Objective: This paper reports an exploratory study to identify patterns of communication behaviour amongst hospital-based healthcare workers. Design: Non- participatory, qualitative observational study. Setting: UK district general hospital. Subjects: Eight physicians and two nurses. Results: Communication behaviours resulted in an interruptive work place, which appeared to contribute to work practice inefficiency. Medical staff generated twice as many interruptions via the telephone and paging system as they received. Hypothesised causes for this level of interruption include a bias by staff to interruptive communication methods, a tendency to seek information from colleagues I preference to printed materials, and poor information provision in support of role-based contact. Staff was also observed to infer the intention of messages based upon insufficient information and clinical teams demonstrated complex communication patterns, which could lead to inefficiency. Conclusion: The results suggest a number of improvements to processes or technologies. Staff may need instruction in appropriate use of communication facilities. Further, excessive emphasis on information technology may be misguided since much may be gained by supporting Information exchange through communication technology. Voicemail and e-mail with acknowledgement, mobile communication, improved support for role-based contact, message screening all may be beneficial in the hospital environment. 18 Pages