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Clinical and academic understandings of interprofessional working are focused mainly on individual factors such as knowledge about different professional roles, and organisational opportunities for interprofessional working (IPW). Less research has examined what happens between people at an interactional level, that is, how interprofessional working is conducted in everyday face-to-face interactions in clinical practice. The current paper proposes a discursive framework for understanding what constitutes IPW in interprofessional meetings at this interactional level. Clinical effectiveness meetings held in intellectual (learning) disability services were used as an example site for IPW. The analysis explored how agenda change points were negotiated, appropriate as agenda change points require collaboration (or agreement) between practitioners to progress to the next point The study found changes in agenda points were accomplished by practitioners conjointly through using discursive strategies including closing questions, and resources such as professional identity and laughter. The agenda provided a frame for the institutional order of the meetings, invoking a trajectory towards timely completion. However, this institutional order was at times subordinated to an 'order of concern', which seemed to enable challenges by managers to the meeting Chair and the agenda that demonstrated adherence not only to the procedural nature of the meetings, but also to the needs of service users and the services discussed. We suggest discursive strategies, resources, and both institutional orders, and order of concerns might provide a framework for developing future training and research, that is able to illuminate how IPW might be enacted in face-to-face team meetings.

Introduction: The health organizations of today are highly complex and specialized. Given this scenario, there is a need for health professionals to work collaboratively within interprofessional work teams to ensure quality and safe care. To strengthen interprofessional teamwork, it is imperative that health organizations enhance strategic human resources management by promoting team member satisfaction., Objective: To analyze the satisfaction of members in interprofessional teams and to explore interpersonal relationships, leadership, and team climate in a hospital context., Methodology: This study is an explanatory sequential mixed methods (quantitative/qualitative) study of 53 teams (409 professionals) at a university hospital in Santiago, Chile. The first phase involved quantitative surveys with team members examining team satisfaction, transformational leadership, and team climate. Social network analysis was used to identify interactions among team members (cohesion and centrality). The second phase involved interviews with 15 professionals belonging to teams with the highest and lowest team satisfaction scores. Findings of both phases were integrated., Results: Significant associations were found among variables, and the linear regression model showed that team climate (β = 0.26) was a better predictor of team satisfaction than team leadership (β = 0.17). Registered nurse was perceived as the profession with the highest score on the transformational leadership measure (mean = 64), followed by the physician (mean = 33). Team networks with the highest and lowest score of team satisfaction showed differences in cohesion and centrality measures. Analysis of interviews identified five themes: attributes of interprofessional work; collaboration, communication, and social interaction; interprofessional team innovation; shared leadership; and interpersonal relationship interface work/social. Integration of findings revealed that team member satisfaction requires participation and communication, common goals and commitment for patient-centered care, clear roles and objectives to support collaborative work, and the presence of a transformational leader to strengthen well-being, dialog, and innovation., Conclusions: Results have the potential to contribute to the planning and decision-making in the field of human resources, providing elements to promote the management of health teams and support team member satisfaction. In turn, this could lead to job permanence especially where the local health needs are more urgent.

Common ground refers to the knowledge shared by two communicating parties to enable communication to occur. We suggest that common ground could enhance collaborative care delivery by serving as the linkage between different healthcare team members. Despite research describing the importance of common ground to facilitate communication, little is known about how common ground forms, moments where it is necessary, and barriers to achieving it. To address this shortcoming we studied collaborative care delivery in two settings and then used Grounded Theory methodology to develop a model of common ground. The model contains four main concepts: moments of common ground, barriers to common ground, fabric of common ground, and consequences of weak common ground. Our findings show that common ground is multi-dimensional with both static and dynamic aspects. The results from this paper help us to better understand collaborative care delivery and how to design information and communication technologies to support it.

The healthcare industry is inadvertently a teamwork industry – and yet – little time is devoted to improving teamwork on the field. As a response to this issue, team development intervention (TDI) tools have flourished. Findings suggest the capability for TDIs to better team competencies, and potentially mitigate prominent healthcare problems. However, team coaching has been excluded as a potential TDI for healthcare. For this reason, we seek to 1) discuss existing team coaching models, integrating findings across the literature, 2) highlight the advantages of Hackman and Wageman (2005)'s model over others, 3) display its empirically-corroborated propositions, and finally, 4) provide general guidance on how to move forward. We move beyond extant literature by providing an outline on what outcomes team coaching can and cannot yield, accumulating evidence from fields outside of healthcare and incorporating team coaching into the TDI literature. By doing so, we hope empirical research on team coaching is incentivized, resulting in an efficient and accessible TDI for healthcare professionals and the field of interprofessional care. [ABSTRACT FROM AUTHOR]

Objectives: We describe a conceptual framework for an approach towards an effective and collaborative communication strategy among interprofessional health care team members. Methods: Interprofessional health care team members apply different communication techniques to share healthcare data. They are often not taught how to recognize and respond to the challenges carried by emotions and pressure to conform among team members. Those two factors have the potential to affect the quality and outcome of communication with a resulting suboptimal clinical decision-making. Here, we developed a Communication Schema that addresses the three critical concepts that are embedded in any conversation, namely: 1 – understanding the contribution of social interaction in teamwork, 2 – recognizing and managing triggered emotions, and 3 – effective inquiries and exploration of points of view. Implications: We call on extending the traditional view of teamwork as a collection of skills to include the reality of interprofessional practice where people working together are influenced by social experience and expectations. The learning conversation schema offers a tool that is sensitive to innate threats to effective communication in working environments and allows its users to circumvent obstacles to optimum shared decision-making. [ABSTRACT FROM AUTHOR]

Improving the hospital discharge process to prevent readmission requires a focus on the coordination and communication between interprofessional team members in and outside of the hospital as well as with patients and their caregivers. Yet little is known about how these actors currently communicate and coordinate during the discharge process. Network analysis allows for a direct look at this communication and coordination. This network analysis study utilized retrospective chart review to identify the individuals involved in the discharge planning and their communication with each other for 205 patients. Using this abstracted data, a network was created for each patient wherein a node was any individual involved in the patient's discharge planning process and a tie was any communication documented in the chart related to discharge planning between individuals. Graphical and structural network analyses were used to compare the networks of readmitted patients and non-readmitted patients. Networks of patients not readmitted were more hierarchical, unidirectional, streamlined compared to those readmitted. These findings demonstrate the feasibility and usefulness of conceptualizing discharge planning as a network. Future efforts to understand discharge planning and create interventions to improve the process may benefit by considering network patterns of communication. [ABSTRACT FROM AUTHOR]

Aim To review empirical studies examining antecedents (sources, causes, predictors) in the management and mitigation of interpersonal conflict. Background Providing quality care requires positive, collaborative working relationships among healthcare team members. In today's increasingly stress-laden work environments, such relationships can be threatened by interpersonal conflict. Identifying the underlying causes of conflict and choice of conflict management style will help practitioners, leaders and managers build an organizational culture that fosters collegiality and create the best possible environment to engage in effective conflict management. Design Integrative literature review. Data sources CINAHL, MEDLINE, Psyc INFO, Proquest ABI/Inform, Cochrane Library and Joanne Briggs Institute Library were searched for empirical studies published between 2002-May 2014. Review methods The review was informed by the approach of Whittemore and Knafl. Findings were extracted, critically examined and grouped into themes. Results Forty-four papers met the inclusion criteria. Several antecedents influence conflict and choice of conflict management style including individual characteristics, contextual factors and interpersonal conditions. Sources most frequently identified include lack of emotional intelligence, certain personality traits, poor work environment, role ambiguity, lack of support and poor communication. Very few published interventions were found. Conclusion By synthesizing the knowledge and identifying antecedents, this review offers evidence to support recommendations on managing and mitigating conflict. As inevitable as conflict is, it is the responsibility of everyone to increase their own awareness, accountability and active participation in understanding conflict and minimizing it. Future research should investigate the testing of interventions to minimize these antecedents and, subsequently, reduce conflict. [ABSTRACT FROM AUTHOR]

Implementing team based workflows can be complex because of the scope of providers involved and the extent of information exchange and communication that needs to occur. While a workflow may represent the ideal structure of communication that needs to occur, information issues and contextual factors may impact how the workflow is implemented in practice. Understanding these issues will help us better design systems to support team based workflows. In this paper we use a case study of palliative sedation therapy (PST) to model a PST workflow and then use it to identify purposes of communication, information issues and contextual factors that impact them. We then suggest how our findings could inform health information technology (HIT) design to support team based communication workflows. [ABSTRACT FROM AUTHOR]

Background:Healthcare technologies and patient care have evolved rapidly. Healthcare communication techniques and technologies have lagged.Purposes:This pilot study was conducted at Duke University Hospital to investigate the benefits of using smartphones among healthcare team members to promote efficient and effective patient care.Methods:This study used a pre–post implementation survey with an educational intervention. Teams (physicians, patient resource managers, physician assistants, and nurses) from medicine and surgery were randomly assigned a smartphone. A validated 28-question survey was used to assess user experience (7-point Likert scale, with 7 indicatingmore reliable,strongly agree, andfaster). Participants were encouraged to attend focus groups to provide feedback on survey content and overall experience. Facilitators used guiding questions and transcripts were used for qualitative analysis.Results:Eighty-nine matched pre- and postsurveys were analyzed. Postimplementation data results declined for a majority of items, although remained favorable. This suggests the reality of smartphone use did not live up to expectations but was still considered an improvement over the current paging system. Differences by device and user were found, such as the iPhone being easier to use and the BlackBerry more professional; nonphysicians were more concerned about training and the sterility of the device. Themes elicited from focus groups included challenges of the current paging system, text message content, device ease of use and utility, service coverage, and professionalism.Conclusions:Participants in this study recognized the benefit of using smartphones to reach team members in a timely and convenient manner while having access to beneficial applications. Lessons were learned for future implementations with more favorable experiences for participants. Perhaps most striking was the shared acknowledgment that the current system doesn't work well and an understanding of why. [ABSTRACT FROM PUBLISHER]

The aim of this study was to identify the social and organizational requirements for a decision support system (DSS) to be implemented in a clinical rheumatology setting, utilizing data-mining techniques. Field observations and focus group interviews were used for data collection. The decision-making was found to be situated, patient-focused, and long-term in nature. At the same time, the main part of peer-to-peer communication was informal. Patient records were involved in almost every decision. The conclusion is that the main challenges, when introducing a DSS at a rheumatology unit, are adapting the system to informal communication structures and integrating it with patient records. Considering incentive structures, understanding workflow and incorporating awareness are relevant issues when addressing these issues in future studies. [ABSTRACT FROM AUTHOR]

As central figures in the healthcare team, nurses encounter a wide range of role expectations that increasingly require heightened interpersonal communication skills. Role dialectics, a construct integrating role theory and relational dialectics scholarship, is introduced to highlight the complexities of healthcare team communication and nurse professionalism. Specifically, researchers examined the role contradictions that emerged in team communication and the discursive processes by which nurses manage role tensions. Analysis of interview transcripts with 50 healthcare workers revealed three role dialectics that reflect over-arching issues of hierarchy, status, and professional identity that challenge nurses' communication in the healthcare team. Findings also identified the specific communication strategies nurses use to manage the role contradictions created in team interactions. Pragmatic conclusions are drawn regarding the evolving role of nurses in healthcare teams. [ABSTRACT FROM AUTHOR]