Interprofessional communication and client centred care consistently influence and support the other four competencies CIHC, Canadian Interprofessional Health Collaborative.
A national interprofessional competency framework. Skip to content Interprofessional Communication and Collaboration Interprofessional communication and collaboration are integral components for safe client care and optimal health outcomes. Strategies for effective interprofessional communication include: Establishing teamwork communication principles to foster open discussions, decision making.
Health communication strategies need to be developed within health care teams to promote cooperation between team members, to share relevant information, and to promote coordination in making relevant health decisions. This article examines the need for teamwork in health care, the challenges to working effectively in teams, and the communication strategies and skills needed to promote teamwork in effective health care teams.
There are numerous complexities to working effectively in health care teams. The challenges to interprofessional coordination are often underestimated and such coordination demands advanced interpersonal and group communication skills, as well as sensitivity to professional and cultural differences. There is limited training for interprofessional teamwork in most health professional educational programs, with each professional group learning in isolation from other groups and health care consumers are rarely well prepared to participate actively in health care teams [ 1 ].
However, once health care professionals and consumers confront complex health care issues, they are expected to be able to work together collaboratively. This commentary article focuses on enhancing understanding how strategic communication can influence group climate, conflict management, and group decision-making in interprofessional health teams to promote effective team performance.
The article is grounded in the Relational Health Communication Competence and Health Outcomes Model that describes the need for collaborative interprofessional health care practices to enhance health outcomes [ 2 , 3 ].
The modern health care system has become exceedingly complex and specialized with a range of different health care professionals working together to help consumers address their health problems. Moreover, the patient and the patient's personal health care support system including key family members, advocates, friends, and others also need to participate actively in making important decisions related to delivery of care, long-term treatment, and rehabilitation [ 8 ].
These interdependent health care professionals and health care consumers often need to work together in interprofessional health care teams to coordinate their efforts and to share relevant information needed to provide the best health care services [ 9 ]. It is not easy to coordinate the different efforts of all the unique individuals who comprise interprofessional health care teams, even though the team members depend upon one another to provide appropriate health care services to achieve the best health outcomes [ 10 , 11 ].
Unfortunately, coordination and cooperation in health care does not happen automatically. In fact, there are often tremendous problems with promoting coordination of care in modern health care systems [ 12 ]. It takes a lot of work to get everyone participating in an interprofessional health care team to work together effectively [ 10 ].
Team members need to learn how to work together cooperatively, how to communicate with one another meaningfully, and how to make good health care decisions together [ 10 - 15 ]. It is critically important for team members to share relevant information they possess concerning the health care situation with all of the different members of their team, including health care providers, administrators, and consumers who are involved in health care situation, so they are all on the same page and know what is going on with the patient and the patient's treatment plan.
Each member of the team is likely to have specialized knowledge and experiences relevant to the health care situation that can help the team make informed health care decisions. However, the best ways to share this specialized knowledge and information may be difficult for team members to accomplish.
Even when team members are able to share their specialized knowledge effectively and all the involved team members have been provided with the latest relevant health information, it does not guarantee that the team members will cooperate with each other in the delivery of care.
Each team member will inevitably have his or her own personal interpretations about the health information provided, and each is likely to make different decisions about priorities for care and the best courses of action based on each person's unique background, expertise, and involvement in the case [ 13 ].
For example, a pharmacist is likely to focus on the benefits and risks concerning medications that may be relevant to the case [ 14 ]. A surgeon is likely to have a different perspective on the case, likely focusing on the different surgical interventions that may be warranted. Certainly, the patient will have a unique perspective about treatment decisions related to his or her concerns about the complexity of different treatments, the potential the treatments will help address the health problem, as well as concerns about implications of different course of treatment for pain, suffering, the length of hospitalization, rehabilitation, and costs.
All of these different orientations to the same health care case are legitimate and important perspectives to consider in making the best health care decisions. Team members can share their different insights and expertise to help address complex health care problems. That is why it is important to work in health care teams. Sharing relevant information and expertise is a necessary part of developing effective health care teams, but it is not enough to enable health care teams to work well.
Team members need to not only share information with each other, they also have to be able to act on the information shared together to make good informed health care decisions. This means that each team member has to be responsive to hearing the perspectives of other team members, each team member must be willing to be influenced by the information shared by other team members, and the team members much be able to make collaborative decisions together that reflect the specialized information and insights shared within the team [ 15 ].
Strategic communication is needed to enable team members to work together to make informed, collaborative, and responsive health care decisions and this module will explore the conceptual issues involved in strategic health care team communication [ 16 ]. There are a variety of important behavioral roles performed by different members of interprofessional health care teams. Communication is the process through with team roles are expressed and team goals are achieved.
Two primary team roles are leadership and follower roles. Leaders are team members who exert influence over team activities by providing other team members with guidance to accomplish specific group goals. Leaders often assign projects and provide task instructions to other team members. For example, a health care team leader might ask other members to review specific laboratory results to determine how well patients are responding to treatments.
The leader might provide them with a form to fill out that guides their review of these lab tests and can be shared with other group members when they meet to make treatment recommendations for the patients.
Leaders depend upon members of the team to follow the directions provided to them followers , enabling leaders to influence group process. Typical team leadership activities include calling for and conducting team meetings to share information and make decisions, establishing standards for group interactions, raising topics for team deliberations, assigning responsibilities among team members, inviting members to share their individual perspectives on different issues under discussion, introducing new and relevant information to the group, initiating team decision making, and introducing strategies for implementing group decisions.
Leaders are often appointed and assigned to official leadership roles. These are formal leaders of health care teams. Frequently the formal leaders of health care teams are senior physicians or the primary provider in-charge of the health care case that the team is addressing.
Sometimes health care teams are also led by senior health care administrators who are appointed as formal leaders. However, there are times when different team members also assume informal leadership roles sometimes referred to as emergent leaders based upon their relevant expertise and experiences concerning specific issues the team is addressing [ 17 ]. These informal leaders help address team issues by leading discussions and decision making activities on topics on which they are especially knowledgeable.
For example, when discussing the best medication regimen for a patient the formal team leader might ask a pharmacist who is a member of the team to lead the discussion and guide medication selection decision-making [ 18 , 19 ].
In another situation, the formal leader might ask a nurse who has been caring for a specific patient to lead discussion about the ways the patient has been responding to treatment [ 20 ]. Both formal and emergent leaders need to be skilled communicators to facilitate group discussions, information sharing, conflict management, decision making, and implementation of team decisions.
Prominent management theorist Kenneth Benne and Paul Sheets [ 21 ] described functional and dysfunctional roles that are often performed in groups by leaders and followers. Functional roles help the group achieve goals, while the dysfunctional goals can distract the team from achieving their goals. Task roles are functional roles that help facilitate accomplishment of team activities and responsibilities. These role activities include contributing ideas, seeking relevant information, and providing feedback to other members to help manage team goal accomplishment.
Maintenance rolesare another type of functional role that helps to establish and preserve good interpersonal relations and cooperation among team members. Maintenance role communication activities include expressing support and encouragement, making comments to reduce tension, and encouraging cooperation.
Dysfunctional roles, however, can limit team progress, and should be minimized to improve group process because they include overly aggressive and blocking behaviors, such as hostile comments or refusing to respond to others' requests, that reduce team effectiveness. Effective interprofessional health care team leaders balance task and maintenance roles, while minimizing the expression of dysfunctional roles.
They try to give all team members an opportunity to communicate, so team interactions are not dominated by one or a few team members. It is important to maintain confidentiality of sensitive and private health issues discussed by the team. It is also important for team members to be receptive to the ideas of other team members and to treat each other with respect.
Failure to follow these expectations can cause serious impediments to accomplishing group goals. There are many challenges to working on health care teams. One of the major challenges is finding the time for busy team members to meet and share information. Scheduling of meetings needs to be responsive to team members' schedules and it is often best to have a standing weekly or bi-weekly meeting schedule that team members can place on their agendas.
Meeting remotely via conference call, Skype, or video conferencing can often make it easier to accommodate team member schedules and travel demands.
There are also time demands in preparing for team meetings, reviewing relevant background materials patient charts, lab results, medication information, research findings, etc. It is important for each team member to be committed to actively preparing and participating in team activities. Another major challenge to working effectively on health care teams is learning how to interact effectively with other health care professionals and health care consumers. Team members typically come from very different professional backgrounds, and sometimes have other differences based upon education, age, gender, and cultural background, that can make team interactions complicated.
In these situations, physicians are in charge of all decision-making without nursing input leading to poorer quality of care.
These hierarchical team structures, where physicians hold a senior position within the team, disempower nurses, resulting in a lack of confidence, fear of humiliation, and the feeling their knowledge and opinions are not valued. Quality patient care is jeopardized when nurses are reluctant to communicate with physicians in order to avoid conflict and fear of repercussions Gillespie, Chaboyer, Longbottom, and Wallis, Addressing this dangerous and unsafe communication barrier is crucial to improving communication and reaching optimum patient care outcomes.
Leadership must approach the negative consequences of a hierarchical team structure with a zero-tolerance policy. To reduce the negative aspects of hierarchy among the team, nurses need to discuss their fears and concerns with management, and together, come up with a plan for remediation.
By collaborating with management, nurses are taking an important step towards improving the delivery of safe, quality patient care. The following interventions led to improved nurse-physician communication in the ICU setting:. Interventions can be modified to apply to a variety of healthcare settings. Nurses need to assess gaps in communication at their workplace, take the initiative to find solutions and integrate them into practice.
Creating unit or agency policies on the use of communication tools or interventions is a necessary step towards reducing the hierarchical structure of the team, leading to improved nurse-physician collaboration. The program provides employees with tools that empower them to voice their concerns, especially in clinical practice situations when patient safety is at risk. When employees are given opportunities to communicate in a safe way, without fear of repercussion or conflict, it minimizes the negative aspects of the hierarchical relationship Clapper, Consider a patient with Chronic Obstructive Pulmonary Disease, with symptoms including shortness of breath, anxiety, restlessness, discouragement, pain, weakness, and activity intolerance.
Patients with these symptoms may struggle with a number of environmental factors that could impact sending and receiving messages from others. Patients may struggle with bright or low lights; warm, still air; or a noisy environment. Papastavrou, Andreou, Efstathiou found the following environmental barriers negatively impacted communication for stroke patients in an acute care setting:.
While this list of barriers was found to be present in a stroke unit, many of them can apply to other units or settings. DeVito identifies four ranges of interpersonal space for communication in the United States:. Arnold and Boggs state therapeutic communication occurs at feet, though more physical space is needed if a patient is anxious.
In contrast, less than 3 feet is often used during a painful procedure or injury. Though a patient-centered approach is needed in all situations, assessing for patient preference can prevent miscommunication. Men and women differ in many ways in respect to both verbal and non-verbal communication behaviors. Yang et al. This means women tend to give more space to other women compared to men.
Patients and coworkers will find it awkward to tell someone to move back though having the awareness that adequate space is essential for transmission of a message from one person to the other.
Another gender barrier to communication is verbal communication. How men and women speak can be judged incorrectly. Smith n. Focus on feelings, senses and meaning.
They rely on their intuition to find answers. Focus on facts, reason and logic. They find answers by analyzing and figuring things out. Disagreement affects many aspects of their relationship and may take a long time to resolve. Subramaniam et al. Jargon is commonly used during communication by medical professionals, and those who are not familiar with these terms are excluded from the conversation.
How would a patient appreciate overhearing a nurse referring to someone as a trainwreck? The use of slang is a more casual type of jargon that is not usually used in professional settings, though can occur among nurses and other staff.
As with jargon, those who do not use or know these terms are again excluded from the conversation. One negative side of slang and jargon is they can have multiple meanings. While some of these meanings can apply to the same situation, one can see how the intended message can be lost when using a word or phrase with multiple meanings. The best approach to effective communication is to follow best practices, as follows:.
Privacy Policy. Skip to main content. Chapter 3. Search for:. Interprofessional Communication Effective communication within the interprofessional team is one of the hallmarks to providing safe, quality care.
Standards of Practice Professional nursing practice requires communication be maintained at a highly effective level. Demonstrates cultural empathy when communicating. Maintains communication with interprofessional team and others to facilitate safe transitions and continuity in care delivery. A previous study showed that cooperation and satisfactory inter-personal communication are needed to provide adequate care to patients [25]. The most common interpersonal clinical encounter occurs between patients and healthcare providers.
Oral communication is the first stage in interaction between healthcare professionals and patients. Encounters between patients and healthcare professionals are either performed directly or through an interpreter. Although there is a risk of misunderstandings in both the above-mentioned clinical encounters, they are more frequent when there is a language barrier and when a third person interpreter is involved in the clinical encounter [26].
In oral communication, there is a risk of both linguistic and cultural misunderstandings in cases of communication through interpreters. If the interpreter and the patient share the same language, just two languages will be involved in the interpretation process bilingual interpretation process. In order to minimize misunderstandings in inter-professional and interpersonal, clinical encounters, satisfactory communication, both in written and oral form is crucial.
Overall, oral communication between clinicians and radiologists functions well. Due to the language barrier and cultural diversity in interpersonal communication, there is a risk of misunderstandings. Joint meetings between radiologists and referring clinicians are necessary for both of them to understand the needs of the other party and to improve communication quality. Uplifting content cuts across the quarantine lines and geographical boundaries, uniting all of us who are experiencing just about the biggest crisis of our lives.
All Rights Reserved! Toggle navigation. Clinical health communication articles, Inter-professional clinical encounters articles, Health outcome articles. Background 1.
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