Teamwork and Collaboration: The Role of Communication in Nursing

In this essay about teamwork and collaboration, the impact of effective or ineffective communication and teamwork is discussed. Also, the role of communication with patients, staff and organisations is revealed.  It is an undeniable reality that effective communication is the ‘’cornerstone’’ of the healthcare professional-patient relationship, and it is imperative to note that teamwork plays a crucial role to deliver desired patients’ clinical outcome.

The Role of Interprofessional Communication in Teamwork and Collaboration With Patients

Ineffective interprofessional communication could contribute to the cause of preventable patient harm such as ‘’hospital-acquired infections, patient falls, diagnostic errors’’, surgical mistakes and medication errors, hence jeopardising the patients’ overall clinical outcome. Rosen also mentioned that a study also showed that ‘’preventable patient deaths were twice as likely to be caused’’ by miscommunication among interdisciplinary team as a medical error. Communication failures often occur during the transition of care, such as hand-over between shift changes and transferring from one area of care to another. The transaction of care is ‘’high-risk interaction’’ among the healthcare teams because crucial information about ‘’patient’s status and plan of care’’ could be ‘’miscommunicated’’ which contribute to inappropriate treatment for patients. Rosen et al. also suggested that communication failures during transition of care between healthcare professional teams are linked with ‘’approximately 28% of surgical adverse events’’.

Despite of communication failures as mentioned above, a well-structured composition of a team and task interdependence would minimise the communication failures, thus producing quality of care; safety; patient experience and clinical outcomes for patients. Team composition impacts the processes of how a healthcare teamwork functions. A well-functioned team demands both technical expertise from health professionals like ‘’procedural clinical and clinical decision skill’’, moreover; it also requires non-technical skills which comprises of high-quality interpersonal and cognitive skills such as ‘’analytical and personal behaviour’’ skills. Rosen et al. revealed that the ‘’ introduction of multidisciplinary round [not only] improves communication and shared awareness between nurses and physicians’’, but it also leads to a decrease in prescribing errors by 60%. Ultimately, effective e communication within multidisciplinary team members would improve teamwork and collaboration to provide a continuous and high-quality patient-care.

Impact of Communication on Teamwork and Collaboration of Staffs

Communication and teamwork have tremendous impact on the job satisfaction of nursing staffs. Ineffective communication and teamwork between interprofessional team within healthcare setting negative influences the patient’s outcome, thus leading to job dissatisfaction and burnout among nurses. Maslow’s needs theory defined job satisfaction as ‘’the match of personal needs to the perceived potential of the job satisfying those needs’’. Historically, physicains, nurses and other health profession functions in ‘’silos leading nurses’ perception of being in physicians’ decision-making process and hurting’’ effectiveness of teamwork.

Health care interprofessional team experience deficient interaction could bring miscommunication, relationship conflicts and information misinterpretation results in low quality care for patients, therefore; leading to job dissatisfaction and burnout among the nurses. Vermeir et al. mentioned that burnout is ‘’ a state of fatigue or frustration brought about devotion to a cause, way of life or relation that failed’’ to meet expected results. A study revealed that burnout rate of nurse is found to be ‘’ranging from 10% in Netherlands to 78% in Greece’’.

Despite the problematic aspects of ineffective teamwork between healthcare professionals, there are quite a few readily available solutions which could be implemented to teamwork and job satisfaction. A pilot study found that the implementation of ‘’a patient-centred physician rounding ‘’ improves the communication and relationship within the interprofessional teams. Interprofessional rounding allows the physicians and nurses view each other as ‘’equal’’ partners, moreover; reducing preventable harms such as medication mistakes and ‘’timely’’ indwelling catheters removal. Overall, effective communication and teamwork builds a ‘’therapeutic alliance’’ between healthcare professionals; therefore, establishing a higher job stratification among nurses.

Ineffectiveness and Benefits of Communication at Organisation Level

Ineffectiveness communication and teamwork could result in undesirable patient outcomes, thus affecting the shared values and cost effectiveness of the organisations. An integrative review suggested that physicians and nurses are trained differently in regard to communication techniques. Foronda et al. described that nurses’ communication style as ‘’descriptive’’ and physicians are to be ‘’succinct’'. A research conducted with 272 nurses from 17 ICUs, found that twenty-one of nurses mentioned about the delay of medical orders; moreover, 18% of ICU nurses criticised physicians of providing ‘’inadequate [patients’] information’’. Lack of communication between nurses and physicians defeats the organisational shared values, team science and cultural humility, hence, result in negative effects on patient safety.

In an addition, interprofessional hierarchy plays a major to prevent effective interprofessional alliance, consequently; diminishing a quality patient-centred care. Interprofessional hierarchies ‘’reduced opportunities’’ to ‘’enhance resistive interprofessional relationship’’ because, physicians historically were ‘’used to having their orders carried’’ with discussion or negotiation. However, Foronda suggested that utilisation of SBAR communication tool would dramatically reduce medical adverse events since ‘’physicians and nurses are on the same page.’’

Ultimately, organisations need to prioritise in ‘’fostering collaborative [interprofessional] team’’ because effective communication would drive staff performance and job satisfaction, therefore; reducing staff ‘’absenteeism’’ results in an improved organisational cost-effectiveness due to a more efficient workplace.

References

• Foronda, C., Macwilliams. B., & Mcarthur,E. (2016). Interprofessional communication in healthcare: An integrative review. Nurse Education in Practice, 19, 36-40.
• Green, B., Oeppen R.S., Smith D.W., Brennan P.A. (2017). Challenging hierarchy in healthcare teams – ways to flatten gradients to improve teamwork and patient care. British Journal of Oral & Maxillofacial Surgery, 55(5), 449-453. doi:  https://doi.org/10.1016/j.bjoms.2017.02.010
• Hemsley, B., Balandin, S., & Worrall, L. (2012). Nursing the patient with complex communication needs: Time as a barrier and a facilitator to successful communication in hospital. Journal of Advanced Nursing, 68(1), 116-126. doi: 10.1111/j.1365-2648.2011.05722.x
• Khamisa, N., Peltzer, K., & Oldenburg, B. (2013). Burnout in Relation to Specific Contributing Factors and Health Outcomes among Nurses: A Systematic Review. International Journal of Environmental Research and Public Health, 10(6), 2214-40.
• Morley L., Cashell A. (2017) Journal of Medical Imaging and Radiation Sciences,  48  (2) , pp. 207-216. doi: https://doi.org/10.1016/j.jmir.2017.02.071
• Rosen, M. A., DiazGranados, D., Dietz, A. S., Benishek, L. E., Thompson, D., Pronovost, P. J., & Weaver, S. J. (2018). Teamwork in healthcare: Key discoveries enabling safer, high-quality care. The American psychologist, 73(4), 433–450. doi:10.1037/amp0000298
• Sharma, U., & Klocke, D. (2014). Attitudes of nursing staff toward interprofessional in-patient-centered rounding. Journal of Interprofessional Care, 28(5), 475-477. doi: 10.3109/13561820.2014.907558
• Vermeir, P., Degroote, S., Vandijck, D., Mariman, A., Deveugele, M., Peleman, R., Verhaeghe, R., Cambre, B., & Vogelaers, D. (2017). Job Satisfaction in Relation to Communication in Health Care Among Nurses: A Narrative Review and Practical Recommendations. SAGE Open, 7(2), SAGE Open, June 2017, Vol.7(2). doi:  10.1177/2158244017711486