Gaps and overlaps in healthcare team communication: analysis of speech

Studying groups in their natural contexts can help build understanding of complex organisational behaviours. Guided by the principles of conversation analysis, we discuss some of the dynamics of multidisciplinary teams in cancer care by examining the communication practices used to negotiate levels of participation in their routine work meetings, while considering patient safety implications.Breast, colorectal and gynaecological cancer teams were videoed over 12-weekly meetings encompassing 822 patient-reviews with a cross-section transcribed using Jefferson notation. A low frequency of gaps between speakers (3%) and high frequency of overlaps (24%) and no-gaps-no-overlaps (73%) was found, pointing to fast turn-transitions, secured predominantly with raised pitch and vocalizations. Securing one’s turn to speak in a multi-speaker fast-paced work group setting, such as cancer meetings, can be challenging due to systemic reduction in turn-taking opportunities, hence unequal participation. This may hinder effective communication and open up opportunity for error; an important patient safety implication.