Shock Patients: Interprofessional Communication to Enhance Diagnosis

Role: MPI with MPI Dr. Anne Stey

Funding: AHRQ R18HS029483

Shock affects one in three patients in the intensive care unit and has a mortality rate of 30-50%. The objective of this project was to promote interprofessional communication and diagnostic concordance, because discordance increases mortality odds. I designed and oversaw the following qualitative and human-centered design methods:

Critical incident technique interviews found that clinicians work across fragmented physical, socio-organizational, and digital environments, balancing urgency to treat shock with intermediate steps to reduce diagnostic uncertainty (Cong et al. 2026).

Co-design with 76 critical care clinicians from 3 hospitals produced Huddle Around SHock (HASH), a multi-component intervention for on-demand communication via videoconference, including an electronic health record (EHR) alert predicting discordance, evidence-based conversation script, novel EHR patient data summary, and EHR order sets (Cong et al., under review).

Implementation of HASH is underway in three hospitals. I contributed to papers that analyzed EHR data to clarify predictors of discordance and mortality for shock patients (Janczewski et al. 2026, Rao et al. in press).

I also contributed to two papers identifying clarity of critical care team roles and communication processes as promoting psychological safety (Diaz et al. 2023) and characterizing effective communication by team leaders (Abahuje et al. 2023).