Using participatory research to identify actionable facilitators and barriers to effective inpatient interdisciplinary communication

Communication failures occur often in the inpatient setting. Efforts to understand and improve communication often exclude patients or are siloed by discipline. We aimed to identify barriers and facilitators to effective communication within interdisciplinary inpatient internal medicine (IM) teams u...

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Bibliographic Details
Published in:	Journal of hospital medicine Vol. 18; no. 2; pp. 130 - 138
Main Authors:	Jenkins, Ashley M, Weber, Danielle E, Arfaa, Jennifer Jasmine E, Arken, Andrew, Clark, Danielle L, Dobbs, Emily, Lahbabi, Betina, Myers, Kurt, Tu, Jamie, Clarke-Myers, Katherine
Format:	Journal Article
Language:	English
Published:	United States Frontline Medical Communications 01-02-2023
Subjects:	Cluster analysis Communication Community-Based Participatory Research Concept mapping Health Facilities Humans Inpatients Interdisciplinary aspects Interdisciplinary Communication Participatory research Patients Qualitative Research Stakeholders
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Summary:	Communication failures occur often in the inpatient setting. Efforts to understand and improve communication often exclude patients or are siloed by discipline. We aimed to identify barriers and facilitators to effective communication within interdisciplinary inpatient internal medicine (IM) teams using a participatory research approach. We conducted a single-center participatory mixed methods study using group-level assessment (GLA) and concept mapping to iteratively engage stakeholders. Stakeholder groups included patients/families, IM faculty, IM residents, nurses and ancillary staff, and care managers. Stakeholder-specific GLA sessions were conducted. Participants responded to prompts addressing interdisciplinary communication then worked in small groups to synthesize the qualitative data into unique ideas. A subset of each stakeholder group then sorted ideas through a concept mapping exercise. Multidimensional scaling and hierarchical cluster analysis were used to generate a concept map of the data. Participants generated 97 unique ideas that were then sorted. The research team chose an eight-cluster concept map representing patient inclusion and engagement, processes and resources, team morale and inclusive dynamics, attitudes and behaviors, effective communication, barriers to communication, the culture of healthcare, and clear expectations. Three larger domains of patient inclusion and engagement, organizational conditions and role clarity, and team dynamics and behaviors were noted. Use of a participatory research approach made it feasible to engage diverse stakeholders including patients. Our results highlight the need to identify context-specific facilitators and barriers of interdisciplinary communication. The importance of clear expectations was identified as a prioritized area to target communication improvement efforts.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	1553-5592 1553-5606
DOI:	10.1002/jhm.13013