Nurse-physician communication is one of the most significant factors that determine quality and safety of patient care. However, many hospitals and clinics still experience communication failures, which results in increased cases of medical mistakes, patients’ complaints, and staff exhaustion. In the course of the interview with a nursing staff at a large urban hospital, it was evident that there are communication breakdowns between the nursing staff and physicians. Both entities aim to provide the best care to the patients, but poor, organized, and professional communication results in poor coordination, miscommunication, and time wastage. This article provides a solution to this problem through an interdisciplinary approach to solving the problem.
Understanding the Communication Breakdown
The first thing which should be done to solve any problem is to identify the possible causes of the problem. Nurses have complained over the years that their input is not valued or even ignored while physicians view nurses as lacking adequate appreciation of clinical reasoning. These perceptions lead to conflict and decrease the readiness to cooperate. Also, there may be poor communication due to staff shortage, shift working or lack of proper handover.
Face-to-face communication is mainly confined to short and structured transactions involving exchange of work-related information and not extensive deliberations on patient care. This can lead to the failure to pass on some information or confusion as to who is responsible for what. For instance, a nurse may report the worsening of a patient’s condition, but if there is no feedback or communication in both directions, vital signs can be dismissed or misunderstood. My colleague in the interview reported that the problem gets worse each year since new residents come in, and some of them do not know how the facility operates or how they can address the nursing staff.
Understanding this breakdown helps to realize where an interdisciplinary approach can be most effective—by designing the systems that enforce respect, active listening, and communication patterns between all the members of the team.
Applying Change Theories and Leadership Strategies
To begin with the problem, it is necessary to use a system approach. The Lewin’s Change Theory is one of the best suited for this purpose and it comprises of three steps namely; unfreezing, changing and refreezing. The unfreezing stage entails sensitisation of the problem of ineffective communication and mobilisation of the support of both the nurses and the physicians.
It is the leadership that has the most significant influence in the process of this transition. Applying the transformational leadership approach that involves encouraging and facilitating the teams can foster interdisciplinary cooperation. Managers who demonstrate courtesy and encourage people to comment on it also contribute to the improvement of the climate. Nurse leaders can act as change agents by scheduling combined training sessions, starting communication processes such as SBAR (Situation, Background, Assessment, Recommendation), and promoting accountability.
The purpose of this step is to build the common vision. When all the members of the team are aware that communication is everybody’s business that has a direct bearing on patients’ safety, then the members are more committed to the process. Leadership support makes change not only possible but also sustainable as seen in this paper.
Strategies to Build and Strengthen Interdisciplinary Teams
Using structured communication tools is one of the best practices that can be used to enhance interdisciplinary communication. For instance, SBAR facilitates the transmission of information and ensures that all clinical information is passed effectively. Another method is making daily interdisciplinary rounds where the nurses, physicians, pharmacists, and case managers are all involved in the discussion of the patient’s care. These short but intense meetings are effective in achieving the goal of constant and immediate communication and cooperation.
Another effective strategy is the implementation of the interdisciplinary huddles at the start of the shifts. Such brief meetings lasting from five to ten minutes help the team to define roles, recognize patient-related risks, and address urgent issues. When such huddles become a normal practice, they lead to development of trust and recognition between the two parties.
It also means that there are no high-ranking officers and those with lower ranks in a strong team. This has to be deliberate and include everyone within an organization, regardless of their position or their job description. One of the ways to facilitate this process is to offer the joint training and continuing education programs that would focus on the teamwork. Reward and recognition of group efforts that are pro-actively organized for the purpose of encouraging the right behaviors also help.
Last but not the least, feedback mechanism must be integrated into the system. It is useful to have an opportunity to assess how effectively the communication strategies are being implemented and what changes are required to enhance the performance of the team.
Conclusion
Nurse-physician collaboration is not a mere concept of the 21st century, but rather a model that has been tested and has been proven to be effective in the health system. When identifying the barriers, implementing the change models, and employing the structured approaches in care delivery, the healthcare teams can promote respect, increase clarity, and develop shared responsibility. This ability will remain vital as the healthcare environment continues to change, and it will be important to have effective communication between different fields of healthcare.
Related Questions
Create a 2-4 page report on an interview you have conducted with a health care professional colleague. You will identify an issue from the interview that could be improved with an interdisciplinary approach, and review best practices and evidence to address the issue. This is the first of three assessments that build on each other.
Introduction
As a baccalaureate-prepared nurse, your participation and leadership in intra- and interdisciplinary teams will be vital to the health outcomes for your patients and organization. One way to approach designing an improvement project, and implementing change, is to become knowledgeable about the challenges that the organization is facing. To do this, you will interview a healthcare professional. This can be a peer, a nursing colleague, administrator, or someone who could provide you with sufficient knowledge and information on a particular problem or concern within the organization.
It would be an excellent choice to complete the Plan-Do-Study-Act (PDSA) Cycle activity prior to developing the report. The activity consists of four questions that create the opportunity to check your understanding of best practices related to each stage of the PDSA cycle, which is one of a number of change models you can read about. The information gained from completing this activity will promote your success with the Interview and Interdisciplinary Issue Identification report. This will take just a few minutes of your time and is not graded.
Professional Context
By interviewing a healthcare colleague of your choice, you will begin to gather information about an interprofessional collaboration problem that your colleague is experiencing, or has experienced, in the workplace. You will identify a change theory and leadership strategies that can be applied to address this problem.
Overview
This assessment is the first of three related assessments in which you will gather interview information, design a proposal for interdisciplinary problem-solving, and report on how an interdisciplinary improvement plan could be implemented in a place of practice. At the end of the course, your interviewee will have a proposal plan that they could present to stakeholders to address an interdisciplinary problem in the workplace.
You may interview a healthcare professional such as a fellow learner, nursing colleague, administrator, business partner, or another appropriate person who could provide you with sufficient information regarding an organizational problem or an area in which the organization is seeking improvements. Consult the Interview Guide for an outline of how to prepare and the types of information you will need to complete this project successfully.
Instructions
For this assessment, you will report on the information gathered during your interview. You will discuss the interview strategy that you used to collect information. Your interview strategy should be supported by citations from the literature. The goal of this assessment is to analyze the interview data and identify an issue that would benefit from an interdisciplinary solution. This could be an issue that has not been addressed by an interdisciplinary approach or one that could benefit from improvements related to the interdisciplinary approach currently in use. Additionally, you will prepare for your Interdisciplinary Plan Proposal assessment by researching change theories, leadership strategies, and collaboration approaches that could be relevant to issue you have identified. Please be certain to review the scoring guide to confirm specific required elements of this assessment. Note that there are differences between basic, proficient and distinguished criteria.
Use the Interview and Issue Identification Template to help you stay organized and concise. As you complete the template, make sure you use APA format for in-text citations for the evidence and best practices that are informing your plan, as well as for the reference list at the end. (Because you’re using a template, a title page is optional.)
Additionally, be sure to address the following criteria. Please study the scoring guide carefully so you know what is needed for a distinguished score.
- Summarize an interview focused on past or current issues at a healthcare organization.
- Identify an issue from an interview for which an evidence-based interdisciplinary approach would be appropriate.
- Describe change theories and a leadership strategy that could help in developing an interdisciplinary solution to an organizational issue.
- Describe collaboration approaches from the literature that could be relevant in establishing or improving an interdisciplinary team to address an organizational issue.
- Organize content so ideas flow logically with smooth transitions; contains few errors in grammar/punctuation, word choice, and spelling.
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