J Am Med Inform Assoc 17:91-98 doi:10.1197/jamia.M3307
  • Original Investigation
  • Research paper

The effects of hands-free communication device systems: communication changes in hospital organizations

  1. Joan S Ash
  1. Oregon Health & Science University, Portland, Oregon, USA
  1. Correspondence to J E Richardson, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd, M/S BICC, Portland, OR 97239, USA; richajos{at}
  • Received 30 July 2009
  • Accepted 21 October 2009


Objective To analyze the effects that hands-free communication device (HCD) systems have on healthcare organizations from multiple user perspectives.

Design This exploratory qualitative study recruited 26 subjects from multiple departments in two research sites located in Portland, Oregon: an academic medical center and a community hospital. Interview and observation data were gathered January through March, 2007.

Measurements Data were analyzed using a grounded theory approach. Because this study was exploratory, data were coded and patterns identified until overall themes ‘emerged’.

Results Five themes arose: (1) Communication access—the perception that HCD systems provide fast and efficient communication that supports workflow; (2) Control—social and technical considerations associated with use of an HCD system; (3) Training—processes that should be used to improve use of the HCD system; (4) Organizational change—changes to organizational design and behavior caused by HCD system implementation; and (5) Environment and infrastructure—HCD system use within the context of physical workspaces.

Conclusion HCD systems improve communication access but users experience challenges integrating the system into workflow. Effective HCD use depends on how well organizations train users, adapt to changes brought about by HCD systems, and integrate HCD systems into physical surroundings.


  • Funding The authors would like to acknowledge funding support from the National Library of Medicine Training Grant 2-T15-LM007088.

  • Competing interests None.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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