Communication and Relational Ties in Inter-Professional Teams in Norwegian Specialized Health Care: A Multicentre Study of Relational Coordination

Merethe Hustoft; Øystein Hetlevik; Jörg Aßmus; Sverre Størkson; Sturla Gjesdal; Eva Biringer

doi:10.5334/ijic.3432

Communication and Relational Ties in Inter-Professional Teams in Norwegian Specialized Health Care: A Multicentre Study of Relational Coordination

International Journal of Integrated Care

Volume 18 (2018): Issue 2

By: Merethe Hustoft, Øystein Hetlevik, Jörg Aßmus, Sverre Størkson, Sturla Gjesdal and Eva Biringer

Open Access

|Apr 2018

Abstract

Introduction: The delivery of integrated care depends on the quality of communication and relationships among health-care professionals in inter-professional teams. The main aim of this study was to investigate individual and team communication and relational ties of teams in specific care processes within specialized health care.

Methods: This cross-sectional multi-centre study used data from six somatic hospitals and six psychiatric units (N = 263 [response rate, 52%], 23 care processes) using a Norwegian version of the Relational Coordination Survey. We employed linear mixed-effect regression models and one-way analyses of variance.

Results: The mean (standard deviation) relational coordination total score ranged from 4.5 (0.33) to 2.7 (0.50). The communication and relationship sub-scale scores were significantly higher within similar functional groups than between contrasting functional groups (P < .05). Written clinical procedures were significantly associated with higher communication scores (P < .05). The proportion of women in a team was associated with higher communication and relationship scores (P < .05).

Conclusion: The Relational Coordination Survey shows a marked variation in team functions within inter-professional teams in specialized health-care settings. Further research is needed to determine the reasons for these variations.

References

Haggerty, JL, Reid, RJ, Freeman, GK, Starfield, BH, Adair, CE and McKendry, R. Continuity of care: a multidisciplinary review. British Medical Journal, (Clinical research ed), 2003; 327(7425): 1219–21. Available from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC274066/pdf/bmj32701219.pdf2. DOI: 10.1136/bmj.327.7425.1219
Open DOI Search in Google Scholar Back to article
Hetlevik, Ø and Gjesdal, S. Personal continuity of care in Norwegian general practice: A national cross-sectional study. Scandinavian Journal of Primary Health Care, 2012; 30(4): 214–21. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3520415/. DOI: 10.3109/02813432.2012.735554
Open DOI Search in Google Scholar Back to article
Hewitt, G, Sims, S and Harris, R. Using realist synthesis to understand the mechanisms of interprofessional teamwork in health and social care. Journal of Interprofessional Care, 2014; 28(6): 501–6. Available from: http://informahealthcare.com/doi/pdfplus/10.3109/13561820.2014.939744. DOI: 10.3109/13561820.2014.939744
Open DOI Search in Google Scholar Back to article
Aller, MB, Vargas, I, Waibel, S, Coderch, J, Sanchez-Perez, I, Colomes, L, Llopart, JR, Ferran, M and Vazquez, ML. A comprehensive analysis of patients’ perceptions of continuity of care and their associated factors. International Journal of Quality Health Care, 2013; 25(3): 291–9. Available from: http://intqhc.oxfordjournals.org/content/intqhc/25/3/291.full.pdf. DOI: 10.1093/intqhc/mzt010
Open DOI Search in Google Scholar Back to article
Nancarrow, SA, Booth, A, Ariss, S, Smith, T, Enderby, P and Roots, A. Ten principles of good interdisciplinary team work. Human Resources for Health, 2013; 11: 19. Available from: https://human-resources-health.biomedcentral.com/articles/10.1186/1478-4491-11-19. DOI: 10.1186/1478-4491-11-19
Open DOI Search in Google Scholar Back to article
Deneckere, S, Euwema, M, Lodewijckx, C, Panella, M, Mutsvari, T, Sermeus, W and Vanhaecht, K. Better interprofessional teamwork, higher level of organized care, and lower risk of burnout in acute health care teams using care pathways: A cluster randomized controlled trial. Medical Care, 2013; 51(1): 99–107. Available from: https://www.ncbi.nlm.nih.gov/pubmed/23132203. DOI: 10.1097/MLR.0b013e3182763312
Open DOI Search in Google Scholar Back to article
Yeager, S. Interdisciplinary collaboration: The heart and soul of health care. Critical Care Nursing Clinics of North America, 2005; 17(2): 143–8. Available from: http://www.sciencedirect.com/science/article/pii/S0899588505000043. DOI: 10.1016/j.ccell.2005.01.003
Open DOI Search in Google Scholar Back to article
Mickan, SM. Evaluating the effectiveness of health care teams. Australian Health Review, 2005; 29(2): 211–7. Available from: https://www.ncbi.nlm.nih.gov/pubmed/15865572. DOI: 10.1071/AH050211
Open DOI Search in Google Scholar Back to article
Salas, E, DiazGranados, D, Klein, C, Burke, CS, Stagl, KC, Goodwin, GF and Halpin, SM. Does team training improve team performance? A meta-analysis. Human Factors, 2008; 50(6): 903–33. Available from: http://hfs.sagepub.com/content/50/6/903.full.pdf. DOI: 10.1518/001872008X375009
Open DOI Search in Google Scholar Back to article
Reeves, S, Pelone, F, Harrison, R, Goldman, J and Zwarenstein, M. Interprofessional collaboration to improve professional practice and healthcare outcomes. Cochrane Database of Systematic Reviews [Internet], 2017; 6. DOI: 10.1002/14651858.CD000072.pub3
Open DOI Search in Google Scholar Back to article
Xyrichis, A and Ream, E. Teamwork: a concept analysis. Journal of Advanced Nursing, 2008; 61(2): 232–41. DOI: 10.1111/j.1365-2648.2007.04496.x
Open DOI Search in Google Scholar Back to article
Momsen, AM, Rasmussen, JO, Nielsen, CV, Iversen, MD and Lund, H. Multidisciplinary team care in rehabilitation: An overview of reviews. Journal of Rehabilitation Medicine, 2012; 44(11): 901–12. Available from: http://www.ingentaconnect.com/content/mjl/sreh/2012/00000044/00000011/art00001?token=00591d2a71d5585c54ed3437a63736a6f7c47745d23663c44502e766f644a467b4d616d3f4e4b34c8c404c6d6. DOI: 10.2340/16501977-1040
Open DOI Search in Google Scholar Back to article
Kaba, A, Wishart, I, Fraser, K, Coderre, S and McLaughlin, K. Are we at risk of groupthink in our approach to teamwork interventions in health care? Medical Education, 2016; 50(4): 400–8. Available from: https://www.ncbi.nlm.nih.gov/pubmed/26995480. DOI: 10.1111/medu.12943
Open DOI Search in Google Scholar Back to article
Sims, S, Hewitt, G and Harris, R. Evidence of collaboration, pooling of resources, learning and role blurring in interprofessional healthcare teams: a realist synthesis. Journal of Interprofessional Care, 2015; 29(1): 20–5. Available from: http://informahealthcare.com/doi/pdfplus/10.3109/13561820.2014.939745. DOI: 10.3109/13561820.2014.939745
Open DOI Search in Google Scholar Back to article
Sims, S, Hewitt, G and Harris, R. Evidence of a shared purpose, critical reflection, innovation and leadership in interprofessional healthcare teams: a realist synthesis. Journal of Interprofessional Care, 2014; (3): 209–215. Available from: http://informahealthcare.com/doi/pdfplus/10.3109/13561820.2014.941459.
Search in Google Scholar Back to article
Sinclair, LB, Lingard, LA and Mohabeer, RN. What’s so great about rehabilitation teams? An ethnographic study of interprofessional collaboration in a rehabilitation unit. Archives of Physical Medicine and Rehabilitation, 2009; 90(7): 1196–201. Available from: http://ac.els-cdn.com/S0003999309002196/1-s2.0-S0003999309002196-main.pdf?_tid=40f955da-df53-11e3-ae21-00000aab0f26&acdnat=1400503621_fcbc0218361f5060092c84273c9be020. DOI: 10.1016/j.apmr.2009.01.021
Open DOI Search in Google Scholar Back to article
Gittell, JH, Fairfield, KM, Bierbaum, B, Head, W, Jackson, R, Kelly, M, Kaskin, R, Lipson, S, Siliski, J, Thornhill, T and Zuckerman, J. Impact of relational coordination on quality of care, postoperative pain and functioning, and length of stay: A nine-hospital study of surgical patients. Medical Care, 2000; 38(8): 807–19. Available from: https://www.ncbi.nlm.nih.gov/pubmed/10929993. DOI: 10.1097/00005650-200008000-00005
Open DOI Search in Google Scholar Back to article
Gittell, JH. Relational coordination: Guidelines for theory, measurement and analysis. Heller School, Boston, Brandeis University USA: Relational Coordination Research Collaboration; 2012.
Search in Google Scholar Back to article
Xyrichis, A and Lowton, K. What fosters or prevents interprofessional teamworking in primary and community care? A literature review. International Journal of Nursing Studies, 2008; 45(1): 140–53. Available from: http://ac.els-cdn.com/S0020748907000375/1-s2.0-S0020748907000375-main.pdf?_tid=9b77bb22-b03c-11e4-b389-00000aab0f6b&acdnat=1423473688_e3754ec3600e45dc9497ea5447a07f7f. DOI: 10.1016/j.ijnurstu.2007.01.015
Open DOI Search in Google Scholar Back to article
Valentine, MA, Nembhard, IM and Edmondson, AC. Measuring teamwork in health care settings: a review of survey instruments. Medical Care, 2015; 53(4): e16–30. Available from: https://www.ncbi.nlm.nih.gov/pubmed/24189550.
Search in Google Scholar Back to article
Vinokur-Kaplan, D. Treatment teams that work (and those that don’t): An application of Hackman’s group effectiveness model to interdisciplinary teams in psychiatric hospitals. Journal of Applied Behavioral Science, 1995; 31(3): 303–27. Available from: http://journals.sagepub.com/doi/abs/10.1177/0021886395313005. DOI: 10.1177/0021886395313005
Open DOI Search in Google Scholar Back to article
Hartgerink, JM, Cramm, JM, Bakker, TJ, van Eijsden, RA, Mackenbach, JP and Nieboer, AP. The importance of relational coordination for integrated care delivery to older patients in the hospital. Journal of Nursing Management, 2014; 22(2): 248–56. Available from: https://www.ncbi.nlm.nih.gov/pubmed/24576117. DOI: 10.1111/j.1365-2834.2012.01481.x
Open DOI Search in Google Scholar Back to article
Hartgerink, JM, Cramm, JM, Bakker, TJEM, van Eijsden, AM, Mackenbach, JP and Nieboer, AP. The importance of multidisciplinary teamwork and team climate for relational coordination among teams delivering care to older patients. Journal of Advanced Nursing, 2013; 70(4): 791–9. DOI: 10.1111/jan.12233
Open DOI Search in Google Scholar Back to article
Cramm, JM, Hoeijmakers, M and Nieboer, AP. Relational coordination between community health nurses and other professionals in delivering care to community-dwelling frail people. Journal of Nurse Management, 2014; 22(2): 170–6. Available from: https://www.ncbi.nlm.nih.gov/pubmed/23441966. DOI: 10.1111/jonm.12041
Open DOI Search in Google Scholar Back to article
Gittell, JH, Godfrey, M and Thistlethwaite, J. Interprofessional collaborative practice and relational coordination: Improving healthcare through relationships. Journal of Interprofessional Care, 2013; 27(3): 210–3. Available from: http://informahealthcare.com/doi/abs/10.3109/13561820.2012.730564. DOI: 10.3109/13561820.2012.730564
Open DOI Search in Google Scholar Back to article
Havens, DS, Vasey, J, Gittell, JH and Lin, WT. Relational coordination among nurses and other providers: impact on the quality of patient care. Journal of Nursing Management, 2010; 18(8): 926–37. Available from: http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2834.2010.01138.x/abstract. DOI: 10.1111/j.1365-2834.2010.01138.x
Open DOI Search in Google Scholar Back to article
Gittell, JH. Relationships between service providers and their impact on customers. Journal of Service Research, 2002; 4(4): 299–311. Available from: http://jsr.sagepub.com/content/4/4/299. DOI: 10.1177/1094670502004004007
Open DOI Search in Google Scholar Back to article
Van Houdt, S, Heyrman, J, Vanhaecht, K, Sermeus, W and De Lepeleire, J. An in-depth analysis of theoretical frameworks for the study of care coordination. International Journal of Integrated Care, 2013; 13: e024. Available from: https://www.ijic.org/articles/10.5334/ijic.1068/. DOI: 10.5334/ijic.1068
Open DOI Search in Google Scholar Back to article
Gittell, JH, Seidner, R and Wimbush, J. A relational model of high performance work system. Academy of Management Proceedings, 2008; (1): 1–6. Available from: http://proceedings.aom.org/content/2008/1/1.163.
Search in Google Scholar Back to article
Størkson, S, Biringer, E, Hartveit, M, Assmus, J and Vanhaecht, K. Psychometric properties of the Norwegian version of the care process self-evaluation tool, CPSET, applied on a specialist care sample. Journal of Interprofessional Care, 2016; 30(6): 804–11. Available from: https://www.researchgate.net/publication/305663505_Psychometric_properties_of_the_Norwegian_version_of_the_Care_Process_Self-Evaluation_Tool. DOI: 10.1080/13561820.2016.1203766
Open DOI Search in Google Scholar Back to article
Schreiber, JB, Nora, A, Stage, FK, Barlow, EA and King, J. Reporting structural equation modelling and confirmatory factor analysis results: A review. Journal of Educational Research, 2006; 99(6): 323–38. DOI: 10.3200/JOER.99.6.323-338
Open DOI Search in Google Scholar Back to article
R Core Team. R: A language and environment for statistical computing. R Foundation for statistical computing. Vienna, Austria; 2016 [cited 19.12.2016]. Available from: http://www.R-project.org/.
Search in Google Scholar Back to article
Rosseel, Y. An R package for structural equation modeling. Journal of Statistical Software, 2012; 48(2): 1–36. Available from: http://www.jstatsoft.org/v48/i02/.
Search in Google Scholar Back to article
Pinhejro, J, Bates, D, Debroy, S and R Core Team. Linear and nonlinear mixed effects models. R package. Version 32016. Available from: https://CRAN.R-project.org/package=nlme. DOI: 10.18637/jss.v048.i02
Open DOI Search in Google Scholar Back to article
Lee, CT, Doran, DM, Tourangeau, AE and Fleshner, NE. Perceived quality of interprofessional interactions between physicians and nurses in oncology outpatient clinics. European Journal of Oncology Nursing, 2014; 18(6): 619–25. Available from: https://www.ncbi.nlm.nih.gov/pubmed/25035193. DOI: 10.1016/j.ejon.2014.06.004
Open DOI Search in Google Scholar Back to article
Tabachnick, BG and Fidell, LS. Using multivariate statistics, sixth ed. Pearson Education; 2013.
Search in Google Scholar Back to article
Schermelleh-Engel, K, Moosbrugger, H and Müller, H. Evaluating the fit of structural equation models: Tests of significance and descriptive goodness of fit measures. Methods for psychosocial research, 2003; 8(2): 23–74. Available from: http://psycnet.apa.org/record/2003-08119-003.
Search in Google Scholar Back to article
Hofstad, H, Naess, H, Moe-Nilssen, R and Skouen, JS. Early supported discharge after stroke in Bergen (ESD Stroke Bergen): A randomized controlled trial comparing rehabilitation in a day unit or in the patients’ homes with conventional treatment. International Journal of Stroke, 2013; 8(7): 582–7. Available from: https://www.ncbi.nlm.nih.gov/pubmed/22594689. DOI: 10.1111/j.1747-4949.2012.00825.x
Open DOI Search in Google Scholar Back to article
Langhorne, P, Taylor, G, Murray, G, Dennis, M, Anderson, C, Bautz-Holter, E, Dey, P, Inderdavik, B, Mayo, N, Power, M, Rodgers, H, Ronning, OM, Rudd, A, Suwanwela, N, Widen-Holmqvist, L and Wolfe, C. Early supported discharge services for stroke patients: a meta-analysis of individual patients’ data. Lancet, 2005; 365(9458): 501–6. Available from: https://www.ncbi.nlm.nih.gov/pubmed/15705460. DOI: 10.1016/S0140-6736(05)70274-9
Open DOI Search in Google Scholar Back to article
Reeves, S, Perrier, L, Goldman, J, Freeth, D and Zwarenstein, M. Interprofessional education: effects on professional practice and healthcare outcomes (update). Cochrane Database of Systematic Reviews, 2013; 3. Available from: https://www.ncbi.nlm.nih.gov/pubmed/23543515. DOI: 10.1002/14651858.CD002213.pub3
Open DOI Search in Google Scholar Back to article
Gittell, JH. Coordinating mechanisms in care provider groups: Relational coordination as a mediator and input uncertainty as a moderator of performance effects. Management Science, 2002; 48(11): 1408–26. Available from: http://www.jstor.org/stable/822615. DOI: 10.1287/mnsc.48.11.1408.268
Open DOI Search in Google Scholar Back to article
Eagly, AH, Wood, W and Diekman, AB. Social role theory of sex differences and similarities: A current appraisal. In: Eckes, T and Trautner, HM (eds.), The developmental social psychology of gender, 2000; 123–74. New York: Psychology Press.
Search in Google Scholar Back to article
Hall, P. Interprofessional teamwork: Professional cultures as barriers. Journal of Interprofessional Care, 2005; 19(Suppl 1): 188–96. Available from: https://www.ncbi.nlm.nih.gov/pubmed/16096155. DOI: 10.1080/13561820500081745
Open DOI Search in Google Scholar Back to article
Baruch, Y and Holtom, BC. Survey response rate levels and trends in organizational research (author abstract). Human Relations, 2008; 61(8): 1139–60. Available from: http://journals.sagepub.com/doi/abs/10.1177/0018726708094863. DOI: 10.1177/0018726708094863
Open DOI Search in Google Scholar Back to article
Wagner, J, Liston, B and Miller, J. Developing interprofessional communication skills. Teaching and Learning in Nursing, 2011; 6(3): 97–101. Available from: https://www.sciencedirect.com/science/article/pii/S1557308710001149. DOI: 10.1016/j.teln.2010.12.003
Open DOI Search in Google Scholar Back to article
Arnold, LM, Bradley, LA, Clauw, DJ, Glass, JM and Goldenberg, DL. Multidisciplinary care and stepwise treatment for fibromyalgia. Journal of Clinical Psychiatry, 2008; 69(12): e35. Available from: https://www.ncbi.nlm.nih.gov/pubmed/19203485. DOI: 10.4088/JCP.1208e35
Open DOI Search in Google Scholar Back to article

Articles in this issue

DOI: https://doi.org/10.5334/ijic.3432 | Journal eISSN: 1568-4156

Journal RSS Feed

Language: English

Submitted on: Sep 19, 2017

Accepted on: Mar 27, 2018

Published on: Apr 27, 2018

Published by: Ubiquity Press

In partnership with: Paradigm Publishing Services

Publication frequency: 4 issues per year

Keywords:

Teamwork,

integrated care,

Relational Coordination,

coordination,

multilevel analysis

© 2018 Merethe Hustoft, Øystein Hetlevik, Jörg Aßmus, Sverre Størkson, Sturla Gjesdal, Eva Biringer, published by Ubiquity Press
This work is licensed under the Creative Commons Attribution 4.0 License.

Volume 18 (2018): Issue 2