local Diversity, Global Connections: Volume 1 Six Approaches to Cross-Cultural Training, Australian Government Publishing Services, Canberra.
Slade, D.M., Cope, W., Pauwels, A., Brosnan, D. & Kalantzis, M. 1994, Local Diversity, Global Connections: Volume 2 Core Principles for Effective Cross-Cultural Training, Australian Government Publishing Services, Canberra.
Slade, D.M., Kalantzis, M. & Cope, W. 1990, Minority Languages and Dominant Culture: Issues of Education, Assessment and Social Equity, Falmer Press, United Kingdom.
Kalantzis, M, Cope, W & Slade, DM 1986, The Language Question: the Maintenance of Languages other than English. Volume 1 Research Findings, Department of Immigration and Ethnic Affairs, Canberra.
Kalantzis, M., Cope, W. & Slade, D.M. 1986, The Language Question: The Maintenance of Languages other than English: Vol II Methodology and Empirical Results, Department of Immigration and Ethnic Affairs, Canberra.
Pun, J, Chan, EA, Man, M, Eggins, S & Slade, D 2019, 'Pre- and post evaluations of the effects of the Connect, Ask, Respond and Empathise (CARE) protocol on nursing handover: A case study of a bilingual hospital in Hong Kong', Journal of Clinical Nursing.View/Download from: Publisher's site
© 2019 John Wiley & Sons Ltd Aims and objectives: To evaluate (a) the perceived effects of the training provided to nurses under a standardised Connect, Ask, Respond and Empathise (CARE) protocol; (b) the ability to enhance the effectiveness of the ISBAR checklist; (c) any increase in nurses' spoken interactions and/or improved comprehension of the patient conditions upon the transfer of responsibility. Background: Nursing handover is a pivotal act of communication with effects on both patient safety and risk management. Previous studies of critical incidents have highlighted ineffective communication, including a lack of interaction and incomplete and unstructured handovers, as a major contributor to patient harm. Design: A pre- and post evaluation study involving a questionnaire survey before and after the 3-hours training. Methods: Forty-nine randomly selected bilingual nurses with no previous professional development experience in handover communication were trained according to the CARE protocol, and their perceptions of nursing handovers were assessed before and after training using questionnaire. The STROBE checklist is used (See File S1). Results: Training of the CARE protocol improved key areas of the handover process. All participating nurses exhibited significant improvements in their perceptions of effective handover from before to after training. Particularly, improvements were observed in the interactive frequency and quality and completeness of the presented patient information per handover. Conclusions: The nurses reported a deeper understanding of their perceptions of handover after a patient-centred intervention, a better quality of interactions (e.g., querying and checking by incoming nurses), a greater focus when managing handovers and a more complete and comprehensive transfer of information between nurses. Relevance to clinical practice: CARE protocol-based training yielded significant improvements in nursing handover practice.
Slade, D, Murray, KA, Pun, JKH & Eggins, S 2019, 'Nurses' perceptions of mandatory bedside clinical handovers: An Australian hospital study', Journal of Nursing Management.View/Download from: Publisher's site
© 2018 John Wiley & Sons Ltd Aims: The research explores (a) nurses' views of the change to mandatory bedside handovers, and (b) these nurses' perceptions of their skills in managing this new practice in an Australian hospital. Background: In Australia, nursing bedside handovers are now considered essential in many hospitals, although most nurses received minimal training at the time this policy was instituted. This research establishes a unique quantitative tool to investigate nurses' views of, and self-reported actions related to, bedside handovers. Method: Prior to the implementation of mandatory bedside handovers in a hospital in Canberra, Australia, nurses in two wards (n = 66) were recruited to complete the new Bedside Handover Attitudes and Behaviours (BHAB) questionnaire. Results: Most nurses strongly value bedside handovers and have confidence in their ability to lead this clinical practice. Conclusions: Researchers identified a high level of alignment between the nurses' acceptance of bedside handovers and nurses' self-reported actions in conducting this communication process. Implications for Nursing Management: Future research should explore the links between nurses' views of, and skills in, the management of bedside handovers, as well as the effects of professional training for this practice. Furthermore, the BHAB questionnaire may be employed in different nursing contexts in future research.
Leung, CCH, Pun, J, Lock, G, Slade, D, Gomersall, CD, Wong, WT & Joynt, GM 2018, 'Exploring the scope of communication content of mechanically ventilated patients', JOURNAL OF CRITICAL CARE, vol. 44, pp. 136-141.View/Download from: UTS OPUS or Publisher's site
Pun, JKH, Chan, EA, Wang, S & Slade, D 2018, 'Health professional-patient communication practices in East Asia: An integrative review of an emerging field of research and practice in Hong Kong, South Korea, Japan, Taiwan, and Mainland China', PATIENT EDUCATION AND COUNSELING, vol. 101, no. 7, pp. 1193-1206.View/Download from: UTS OPUS or Publisher's site
Slade, D, Pun, J, Murray, KA & Eggins, S 2018, 'Benefits of Health Care Communication Training for Nurses Conducting Bedside Handovers: An Australian Hospital Case Study', JOURNAL OF CONTINUING EDUCATION IN NURSING, vol. 49, no. 7, pp. 329-+.View/Download from: UTS OPUS or Publisher's site
Ng, GWY, Pun, JKH, So, EHK, Chiu, WWH, Leung, ASH, Stone, YH, Lam, CL, Lai, SPW, Leung, RPW, Luk, HW, Leung, AKH, Au Yeung, KW, Lai, KY, Slade, D & Chan, EA 2017, 'Speak-up culture in an intensive care unit in Hong Kong: A cross-sectional survey exploring the communication openness perceptions of Chinese doctors and nurses', BMJ Open, vol. 7, no. 8, pp. 1-11.View/Download from: UTS OPUS or Publisher's site
© Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted. Objectives Despite growing recognition of the importance of speaking up to protect patient safety in critical care, little research has been performed in this area in an intensive care unit (ICU) context. This study explored the communication openness perceptions of Chinese doctors and nurses and identified their perceptions of issues in ICU communication, their reasons for speaking up and the possible factors and strategies involved in promoting the practice of speaking up. Design A mixed-methods design with quantitative and sequential qualitative components was used. Setting and participants Eighty ICU staff members from a large public hospital in Hong Kong completed a questionnaire regarding their perceptions of communication openness. Ten clinicians whose survey responses indicated support for open communication were then interviewed about their speak-up practices. Results The participating ICU staff members had similar perceptions of their openness to communication. However, the doctors responded more positively than the nurses to many aspects of communication openness. The two groups also had different perceptions of speaking up. The interviewed ICU staff members who indicated a high level of communication openness reported that their primary reasons for speaking up were to seek and clarify information, which was achieved by asking questions. Other factors perceived to influence the motivation to speak up included seniority, relationships and familiarity with patient cases. Conclusions Creating an atmosphere of safety and equality in which team members feel confident in expressing their personal views without fear of reprisal or embarrassment is necessary to encourage ICU staff members, regardless of their position, to speak up . Because harmony and saving face is valued i...
Pun, JK, Chan, EA, Murray, KA, Slade, D & Matthiessen, CM 2017, 'Complexities of emergency communication: clinicians' perceptions of communication challenges in a trilingual emergency department.', Journal of Clinical Nursing, vol. 26, no. 21-22, pp. 3396-3407.View/Download from: UTS OPUS or Publisher's site
To understand the challenges that clinicians face in communicating with patients and other clinicians within a Hong Kong trilingual emergency department.Effective communication has long been recognised as fundamental to the delivery of quality health care, especially in high-risk and time-constrained environments such as emergency departments. The issue of effective communication is particularly relevant in Hong Kong emergency departments, due to the high volume of patients and the linguistic complexity of this healthcare context. In Hong Kong, emergency department clinicians are native speakers of Chinese, but have received their medical training in English. The clinicians read and record virtually all of their medical documentation in English, yet they communicate verbally with patients in Cantonese and Mandarin. In addition, communication between clinicians occurs in spoken Cantonese, mixed with medical English. Thus, medical information is translated numerous times within one patient journey. This complex linguistic environment creates the potential for miscommunication.A mixed-methods design consisting of a quantitative survey with a sequential qualitative interview.Data were collected in a survey from a purposive sample of 58 clinicians and analysed through descriptive statistics. Eighteen of the clinicians were then invited to take part in semi-structured interviews, the data from which were then subjected to a manifest content analysis.Nearly half of the clinicians surveyed believed that medical information may be omitted or altered through repeated translation in a trilingual emergency department. Eighty-three per cent of clinicians stated that there are communication problems at triage. Over 40% said that they have difficulties in documenting medical information. Around 50% believed that long work hours reduced their ability to communicate effectively with patients. In addition, 34% admitted that they rarely or never listen to patients during a consulta...
Macqueen, S, Woodward-Kron, R, Flynn, E, Reid, K, Elliott, K & Slade, D 2016, 'A Resource for Teaching Emergency Care Communication', The Clinical Teacher, vol. 13, no. 3, pp. 192-196.View/Download from: UTS OPUS or Publisher's site
BACKGROUND: Communication in emergency departments (EDs), often between several health professionals and patients and relatives, is a major cause of patient complaint and error; however, communication-skills teaching for medical students largely focuses on individual clinician-patient interactions. CONTEXT: We developed and implemented an evidence-informed online resource, Communication for Health in Emergency Contexts (CHEC; http://www.chec.meu.medicine.unimelb.edu.au/resources) to raise medical students' awareness of the challenges of communication in the ED, and to provide students with communication strategies for addressing these challenges. The foundation of the CHEC resource was the findings and data from a large research project conducted at five emergency departments in Australia over the period 2006-2009. From this, we developed ED scenarios and teaching vignettes using authentic communication data. The project included a nationwide medical curriculum scoping phase, involving interviews with medical students and educators, on ED communication curriculum needs in order to inform the educational activities. INNOVATION: The CHEC resource provides students with the opportunity to follow real-life scenarios through all stages of the ED journey, whereas insights from ED medical and nursing staff provide learning opportunities about interprofessional communication for medical students. Evaluation suggests that students find the resource useful, and that the resource has been successfully embedded in medical and junior doctor training on communication and quality and safety. IMPLICATIONS: The CHEC resource enhances the capacity of busy clinical educators to raise students' awareness of the communication needs of emergency health care by focusing on communication in high-stress, time-pressured settings using a web format. The CHEC resource provides students with the opportunity to follow real-life scenarios through all stages of the ED journey.
Slade, DM & Eggins, S 2016, 'Contrasting discourse styles and barriers to patient participation in bedside nursing handovers', Communication and Medicine, vol. 13, no. 1, pp. 71-83.View/Download from: UTS OPUS or Publisher's site
This paper applies qualitative discourse analysis to
'shift-change handovers', events in which nurses hand
over care for their patients to their colleagues. To
improve patient safety, satisfaction and inclusion,
hospitals increasingly require nursing staff to hand
over at the patient's bedside, rather than in staff-only
areas. However, bedside handover is for many a new
and challenging communicative practice. To evaluate
how effectively nurses achieve bedside handover,
we observed, audio-recorded and transcribed nursing
shift-change handovers in a short stay medical
ward at an Australian public hospital. Drawing on
discourse analysis influenced by systemic functional
linguistics we identify four handover styles: exclusive
vs inclusive and objectifying vs agentive. The styles
capture interactional/interpersonal meaning choices
associated with whether and how nurses include
patients during handover, and informational/ideational
meaning choices associated with whether or
not nurses select and organise clinical information
in ways that recognise patients' agency. We argue
that the co-occurrence of inclusive with agentive and
exclusive with objectifying styles demonstrates that
how nurses talk about their patients is powerfully influenced
by whether and how they also talk to them.
In noting the continued dominance of exclusive objectifying
styles in handover interactions, we suggest
that institutional change needs to be supported by
Chandler, E, Slade, D, Pun, J, Espindola, E, Lock, G, Matthiessen, CMIM & Ng, C 2015, 'Communication in Hong Kong Accident and Emergency Departments: The Clinicians' Perspectives', Global Qualitative Nursing Research, pp. 1-11.View/Download from: UTS OPUS or Publisher's site
de Silva Joyce, H, Slade, D, Bateson, D, Scheeres, H, McGregor, J & Weisberg, E 2015, 'Patient-centred Discourse in Sexual and Reproductive Health Consultations', Discourse & Communication, vol. 9, no. 3, pp. 275-292.View/Download from: UTS OPUS or Publisher's site
Eggins, S & Slade, D 2015, 'Communication in Clinical Handover: Improving the Safety and Quality of the Patient Experience.', Journal of public health research, vol. 4, no. 3, p. 666.View/Download from: UTS OPUS or Publisher's site
Pun, J, Matthiessen, C, Murray, K & Slade, DM 2015, 'Factors affecting communication inemergency departments: doctors andnurses' perceptions of communicationin a trilingual ED in Hong Kong', International Journal of Emergency Medicine, vol. 8, no. 48, pp. 1-12.View/Download from: UTS OPUS or Publisher's site
Background: This study investigates clinicians' views of clinician-patient and clinician-clinician communication,
including key factors that prevent clinicians from achieving successful communication in a large, high-pressured
trilingual Emergency Department (ED) in Hong Kong.
Methods: Researchers interviewed 28 doctors and nurses in the ED. The research employed a qualitative
ethnographic approach. The interviews were audio-recorded, transcribed, translated into English and coded using
the Nvivo software. The researchers examined issues in both clinician-patient and clinician-clinician communication.
Through thematic analyses, they identified the factors that impede communication most significantly, as well as the
relationship between these factors. This research highlights the significant communication issues and patterns in
Hong Kong EDs.
Results: The clinician interviews revealed that communication in EDs is complex, nuanced and fragile. The data
revealed three types of communication issues: (1) the experiential parameter (i.e. processes and procedures), (2) the
interpersonal parameter (i.e. clinicians' engagements with patients and other clinicians) and (3) contextual factors
(i.e. time pressures, etc.). Within each of these areas, the specific problems were the following: compromises in
knowledge transfer at key points of transition (e.g. triage, handover), inconsistencies in medical record keeping,
serious pressures on clinicians (e.g. poor clinician-patient ratio and long working hours for clinicians) and a lack of
focus on interpersonal skills.
Conclusions: These communication problems (experiential, interpersonal and contextual) are intertwined, creating a
complex yet weak communication structure that compromises patient safety, as well as patient and clinician
satisfaction. The researchers argue that hospitals should develop and implement best-practice policies and
educational programmes for clinicians that focus on the following: (1) understanding the...
Slade, D, Chandler, E, Pun, J, Lam, M, Matthiessen, CMIM, Williams, G, Espindola, E, Veloso, FOD, Tsui, KL, Tang, SYH & Tang, KS 2015, 'Effective healthcare worker-patient communication in Hong Kong accident and emergency departments', Hong Kong Journal of Emergency Medicine, vol. 22, no. 2, pp. 69-83.View/Download from: UTS OPUS
Big data is a hot topic in the academic sector, and healthcare researchers are definitely not an exception. This article aims to provide a showcase in emergency medicine research to demonstrate the advantages of conducting such research using big data. Big data is a new and cost-effective research approach, and emergency medicine researchers could benefit from using this approach and by doing so producing high-quality research at a faster pace.
Rider, EA, Kurtz, S, Slade, D, Longmaid, HE, Ho, M-J, Pun, JK-H, Eggins, S & Branch, WT 2014, 'The International Charter for Human Values in Healthcare: An interprofessional global collaboration to enhance values and communication in healthcare', Patient Education and Counseling, vol. 96, no. 3, pp. 273-280.View/Download from: UTS OPUS or Publisher's site
Eggins, SE & Slade, DM 2012, 'Clinical handover as an interactive event: Informational and interactional communication strategies in effective shift-change handovers.', Communication and Medicine, vol. 9, no. 3, pp. 215-227.View/Download from: UTS OPUS or Publisher's site
Clinical handover - the transfer between clinicians of responsibility and accountability for patients and their care (AMA 2006) - is a pivotal and high-risk communicative event in hospital practice. Studies focusing on critical incidents, mortality, risk and patient harm in hospitals have highlighted ineffective communication - including incomplete and unstructured clinical handovers - as a major contributing factor (NSW Health 2005; ACSQHC 2010). In Australia, as internationally, Health Departments and hospital management have responded by introducing standardised handover communication protocols. This paper problematises one such protocol - the ISBAR tool - and argues that the narrow understanding of communication on which such protocols are based may seriously constrain their ability to shape effective handovers. Based on analysis of audio-recorded shift-change clinical handovers between medical staff, we argue that handover communication must be conceptualised as inherently interactive and that attempts to describe, model and teach handover practice must recognise both informational and interactive communication strategies. By comparing the communicative performance of participants in authentic handover events we identify communication strategies that are more and lesslikely to lead to an effective handover and demonstrate the importance of focusing close up on communication to improve the quality and safety of healthcare interactions.
Slade, D, Scheeres, H, Manidis, M, Iedema, R, Dunston, R, Stein-Parbury, J, Matthiessen, C, Herke, M & McGregor, J 2008, 'Emergency communication: the discursive challenges facing emergency clinicians and patients in hospital emergency departments', Discourse & Communication, vol. 2, pp. 271-298.View/Download from: UTS OPUS
Slade, D.M. 1997, 'Spoken Language in the ESL Classroom', Interchange.
Slade, D.M. 1997, 'Stories and Gossip in English: the macro-structure of casual talk', Prospect.
Clyne, M. & Slade, D.M. 1994, 'Spoken Discourse Studies in Australia', Australian Review of Applied Linguistics, vol. 11.
Slade, D.M. 1994, 'Effective Communication in the Restructured Workplace: Job Performance', Australian Language Matters, vol. 2, no. 4.
Slade, D.M. 1994, 'Gossip: Two Complementary Perspectives on the Analysis of Casual Conversation in English', Australian Review of Applied Linguistics, vol. 11, pp. 47-83.
Mattiessen, C, Slade, DM & Macken-Horarik, M 1992, 'Language in Context: A New Model for Evaluating Student Writing', Linguistics and Education, vol. 4, no. 2, pp. 173-195.
Slade, DM & Gibbons, J 1988, 'Testing Bilingual Proficiency in Australia: Issues, Methods, Findings', Evaluation and Research in Education, no. 1.
Barthel, A., Hughes, C. & Slade, D.M. 1987, 'Needs-based Programming and the Provision of English Language Tuition in the A.M.E.P.', Prospect, vol. 2, no. 1, pp. 171-183.
Slade, D.M. 1986, 'Teaching Casual Conversation to Adult E.S.L. Learners', Prospect, vol. 2, no. 1, pp. 68-89.
Slade, D.M. & Gardner, R. 1985, 'Interactional Skills in Casual Conversation', Australian Review of Applied Linguistics, vol. 8, no. 1, pp. 105-121.
Using ethnographic discourse analysis in an Emergency Department in Hong Kong, this study explored the features of doctor-patient interactions in a hospital setting. By audio-recording 10 patient journeys, from triage to disposition, we analyzed the complexity of turn-taking patterns in spoken interactions between patients and doctors, as well as the subsequent complexities in this communication process. In particular, we traced the flow of communication surrounding the patients' medical conditions at different stages of their journeys (e.g., taking patient history, making diagnosis and translating medical information in a bilingual environment). Communication in this Emergency Department, as in all Emergency Departments in Hong Kong, involves repeated translation from spoken Cantonese interactions to the written English patient notes and vice versa. For this study, the ethnographic discourse analysis includes different layers of detailed language diagnoses of the observed interactions (e.g., turn-taking strategies, speech functions and exchange structures). In this analysis, we examined the strategies that doctors used to transfer medical knowledge to their patients and with other clinicians; this research illustrated how a series of contextual factors (e.g., time pressure, staff shortages) were linked with the quality of doctor–patient communication. To illuminate the path for future research, we developed a dual-goal communication framework focusing on both medical and interpersonal aspects of the doctor–patient relationship. We strongly recommend the application of this framework for training medical students, junior clinicians and clinicians in practice.
Eggins, S & Slade, DM 2016, 'Clinical Handover in Context: Risks and Protections Across a Hospital Patient's Journey' in Eggins, Slade, DM & Geddes, F (eds), Effective Communication in Clinical Handover from Research to Practice, De Gruyter Mouton, Berlin, pp. 131-155.View/Download from: UTS OPUS or Publisher's site
One weekday afternoon an 18-year-old patient, we'll call her Belinda Page,1 arrives at
the emergency department of a busy tertiary teaching hospital, complaining of shortness
of breath and chest pain due to a flare-up of her asthma. During the six hours
Belinda spends in the emergency department she develops additional symptoms –
and numbness, particularly down her left side. She undergoes an emergency
MRI, x-rays and other tests but the emergency department night registrar, Dr Ken Lee –
a relatively junior non-English speaking background doctor – cannot reach a diagnosis.
Under pressure to move patients out of the emergency department as quickly as
possible, during the night he calls the senior neurology consultant, Dr Richard Lancer,
who declines to admit Belinda before reviewing her. Dr Lee then calls the Ward M consultant,
Dr Allenanda, who reluctantly agrees to admit Belinda to a general medical
assessment ward, until the neurology staff can review her the next day.
Over the next day we observed and recorded as many of the interactions with and
about Belinda as we could, including consultations and examinations, formal and
informal discussions about her case and nursing and medical handovers. The first
occurred at 8 am the next morning when, after working a 12-hour shift, Dr Lee fronted
up to a large auditorium to give the whole-of-hospital medical handover of all the
patients he had admitted overnight. He sat on a solitary chair placed front and center
of the auditorium, almost as if he were to be interrogated. In the tiered rows of seats
facing him sat those members of the hospital's day shift medical staff who had the
time and motivation to attend (attendance is not compulsory). On this morning, about
25 doctors were present, ranging from interns to senior consultants. They included
the two female registrars from Ward M (Dr Pantani and Dr Lingren) and a male cardiology
consultant (Dr Davidson). The neurology consultant Dr Lancer arrived about
Eggins, S & Slade, DM 2016, 'Communication in Bedside Nursing Handovers' in Eggins, S, Slade, DM & Geddes, F (eds), Effective Communication in Clinical Handover from Research to Practice, De Gruyter Mouton, Berlin, pp. 97-113.View/Download from: UTS OPUS or Publisher's site
The previous chapters have described the challenges of emergency department
clinical handovers when medical staff change. In this chapter the focus shifts to
nursing staff shift changes in a general medical ward. We describe and analyze
the practice of bedside handovers in a metropolitan teaching hospital, hospital B,
acknowledging the challenges but also the benefits of this semi-public clinical
handover mode for nurses and patients. In chapter 7 we then suggest strategies and
resources to improve patient safety and to increase nurse and patient satisfaction
with the practice.
Eggins, S & Slade, DM 2016, 'Resource: Communicating Effectively in Bedside Nursing Handovers' in Eggins, S, Slade, DM & Geddes, F (eds), Effective Communication in Clinical Handover from Research to Practice, De Gruyter Mouton, Berlin, pp. 115-125.View/Download from: UTS OPUS or Publisher's site
Chapter 6 described the challenges nurses faced at the research site when implementing
the mandated policy of bedside handovers. In response to our research findings,
and with the strong support of the local health department, we developed a twohour
training module 'Better Bedside Handovers', and a train-the-trainer package.
At time of writing we have delivered this training to more than 300 nurses and nurse-managers.
The training is described in full in Slade et al. (in preparation). In this
chapter we summarize the training module design and present the communication
protocols and tools that we developed.
Eggins, S, Geddes, F & Slade, DM 2016, 'iCARE: an Integrated Translational Model of Effective Clinical Handover Communication' in Eggins, S, Slade, DM & Geddes, F (eds), Effective Communication in Clinical Handover from Research to Practice, De Gruyter Mouton, Berlin, pp. 295-323.View/Download from: UTS OPUS or Publisher's site
Our final example of a handover event brings together many of the challenges with
clinical handover identified in earlier chapters.
Early one weekday evening, Sartaj1, a tall, strong man who speaks English as
a second language, brought his wife Indira to hospital B's emergency department.
Indira was 33-weeks pregnant and had suffered a miscarriage in the past. The couple
were of Indian background. Sartaj told the triage nurse that Indira was complaining
of nausea and vomiting and had headaches. Sartaj explained that he had taken Indira
to the other major public hospital in the city earlier in the day, but that she had been
discharged home after a few hours in their emergency department.
Several hours later, hospital B's emergency department night registrar examined
Indira. He found her unwell – still nauseous and complaining of severe headaches.
He was unable to reach a diagnosis but wanted to admit Indira for observation and
tests. However, no beds were available in the antenatal ward. He made several phone
calls to consultants and other wards, looking for a bed where Indira could be cared for
while she waited for a bed in antenatal. At around 3 am Indira was admitted to Ward M,
the hospital's general medical ward, where she stayed for 10 hours before being transferred
to a bed in the antenatal ward.
Throughout her admission and handover, Indira was accompanied by Sartaj.
With the consent of Sartaj and Indira, an ECCHo researcher observed and audiorecorded
the transfer from Ward M to the antenatal ward.
Geddes, F, Slade, DM, Eggins, S, Watson, B, Manias, E, Della, P & Jones, D 2016, 'Clinicians' Voices: What Healthcare Professionals Say About Handover Practice' in Eggins, S, Slade, DM & Geddes, F (eds), Effective Communication in Clinical Handover from Research to Practice, De Gruyter Mouton, Berlin, pp. 25-42.View/Download from: UTS OPUS or Publisher's site
The following patient story is taken verbatim from a junior doctor's recount of an adverse event submitted to the ECCHo handover survey
Slade, DM, Eggins, S, Geddes, F, Watson, B, Manias, E, Bear, J & Pirone, C 2016, 'Effective Communication in Clinical Handover: Challenges and Risks' in Eggins, S, Slade, DM & Geddes, F (eds), Effective Communication in Clinical Handover from Research to Practice, De Gruyter Mouton, Berlin, pp. 5-24.View/Download from: UTS OPUS
Slade, DM, Matthiessen, CM, Lock, G, Pun, J & Lam, M 2016, 'Patterns of Interaction in Doctor-patient Communication and Their Impact on Health Outcomes' in Ortega, L, Tyler, A, Park, HI & Uno, M (eds), The Usage-based Study of Language Learning and Multilingualism, Georgetown University Press, Washington, DC, pp. 235-254.View/Download from: UTS OPUS
Slade, DM, Pun, J, Lock, G & Eggins, S 2016, 'Potential risk points In doctor–patient communication: An analysis of Hong Kong emergency department medical consultations' in de Silva Joyce, H (ed), Language at work: Analysing Language Use in Work, Education, Medical and Museum Contexts, Cambridge Scholars Publishing, Newcastle upon Tyne, pp. 146-165.View/Download from: UTS OPUS
Matthiessen, C & Slade, DM 2011, 'Analysing Conversation' in Wodak, R, Johnstone, B & Kerswill, P (eds), The Sage Handbook of Sociolinguistics, Sage, Los Angeles, London, California, New Delhi, Singapore & Washington DC, pp. 367-387.View/Download from: UTS OPUS
McCarthy, M., Matthiessen, C.M. & Slade, D.M. 2010, 'Discourse Analysis' in Norbert Schmitt (ed), An Introduction to Applied Linguistics, Hodder Arnold, United Kingdom, pp. 146-160.
Thornbury, S & Slade, DM 2009, 'The Grammar of Conversation' in Cook, G & North, S (eds), Applied Linguistics in Action: A Reader, Routledge, London.
McCarthy, M. & Slade, D.M. 2007, 'Extending our Understanding of Spoken Discourse' in Cummins, J. & Davison, C. (eds), International Handbook of English Language Teaching, Springer, New York, USA, pp. 859-875.View/Download from: UTS OPUS
De Silva Joyce, H.C. & Slade, D.M. 2000, 'The Nature of Casual Conversation: Implications for Teaching' in de Silva Joyce, H. (ed), Teachers Voices: 6 Teaching Casual Conversaton, NCELTR, Macquarie University, Australia.
Slade, DM 1995, 'Spoken and Written Language of Training: An Australian Case Study' in Tickoo, M (ed), Theory and Practice.
Macken-Horarik, M. & Slade, D.M. 1993, 'Assessment: An Effective Foundation for Learning in the School Context' in Cope, W. & Kalantzis, M. (eds), The Powers of Literacy: Genre Approaches to Teaching Writing, Falmer Press, London, pp. 179-203.
Slade, D.M. & Gardner, R. 1993, 'Teaching Casual Conversation: The Issue of Simplification' in Tickoo, M.L. (ed), Simplification: Theory and Application, Anthology Series 31, SEAMEO Regional Language Centre, pp. 82-101.
Kalantzis, M., Cope, W. & Slade, D.M. 1990, 'Minority Languages and Mainstream Culture: Problems of Equity and Assessment' in de Jong, J.H.A.L. & Stevenson, D.K. (eds), Individualising the Assessment of Language Abilities, Multilingual Matters, Clevedon-Philadelphia, pp. 196-214.
Slade, DM, Manidis, M, McGregor, J, Scheeres, H, Stein-Parbury, J, Dunston, R, Stanton, N, Chandler, E, Matthiessen, C & Herke, M University of Technology, Sydney 2011, Communicating in hospital emergency departments, Volume 1: Final report, Sydney.
Slade, DM, Manidis, M, McGregor, J, Scheeres, H, Stein-Parbury, J, Dunston, R, Stanton, N, Chandler, N, Matthiessen, C & Herke, M University of Technology Sydney 2011, Communicating in hospital emergency departments, Volume 2: Executive Summary, Sydney.
Slade, DM, Woodward-Kron, R, Flynn, E, Stein-Parbury, J, Widin, J, Smith, L & Scheeres, H The University of Melbourne 2011, Multimedia learning and teaching resources: Communication for Health in Emergency Contexts (CHEC): Teaching and learning resource for Emergency Department Communication, Final report, Melbourne.
Media learning and teaching resources
Slade, DM, Scheeres, H, de Silva Joyce, H, McGregor, J, Weisberg, E, Bateson, D, Stanton, N & Herke, M University of Technology Sydney 2009, Developing Effective Communication between Doctors and Clients: Sexual and Reproductive Health Consultations, Sydney.
Bell, C, Dunston, R, Fitzgerald, T, Hawke, G, Lee, A, Lee, A, Matthews, L, Nisbet, G, Pockett, R, Slade, D, White, J & et al Centre for Research in Learning and Change 2008, Interprofessional health education in Australia: A proposal for future research and development, no. L-TIPP, Sydney.
Slade, DM, Joyce, H, Nesbitt, C, Scheeres, H & Solomon, N Department of Immigration, Technology and Regional Development 1995, Effective Communication in the Restructured Workplace, Volume 1: Team Work, Canberra.
Slade, DM, Joyce, H, Nesbitt, C, Scheeres, H & Solomon, N Department of Immigration, Technology and Regional Development 1995, Effective Communication in the Restructured Workplace, Volume 2: Team Meetings, Canberra.
Slade, DM, Joyce, H, Nesbitt, C, Scheeres, H & Solomon, N Department of Immigration, Technology and Regional Development 1995, Effective Communication in the Restructured Workplace, Volume 3: Job Performance, Canberra.
Slade, DM, Joyce, H, Nesbitt, C, Scheeres, H & Solomon, N Department of Immigration, Technology and Regional Development 1995, Effective Communication in the Restructured Workplace, Volume 4: The Spoken and Written Language of Training, Canberra.
Cope, W, Pauwels, A, Slade, DM, Brosnan, D & Neil, D Australian Government Publishing Services 1994, Local Diversity, Global Connections, Volume 1 Six Approaches to Cross-Cultural Training, Canberra.
Cope, W, Pauwels, A, Slade, DM, Brosnan, D & Neil, D Australian Government Publishing Services 1994, Local Diversity, Global Connections, Volume 2: Core Principles for Effective Cross-Cultural Training, Canberra.