Interprofessional communication failures in acute care chains: How can we identify the causes?

Abstract

Although communication failures between professionals in acute care delivery occur, explanations for these failures remain unclear. We aim to gain a deeper understanding of interprofessional communication failures by assessing two different explanations for them. A multiple case study containing six cases (i.e. acute care chains) was carried out in which semi-structured interviews, physical artifacts and archival records were used for data collection. Data were entered into matrices and the pattern-matching technique was used to examine the two complementary propositions. Based on the level of standardization and integration present in the acute care chains, the six acute care chains could be divided into two categories of care processes, with the care chains equally distributed among the categories. Failures in communication occurred in both groups. Communication routines were embedded within organizations and descriptions of communication routines in the entire acute care chain could not be found. Based on the results, failures in communication could not exclusively be explained by literature on process typology. Literature on organizational routines was useful to explain the occurrence of communication failures in the acute care chains. Organizational routines can be seen as repetitive action patterns and play an important role in organizations, as most processes are carried out by means of routines. The results of this study imply that it is useful to further explore the role of organizational routines on interprofessional communication in acute care chains to develop a solution for failures in handover practices.

The Patient Care Paradox: An Interprofessional Qualitative Study of Agitated Patient Care in the Emergency Department

“…These interprofessional challenges are not unique to the ED, and poor communication and lack of cohesion between providers leading to limitations in definitive decision-making occur across the healthcare system. [42][43][44] However, our study found that these barriers to effective teamwork appear to exacerbate safety threats when patients present with acute agitation. A recently published framework for interprofessional collaboration cited structured team process and dynamic delegation of roles/responsibilities as core concepts for effective healthcare teams, as reflected in our study findings.…”

“…Staff expressed a need for enhanced coordination among healthcare team members during an agitated patient encounter, but noted barriers to teamwork due to silos and hierarchy causing antagonism between providers of different professions. These interprofessional challenges are not unique to the ED, and poor communication and lack of cohesion between providers leading to limitations in definitive decision‐making occur across the healthcare system . However, our study found that these barriers to effective teamwork appear to exacerbate safety threats when patients present with acute agitation.…”

Improving the governance of patient safety in emergency care: a systematic review of interventions

“…We defined the chain of emergency care as: the interprofessional structure in which emergency care is delivered by multiple providers with the aim to provide seamless care to patients with acute care needs. 6 …”

Heidelberger Interprofessionelle Ausbildungsstation (HIPSTA): a practice- and theory-guided approach to development and implementation of Germany’s first interprofessional training ward

“…IPCP occurring “when multiple health workers from different professional backgrounds provide comprehensive services by working with patients, their families, carers and communities to deliver the highest quality of care across settings” [5] has been identified as a key element to address these challenges. Shortcomings in collaboration between various health professions have repeatedly been linked to care failures, problems in work processes and patient safety [1], [2], [4]. Consequently health policy leaders across the globe have called for the use of IPCP as a key approach to improve the quality and safety of patient care [5], [6], [7], [8].…”

“…Failure to deliver efficient interprofessional collaborative practice (IPCP) has repeatedly been linked to deficits in care and impaired patient-safety [1], [2], [3], [4]. Consequently, health policy makers across the globe have called for the use of IPCP to improve quality and safety of care and address the upcoming challenges to health services [5], [6], [7], [8].…”