Situational awareness, relational coordination and integrated care delivery to hospitalized elderly in The Netherlands: a comparison between hospitals

Abstract

BackgroundIt is known that interprofessional collaboration is crucial for integrated care delivery, yet we are still unclear about the underlying mechanisms explaining effectiveness of integrated care delivery to older patients. In addition, we lack research comparing integrated care delivery between hospitals. Therefore, this study aims to (i) provide insight into the underlying components ‘relational coordination’ and ‘situational awareness’ of integrated care delivery and the role of team and organizational context in integrated care delivery; and (ii) compare situational awareness, relational coordination, and integrated care delivery of different hospitals in the Netherlands.MethodsThis cross-sectional study took place in 2012 among professionals from three different hospitals involved in the delivery of care to older patients. A total of 215 professionals filled in the questionnaire (42% response rate).Descriptive statistics and paired-sample t-tests were used to investigate the level of situational awareness, relational coordination, and integrated care delivery in the three different hospitals. Correlation and multilevel analyses were used to investigate the relationship between background characteristics, team context, organizational context, situational awareness, relational coordination and integrated care delivery.ResultsNo differences in background characteristics, team context, organizational context, situational awareness, relational coordination and integrated care delivery were found among the three hospitals. Correlational analysis revealed that situational awareness (r = 0.30; p < 0.01), relational coordination (r = 0.17; p < 0.05), team climate (r = 0.29; p < 0.01), formal internal communication (r = 0.46; p < 0.01), and informal internal communication (r = 0.36; p < 0.01) were positively associated with integrated care delivery. Stepwise multilevel analyses showed that formal internal communication (p < 0.001) and situational awareness (p < 0.01) were associated with integrated care delivery. Team climate was not significantly associated with integrated care delivery when situational awareness and relational coordination were included in the equation. Thus situational awareness acted as mediator between team climate and integrated care delivery among professionals delivering care to older hospitalized patients.ConclusionsThe results of this study show the importance of formal internal communication and situational awareness for quality of care delivery to hospitalized older patients.

Candidate SNP Markers of Atherogenesis Significantly Shifting the Affinity of TATA-Binding Protein for Human Gene Promoters Show Stabilizing Natural Selection as a Sum of Neutral Drift Accelerating Atherogenesis and Directional Natural Selection Slowing It

“…Consequently, readers can see reliable predominance of candidate SNP markers of atherogenesis acceleration over those of its deceleration, which means that the above-mentioned neutral drift of this kind of human SNPs supports atherogenesis acceleration. This finding seems to be in line with one of the well-known gerontological health care strategies when in utero, in childhood, adolescence, and reproductive adulthood, the human body can successfully respond to deadly stressors (e.g., acute infection) by subthreshold slowly progressing pathologies (e.g., atherogenesis), with clinically over-threshold manifestations (e.g., stroke) seen only in the very old [157]. It is important that this observation is statistically significant here, whereas in our previous article [55], there was only a tendency for this pattern (i.e., n↑ =19, n↓ =16, p > 0.33).…”

Relational coordination among home healthcare professions and goal attainment in nursing care

“…The authors measured interprofessional coordination with the Japanese version of the RCS (RCS‐J; Naruse, Sakai, & Nagata, ). The RCS is a valid and reliable measure that has already been applied to home care (Weinberg, Lusenhop, Gittell, & Kautz, ), primary care (Cramm & Nieboer, , ; Cramm, Hoeijmakers, & Nieboer, ), and hospital settings (Hartgerink et al ., , ; Havens, Vasey, Gittell, & Lin, ). Seven items of the RCS‐J encompass three relationship dimensions and four communication dimensions rated on a 5 point Likert scale.…”

Situational awareness in the outpatient encounter between patients with breast cancer or malignant melanoma and healthcare professionals: Patients’ perceptions

“…The consequence can be errors in clinical judgement (Jeffs, Tregunno, MacMillan, & Espin, ), clinical decision‐making (Stubbings, Chaboyer, & McMurray, ) and inadequate nursing care (Aiken et al, ; Conroy, ; Muntlin Athlin, Brovall, Wengstrom, Conroy, & Kitson, ), which may lead to poor outcomes for the patients as, for example, postoperative mortality (Ball et al, ). Situational awareness is seen as an important phenomenon and one particularly crucial for improving clinical patient outcomes (Green et al, ; Hartgerink et al, ). HCPs play a crucial role in providing attention on the patients’ perspectives and needs, and what HCPs do or fail to do may compromise patient safety (Green et al, ).…”