Team based communication and the healthcare communication space

The Perceived Ease of Use and Perceived Usefulness of a Web-Based Interprofessional Communication and Collaboration Platform in the Hospital Setting: Interview Study With Health Care Providers

BACKGROUND

Hospitalized patients with complex care needs require an interprofessional team of health professionals working together to support their care in hospitals and during discharge planning. However, interprofessional communication and collaboration in inpatient settings are often fragmented and inefficient, leading to poor patient outcomes and provider frustration. Health information technology can potentially help improve team communication and collaboration; however, to date, evidence of its effectiveness is lacking. There are also concerns that current implementations might further fragment communication and increase the clinician burden without proven benefits.

OBJECTIVE

In this study, we aimed to generate transferrable lessons for future designers of health information technology tools that facilitate team communication and collaboration.

METHODS

A secondary analysis of the qualitative component of the mixed methods evaluation was performed. The electronic communication and collaboration platform was implemented in 2 general internal medicine wards in a large community teaching hospital in Mississauga, Ontario, Canada. Fifteen inpatient clinicians in those wards, including nurses, physicians, and allied health care providers, were recruited to participate in semistructured interviews about their experience with a co-designed electronic communication and collaboration tool. Data were analyzed using the Technology Acceptance Model, and themes related to the constructs of perceived ease of use (PEOU) and perceived usefulness (PU) were identified.

RESULTS

A secondary analysis guided by the Technology Acceptance Model highlighted important points. Intuitive design precluded training as a barrier to use, but lack of training may hinder participants' PEOU if features designed for efficiency are not discovered by users. Organized information was found to be useful for creating a comprehensive clinical picture of each patient and facilitating improved handovers. However, information needs to be both comprehensive and succinct, and information overload may negatively impact PEOU. The mixed paper and electronic practice environment also negatively impacted PEOU owing to unavoidable double documentation and the need for printing. Participants perceived the tool to be useful as it improved efficiency in information retrieval and documentation, improved the handover process, afforded another mode of communication when face-to-face communication was impractical, and improved shared awareness. The PU of this tool depends on its optimal use by all team members.

CONCLUSIONS

Electronic tools can support communication and collaboration among interprofessional teams caring for patients with complex needs. There are transferable lessons learned that can improve the PU and PEOU of future systems.

Multi-level learning in public healthcare medical teams: the role of the social environment

PURPOSE

This study explores how individual, dyad and team levels of learning interact in public healthcare medical teams.

DESIGN/METHODOLOGY/APPROACH

A single interpretive case study is carried out in the public Health Service Executive (HSE) in Ireland, involving three rounds of semi-structured interviews with non-consultant hospital doctors (NCHDs), supported by relevant professional documentation and researcher log entries.

FINDINGS

An experience hierarchy, interpersonal relationships and social dynamics form the backdrop to learning interactions within public healthcare medical teams. Individual and team learning primarily occur in informal settings where interpreting and developing understanding takes place either in dyads, small groups or with the whole team. NCHD learning may vary depending on how effectively they build interpersonal relationships, take advantage of informal learning opportunities and manage the social dynamics within their team. Willingness and confidence to share insights and asking questions are triggers for individual and team learning.

RESEARCH LIMITATIONS/IMPLICATIONS

As a single case study focused on the HSE NCHD individual and team learning experience, this research study represents a relatively small exploration of individual and team learning interplay in the public healthcare medical team environment. The development of learning theory in this domain presents an intriguing avenue of further research, including observation of interactions within a team.

PRACTICAL IMPLICATIONS

The findings have practical relevance to those who are interested in the effectiveness of post-graduate/ NCHD learning in the public healthcare system. Interpersonal relationships and social norms play strong roles in how interaction and learning occurs in a team. These findings highlight the challenge of ensuring consistent quality across individual NCHDs or across hospital sites when training is heavily influenced by the approach of senior colleagues/ consultants to their more junior colleagues and the degree to which they take an active interest in NCHD learning.

ORIGINALITY/VALUE

The proposed learning framework is a key theoretical contribution, which draws upon the multi-levels of learning and provides greater insight into how individual, dyad and team learning interact in public healthcare medical teams when managing patient care. The findings have practical relevance in how to facilitate effective teamwork and learning interactions and for those who are interested in the consistency and quality of the training experience for NCHDs.