Promoters and barriers in hospital team communication. A focus group study

Abstract

Purpose: Poor teamwork and communication in healthcare teams have been correlated to adverse events and higher patient morbidity and mortality. However, detailed insight into the link between team communication and medical error is still lacking. The objective of this study is to identify the common characteristics of team communication among multiprofessional teams at four Danish acute care university hospitals. Method: Four focus group interviews with multiprofessional hospital teams (N = 24). Results: Communication is particularly vulnerable during handover of patient information between shifts or units, when a team has to establish skills and roles during teamwork and when staff has to await and combine information from different chart systems. Established frameworks for communication, mutual knowledge, ease of speaking up, experience in getting the message through, and focus on teamwork and communication promote safe information exchange. Lack of standard assignments and procedures, a flat hierarchy that leaves responsibility unclear, different agendas for the treatment of the patient, interruptions, and multitasking, inhibit safe information exchange. Conclusion: Power distance, team structure, and hospital organization influence team communication and vary between settings and national cultures. These factors must be accounted for before developing or adapting team communication interventions to improve patient safety.

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