Purposeful interprofessional team intervention improves relational coordination among advanced heart failure care teams

Blakeney, Erin Abu-Rish; Lavallee, Danielle C.; Baik, Dawon; Pambianco, Susan; O’Brien, Kevin D.; Zierler, Brenda K.

doi:10.1080/13561820.2018.1560248

Cited by 31 publications

(22 citation statements)

References 41 publications

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“…As outlined in table 1, its domains accounted for many of the factors identified in resuscitations that went well and were perceptibly missing from those cases that were felt to be less than ideal. Of note, the centrality of team briefings to trauma care is in keeping with the findings from other studies that suggest cross-functional meetings, with broad participation, are a mechanism to promote RC 12 26. We found RC to be a useful framework in the acute trauma environment and hypothesise it can likely be applied more broadly in other resuscitation contexts.…”

Section: Discussionsupporting

confidence: 85%

“…While RC theory has been used in healthcare settings such as postsurgical wards, inpatient wards, and outpatient clinics, to our knowledge, we are the first group to apply the concept to a hyperacute resuscitation environment of severe trauma 9 10 12. We decided to simultaneously collect qualitative data, in addition to the RC metrics, to build further understanding about this construct in the setting of trauma.…”

Section: Discussionmentioning

confidence: 99%

“…RC is particularly critical in situations where teams are faced with high levels of task interdependence, uncertainty and time constraint. The theory has been applied in several healthcare contexts and offers an attractive lens for inquiry in this setting 9–12…”

Section: Introductionmentioning

confidence: 99%

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Doing our work better, together: a relationship-based approach to defining the quality improvement agenda in trauma care

Purdy

McLean²,

Alexander

et al. 2020

BMJ Open Qual

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BackgroundTrauma care represents a complex patient journey, requiring multidisciplinary coordinated care. Team members are human, and as such, how they feel about their colleagues and their work affects performance. The challenge for health service leaders is enabling culture that supports high levels of collaboration, co-operation and coordination across diverse groups. We aimed to define and improve relational aspects of trauma care at Gold Coast University Hospital.MethodsWe conducted a mixed-methods collaborative ethnography using the relational coordination survey—an established tool to analyse the relational dimensions of multidisciplinary teamwork—participant observation, interviews and narrative surveys. Findings were presented to clinicians in working groups for further interpretation and to facilitate co-creation of targeted interventions designed to improve team relationships and performance.FindingsWe engaged a complex multidisciplinary network of ~500 care providers dispersed across seven core interdependent clinical disciplines. Initial findings highlighted the importance of relationships in trauma care and opportunities to improve. Narrative survey and ethnographic findings further highlighted the centrality of a translational simulation programme in contributing positively to team culture and relational ties. A range of 16 interventions—focusing on structural, process and relational dimensions—were co-created with participants and are now being implemented and evaluated by various trauma care providers.ConclusionsThrough engagement of clinicians spanning organisational boundaries, relational aspects of care can be measured and directly targeted in a collaborative quality improvement process. We encourage healthcare leaders to consider relationship-based quality improvement strategies, including translational simulation and relational coordination processes, in their efforts to improve care for patients with complex, interdependent journeys.

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Section: Discussionsupporting

confidence: 85%

Section: Discussionmentioning

confidence: 99%

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Doing our work better, together: a relationship-based approach to defining the quality improvement agenda in trauma care

Purdy

McLean²,

Alexander

et al. 2020

BMJ Open Qual

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“…Such practice may promote the goals of all nutritional care for older persons in long‐term care settings (e.g. to improve food intake and nutritional status, as well as independent living) .…”

Section: Introductionmentioning

confidence: 99%

“…Effective delivery of healthcare is highly interdependent within and among interprofessional care teams and the persons they serve . Thus, to achieve person‐centred caring cultures, healthcare professionals need to feel valued for their work, which is also a key outcome of person‐centred practice .…”

Section: Introductionmentioning

confidence: 99%

Hospital nurses and home care providers’ experiences of participation in nutritional care among older persons and their family caregivers: a qualitative study

Hestevik

Molin

Bergland

et al. 2019

J Human Nutrition Diet

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Background A person‐centred approach to nutritional care has the potential to increase an older person’s role in making informed decisions about their own care and possibly improving their quality of life. However, despite the considerable interest shown in person‐centred nutritional care in recent years, delivery of such care still appears to lack consideration for older persons’ needs and preferences. The present study aimed to explore healthcare professionals’ views on how older persons and their family caregivers participate in decisions about their own nutritional care and possible barriers for that participation. Methods Semi‐structured in‐depth interviews with 23 healthcare professionals in acute geriatric care and home care were conducted. Data were analysed thematically. Results The analysis of the interviews resulted in three main themes: (i) lack of shared decision‐making in nutritional care; (ii) conflict between patient’s preferences and standard nutritional care procedures; and (iii) the value of family caregivers who are seldom involved in nutritional care. Conclusions Healthcare professionals were aware of the importance of actively engaging older persons and their family members in the nutritional care to achieve positive outcomes. However, they encountered individual and structural barriers, including resistance from patients and family caregivers, conflicts between the patients’ nutritional wishes and standard nutritional procedures, a wish to shield the family caregivers from the stress of caring for a sick relative, and lack of time and caring structures that facilitate the older persons and their family’s active participation.

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Building then dismantling relational coordination: Mechanisms that distinguish functional and dysfunctional dynamics between HR practices and relational coordination

Kim

Noh

2022

Human Resource Management

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With the growing importance of relational coordination in today's multidisciplinary, interdependent work environment, practitioners are faced with challenges in designing and implementing relationship-oriented HR practices. We aim to identify key mechanisms either enabling or inhibiting the functional interplay between HR practices and relational coordination. Through an inductive qualitative study of a newsroom organization in Korea before and after the changes in its HR practices, we compared and contrasted functional and dysfunctional dynamics among HR practices, interpersonal relationships, and relational coordination. Before the changes, reporters coordinated across levels and functions as HR practices integrated formal and informal interactions and supported the shared notion on which professional behaviors and values are expected of a reporter. However, with the changes in HR practices, relational coordination among reporters dismantled as they experienced segregation between formal and informal interactions and upheld two different notions of journalistic values. Reporters were divided into two separate informal groups which rarely overlapped with formal work groups and these segregated interactions prevented reporters from sharing knowledge across levels and functions. Further, with the conflicting notion of journalistic values, reporters constantly debated over specific goals of practicing journalism and expressed disrespect toward those who held a different set of journalistic values. These findings redirect research by highlighting the fragility of relational coordination and the importance of designing HR practices which reflect formal and informal relational dynamics among employees and consolidate members under the same shared notion of professional values. K E Y W O R D S changes in HR practices, integration of formal and informal interactions, relational coordination, relational coordination dismantling process, shared professional values 1 | INTRODUCTION Relational coordination, "coordinating work through relationships of shared goals, shared knowledge, and mutual respect," (Gittell, 2016, p. 13) has been widely studied in various industries including educa-

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Purposeful interprofessional team intervention improves relational coordination among advanced heart failure care teams

Cited by 31 publications

References 41 publications

Doing our work better, together: a relationship-based approach to defining the quality improvement agenda in trauma care

Doing our work better, together: a relationship-based approach to defining the quality improvement agenda in trauma care

Hospital nurses and home care providers’ experiences of participation in nutritional care among older persons and their family caregivers: a qualitative study

Building then dismantling relational coordination: Mechanisms that distinguish functional and dysfunctional dynamics between HR practices and relational coordination

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