Communication and Relational Ties in Inter-Professional Teams in Norwegian Specialized Health Care: A Multicentre Study of Relational Coordination

Abstract

Introduction:The delivery of integrated care depends on the quality of communication and relationships among health-care professionals in inter-professional teams. The main aim of this study was to investigate individual and team communication and relational ties of teams in specific care processes within specialized health care.Methods:This cross-sectional multi-centre study used data from six somatic hospitals and six psychiatric units (N = 263 [response rate, 52%], 23 care processes) using a Norwegian version of the Relational Coordination Survey. We employed linear mixed-effect regression models and one-way analyses of variance.Results:The mean (standard deviation) relational coordination total score ranged from 4.5 (0.33) to 2.7 (0.50). The communication and relationship sub-scale scores were significantly higher within similar functional groups than between contrasting functional groups (P < .05). Written clinical procedures were significantly associated with higher communication scores (P < .05). The proportion of women in a team was associated with higher communication and relationship scores (P < .05).Conclusion:The Relational Coordination Survey shows a marked variation in team functions within inter-professional teams in specialized health-care settings. Further research is needed to determine the reasons for these variations.

Relational coordination in interprofessional teams and its effect on patient-reported benefit and continuity of care: a prospective cohort study from rehabilitation centres in Western Norway

“…Gittell indicated that team functions are strong when the reported RC scores are ≥4 on a five-point scale, which was found for nine of the 15 teams included in this study [ 10 ]. An earlier study investigating RC in 23 teams from six somatic hospitals and six psychiatric units in Western Norway found that 14 of 23 teams had a RC score below 3.4, which was the lowest score for rehabilitation teams in the present study [ 30 ]. Further, in this previous study, half of the teams showed relationship scores below 3.8, compared with only one rehabilitation team in the present study [ 30 ].…”

“…An earlier study investigating RC in 23 teams from six somatic hospitals and six psychiatric units in Western Norway found that 14 of 23 teams had a RC score below 3.4, which was the lowest score for rehabilitation teams in the present study [ 30 ]. Further, in this previous study, half of the teams showed relationship scores below 3.8, compared with only one rehabilitation team in the present study [ 30 ]. The RC scores in this study were also high compared with previous international studies, indicating strong team functions for interprofessional teams in rehabilitation centre in Western Norway [ 8 , 26 , 29 , 43 , 44 ].…”

“…The RC Survey is based on RC theory and is used in both hospital and primary health care settings [ 14 , 26 – 29 ]. The survey has been translated into Norwegian language and validated for Norwegian health care settings in a previous study [ 30 ]. The survey comprises seven items evaluating interprofessional team function divided into two sub-scales: four communication items (frequency, accuracy, timeliness and problem solving) and three relationship items (shared goals, shared knowledge and mutual respect) [ 9 ].…”

The effect of team collaboration and continuity of care on health and disability among rehabilitation patients: a longitudinal survey-based study from western Norway

“…RC is a self-reporting validated survey measuring team functions among members of interprofessional teams [20, 41]. The RC survey has recently been translated into Norwegian and validated within teams in specialised health care settings [42]. This study found a satisfactory two-factor solution (Cronbach’s alpha in parentheses); RC communication = four items: frequency, accuracy, timeliness and problem-solving ( α = 0.93), RC relationship = three items: shared knowledge, shared goals, mutual respect) ( α = 0.80) [42, 43].…”

“…Responses were reported on a 5-point Likert scale (one = never, two = rarely, three = occasionally, four = often and five = always). RC has been used in various health care settings, such as primary health [44], hospital settings [42, 45] and secondary rehabilitation services [18]. RC subscale scores were obtained for all teams ( N = 15) in all rehabilitation centres by conducting a survey among health care professionals ( N = 124, 52% response rate).…”