Preferences and experiences of interdisciplinary communication across hospital unit types: A survey of three health professions in a Regina, Saskatchewan hospital

Abstract

In the literature, interdisciplinary communication has been linked to high quality patient care, reduced medical error and improved patient and care provider satisfaction. Information sharing, role clarity, and shared goal setting amongst care providers are also attributed with interdisciplinary communication. The Accountable Care Unit (ACU) is an innovative, microsystem-based approach to inpatient hospital care that incorporates distinct features facilitating interdisciplinary collaboration and communication including: geographic co-location of a physicians’ patients and Structured Interdisciplinary Bedside Rounds (SIBR). During SIBR, care providers meet at the patient’s bedside and use a standardized communication protocol to provide and receive information. Traditional hospital wards, on the contrary, lack such features and intentional design. While existing research has separately explored outcomes of ACUs and aspects of interdisciplinary care, no known study has assessed healthcare providers experiences with interdisciplinary communication on ACUs versus traditional wards. The overarching purpose of this study was to understand perceived differences between interdisciplinary communication on traditional medicine wards and ACUs. The research questions that prompted this investigation included: 1. What are the experiences and perceptions of interdisciplinary communication on ACUs at the Pasqua Hospital by nurses, pharmacists and physicians who have previously worked on a traditional medicine ward? 2. How do participants perceive interdisciplinary communication on an ACU versus a traditional ward? 3.Do common themes emerge amongst research participants with similar demographics or professions? The first ACU in Canada was implemented in 2016 on unit 4A at the Pasqua Hospital in Regina, Saskatchewan to reduce lengths of stay, decrease mortality rates, and improving patient and staff satisfaction. In the following years, additional ACUs were implemented at the Pasqua Hospital and in other Saskatchewan hospitals. This research was carried out via an online survey that offered 9 demographic questions and 6 qualitative questions pertaining to interdisciplinary communication both generally, on ACUs, and on traditional wards. The survey was administered from July 13 2022 until October 31 2022 to physicians, pharmacists and nurses who volunteered to participate and who had work experience on both types of units. Fifteen respondents completed the survey and responses were analyzed using descriptive statistics and thematic analysis. Participants of this study reported an overall positive and enhanced experience with interdisciplinary communication on ACUs, generally finding it more effective than on traditional units. Reasons for this included structured communication amongst multiple care providers, regionalization of patients within the hospital with consistency in care providers, respect, and role clarity. Conversely, participants reported interdisciplinary communication to be more difficult on traditional units due to a lack of structure, absence or unavailability of team members, professional silos, hierarchies and egos. With the exception of respondents’ profession, correlations between demographic information, such as gender or age, and thematic codes proved to be inconclusive. The findings of this research could assist in guiding policies that adopt techniques or models, such as microsystem-based care models and scheduled, structured interdisciplinary rounds, which foster improved interdisciplinary communication and teamwork on acute care medicine wards. The implementation of such approaches could improve staff satisfaction, retention, and patient safety, while reducing liability risks and medical errors. Future researchers may consider investigating ACUs at other sites while acquiring more in-depth demographic information of increasingly diversified participants.