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医疗保健专业人员跨专业团队中的沟通网络模型:烧伤病房的横断面研究

A network model of communication in an interprofessional team of healthcare professionals: A cross-sectional study of a burn unit.

作者信息

Shoham David A, Harris Jenine K, Mundt Marlon, McGaghie William

机构信息

a Department of Public Health Sciences, School of Medicine , Loyola University Chicago , Chicago , Illinois , USA.

b Leischner Institute for Medical Education , Loyola University Chicago , Chicago , Illinois , USA.

出版信息

J Interprof Care. 2016 Sep;30(5):661-7. doi: 10.1080/13561820.2016.1203296. Epub 2016 Jul 19.

Abstract

Healthcare teams consist of individuals communicating with one another during patient care delivery. Coordination of multiple specialties is critical for patients with complex health conditions, and requires interprofessional and intraprofessional communication. We examined a communication network of 71 health professionals in four professional roles: physician, nurse, health management, and support personnel (dietitian, pharmacist, or social worker), or other health professionals (including physical, respiratory, and occupational therapists, and medical students) working in a burn unit. Data for this cross-sectional study were collected by surveying members of a healthcare team. Ties were defined by asking team members whom they discussed patient care matters with on the shift. We built an exponential random graph model to determine: (1) does professional role influence the likelihood of a tie; (2) are ties more likely between team members from different professions compared to between team members from the same profession; and (3) which professions are more likely to form interprofessional ties. Health management and support personnel ties were 94% interprofessional while ties among nurses were 60% interprofessional. Nurses and other health professionals were significantly less likely than physicians to form ties. Nurses were 1.64 times more likely to communicate with nurses than non-nurses (OR = 1.64, 95% CI: 1.01-2.66); there was no significant role homophily for physicians, other health professionals, or health management and support personnel. Understanding communication networks in healthcare teams is an early step in understanding how teams work together to provide care; future work should evaluate the types and quality of interactions between members of interprofessional healthcare teams.

摘要

医疗团队由在提供患者护理期间相互交流的个体组成。对于患有复杂健康状况的患者而言,多个专业的协作至关重要,这需要跨专业和专业内的沟通。我们研究了一个由71名医疗专业人员组成的沟通网络,这些人员担任四个专业角色:医生、护士、健康管理及支持人员(营养师、药剂师或社会工作者),或其他医疗专业人员(包括物理治疗师、呼吸治疗师、职业治疗师和医学生),他们在一个烧伤病房工作。这项横断面研究的数据是通过对一个医疗团队的成员进行调查收集的。通过询问团队成员在轮班期间与谁讨论患者护理事宜来定义联系。我们构建了一个指数随机图模型来确定:(1)专业角色是否会影响建立联系的可能性;(2)与来自同一专业的团队成员相比,来自不同专业的团队成员之间建立联系的可能性是否更大;(3)哪些专业更有可能形成跨专业联系。健康管理和支持人员之间的联系有94%是跨专业的,而护士之间的联系有60%是跨专业的。护士和其他医疗专业人员建立联系的可能性明显低于医生。护士与护士交流的可能性是非护士的1.64倍(OR = 1.64,95% CI:1.01 - 2.66);医生、其他医疗专业人员或健康管理及支持人员不存在显著的同质性角色。了解医疗团队中的沟通网络是理解团队如何共同提供护理的早期步骤;未来的工作应评估跨专业医疗团队成员之间互动的类型和质量。

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