Relational coordination among home healthcare professions and goal attainment in nursing care

Sakai, Mahiro; Naruse, Takashi; Nagata, Satoko

doi:10.1111/jjns.12117

Cited by 14 publications

(8 citation statements)

References 35 publications

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“…For example, in the airline industry, relational coordination across 12 workgroups was associated with quality outcomes such as fewer passenger complaints, fewer late arrivals, and fewer baggage handling errors (Gittell, 2001). Similarly, subsequent studies in health care found relational coordination among interdisciplinary staff was positively associated with quality outcomes such as postoperative functional status, patient-reported quality of care and quality of life, family satisfaction with care, patient trust and confidence in their providers, and patient psychological well-being (Azar et al, 2017;Bae et al, 2010;Cramm et al, 2014;Cramm & Nieboer, 2012a, 2014aDeJesus, 2015;Gittell, 2002a;Gittell et al, 2000;Gittell et al, 2008;Havens et al, 2010;Noël et al, 2013;Romanow et al, 2018;Sakai et al, 2015;Sakai et al, 2016;Weinberg et al, 2007) as well as staff-reported quality of care (McDermott et al, 2017;McIntosh et al, 2014). These findings were further replicated in studies conducted in the pharmacy, professional services, higher education, and elder care industries (Alvarez, 2014;Drewery et al, 2016;Gittell et al, 2008;Hoos et al, 2012;Margalina et al, 2017;Skakon, 2014).…”

Section: Quality Outcomesmentioning

confidence: 93%

Revisiting Relational Coordination: A Systematic Review

Bolton

Logan

Gittell

2021

The Journal of Applied Behavioral Science

148

154

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Work is increasingly complex, specialized, and interdependent, requiring coordination across roles, disciplines, organizations, and sectors to achieve desired outcomes. Relational coordination theory proposes that relationships of shared goals, shared knowledge, and mutual respect help to support frequent, timely, accurate, problem-solving communication, and vice versa, enabling stakeholders to effectively coordinate their work across boundaries. While the theory contends that cross-cutting structures can strengthen relational coordination, and that relational coordination promotes desired outcomes for multiple stakeholders, the empirical evidence supporting the theory has not previously been synthesized. In this article, we systematically review all empirical studies assessing the predictors and outcomes of relational coordination published from 1991 to 2019. We find evidence supporting the existing theory and discuss how that evidence supports expanding the theory from a linear structure–process–outcomes model to a dynamic model of change. An agenda for researchers and practitioners is proposed.

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Section: Quality Outcomesmentioning

confidence: 93%

Revisiting Relational Coordination: A Systematic Review

Bolton

Logan

Gittell

2021

The Journal of Applied Behavioral Science

148

154

View full text Add to dashboard Cite

show abstract

“…Strong RC across organizations serving the same constituents enables participants to achieve higher quality outcomes more efficiently (27,28,31,32). A recent systematic review (29) identified several healthcare studies which positively associated relational coordination among interdisciplinary staff to quality outcomes including postoperative functional status, patient reported quality of care and quality of life, family satisfaction with care, patient trust and confidence with providers, and patient psychological well-being (27)(28)(29)(33)(34)(35)(36)(37)(38)(39)(40)(41)(42)(43)(44). Despite the growing evidence of relational coordination on patient and provider outcomes, only 14% of all RC findings were based on relational coordination between providers and their clients, including caregivers (29).…”

Section: Theorymentioning

confidence: 99%

Timely Communication Through Telehealth: Added Value for a Caregiver During COVID-19

Hajjar

Kragen

2021

Front. Public Health

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Objective: This caregiver case study applies the lens of relational coordination theory (RC) to examine the value of telehealth as a medium of care coordination for a pediatric patient with hypermobile Ehlers-Danlos Syndrome (hEDS) during the COVID-19 pandemic.Background: The COVID-19 pandemic has placed an unprecedented burden on the delivery of healthcare around the globe and has increased the reliance on telehealth services. Delivering telehealth requires a high level of communication and coordination within and across providers as well as between providers, patients and their families. However, it is less clear how telehealth impacts the coordination of care. In this paper, we provide insight into the quality of care coordination between providers and an informal caregiver following policy changes to the provider payment structure in Massachusetts.Methods: This paper employs a single-case, autoethnographic study design where one of the authors uses their experiential insights, as mother of the patient, to inform a wider cultural and political understanding of the shift to remote caregiving for a pediatric patient with hEDS. Data was collected using reflective journaling, interactive interviews, and participant observation and analyzed using content analysis.Results: Findings revealed four interrelating roles of the caregiver including, logistics support, boundary spanner, home health aide, and cultural translator. The adoption of telehealth was associated with improved timeliness and frequency of communication between the caregiver and providers. Findings about the impact of telehealth adoption on accuracy of communication were mixed. Mutual respect between the caregiver and providers remained unchanged during the study period.Conclusions: This paper highlights areas where payer policy may be modified to incentivize timely communication and improve coordination of care through telehealth services. Additional insight from the perspective of an informal caregiver of a patient with a rare chronic disease provides an understudied vantage to the care coordination process. We contribute to relational coordination theory by observing the ways that caregivers function as boundary spanners, and how this process was facilitated by the adoption of telehealth. Insights from this research will inform the development of telehealth workflows to engage caregivers in a way that adds value and strengthens relational coordination in the management of chronic disease.

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“…In a prior series of studies [47,48], we incorporated the evidence-based practices of strengths-based learning [49,50], systematic observation [51], efficiency [48,52], and relationship-based teamwork [53,54] into a specific frontline staff huddling program known as the LOCK program. The LOCK program enables staff to (1) Learn from bright spots (focus on positive evidence of strengths); (2) Observe (collect data through systematic observation); (3) Collaborate in huddles (conduct frontline staff huddles); and (4) Keep it bite-size (limit activities to 5-15 min for efficiency) [48,55].…”

Section: Huddling and The Lock Programmentioning

confidence: 99%

Enhancing sleep quality for nursing home residents with dementia: a pragmatic randomized controlled trial of an evidence-based frontline huddling program

et al. 2021

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Background Disturbed sleep places older adults at higher risk for frailty, morbidity, and even mortality. Yet, nursing home routines frequently disturb residents’ sleep through use of noise, light, or efforts to reduce incontinence. Nursing home residents with Alzheimer’s disease and or related dementias—almost two-thirds of long-stay nursing home residents—are likely to be particularly affected by sleep disturbance. Addressing these issues, this study protocol implements an evidence-based intervention to improve sleep: a nursing home frontline staff huddling program known as LOCK. The LOCK program is derived from evidence supporting strengths-based learning, systematic observation, relationship-based teamwork, and efficiency. Methods This study protocol outlines a NIH Stage III, real-world hybrid efficacy-effectiveness pragmatic trial of the LOCK sleep intervention. Over two phases, in a total of 27 non-VA nursing homes from 3 corporations, the study will (1) refine the LOCK program to focus on sleep for residents with dementia, (2) test the impact of the LOCK sleep intervention for nursing home residents with dementia, and (3) evaluate the intervention’s sustainability. Phase 1 (1 year; n = 3 nursing homes; 1 per corporation) will refine the intervention and train-the-trainer protocol and pilot-tests all study methods. Phase 2 (4 years; n = 24 nursing homes; 8 per corporation) will use the refined intervention to conduct a wedge-design randomized, controlled, clinical trial. Phase 2 results will measure the LOCK sleep intervention’s impact on sleep (primary outcome) and on psychotropic medication use, pain and analgesic medication use, and activities of daily living decline (secondary outcomes). Findings will point to inter-facility variation in the program’s implementation and sustainability. Discussion This is the first study to our knowledge that applies a dementia sleep intervention to systematically address known barriers to nursing home quality improvement efforts. This innovative study has future potential to address clinical issues beyond sleep (safety, infection control) and expand to other settings (assisted living, inpatient mental health). The study’s strong team, careful consideration of design challenges, and resulting rigorous, pragmatic approach will ensure success of this promising intervention for nursing home residents with dementia. Trial registration NCT04533815, ClinicalTrials.gov, August 20, 2020.

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Relational coordination among home healthcare professions and goal attainment in nursing care

Abstract: The finding of this study suggest that well-coordinated professionals may fulfill client needs better than poorly coordinated professionals do. Future research is needed to determine whether similar results are obtained in individual clients using a well-validated goal attainment scale.

Cited by 14 publications

References 35 publications

Revisiting Relational Coordination: A Systematic Review

Revisiting Relational Coordination: A Systematic Review

Timely Communication Through Telehealth: Added Value for a Caregiver During COVID-19

Enhancing sleep quality for nursing home residents with dementia: a pragmatic randomized controlled trial of an evidence-based frontline huddling program

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