Kim Linda Y, Giannitrapani Karleen F, Huynh Alexis K, Ganz David A, Hamilton Alison B, Yano Elizabeth M, Rubenstein Lisa V, Stockdale Susan E
Center for the Study of Healthcare Innovation, Implementation & Policy (CSHIIP), VA Greater Los Angeles Healthcare System, Los Angeles, CA, USA.
Center for Innovation to Implementation (Ci2i), VA Palo Alto Health Care System, Palo Alto, Menlo Park, CA, USA.
J Interprof Care. 2019 Nov-Dec;33(6):836-838. doi: 10.1080/13561820.2019.1577809. Epub 2019 Feb 6.
Although numerous scholars have emphasized the need for effective communication between members of interprofessional teams, few studies provide a clear understanding of what constitutes effective team communication in primary care settings, specifically where patient-centered medical home (PCMH) teams have been implemented. This paper describes the elements of effective communication as perceived by members of interprofessional PCMH primary care teams, and identifies elements of effective communication that have persisted over time. Using transcribed text from 75 semi-structured interviews, we applied the grounded theory method of constant comparison to categorize emergent themes relating to elements of team communication. Interprofessional PCMH team members described the elements of effective communication as: 1) shared knowledge, 2) situation/goal awareness, 3) problem-solving, 4) mutual respect; and communication that is 5) transparent, 6) timely, 7) frequent, 8) consistent, and 9) parsimonious. Parsimony is an emergent theme that may be especially relevant for interprofessional PCMH teams challenged with structured clinic schedules. Future work could focus on understanding how to teach and sustain effective parsimonious communication. Comprehensive quality improvement efforts incorporating a variety of strategies, including team communication training, information and communication technologies, and standardized communication tools may facilitate communication of pertinent patient information in a brief and concise manner.
尽管众多学者强调跨专业团队成员之间进行有效沟通的必要性,但很少有研究能让人清楚地了解在初级保健环境中,特别是在已实施以患者为中心的医疗之家(PCMH)团队的地方,什么构成了有效的团队沟通。本文描述了跨专业PCMH初级保健团队成员所认为的有效沟通要素,并确定了长期存在的有效沟通要素。我们使用了75次半结构化访谈的文字记录,应用持续比较的扎根理论方法对与团队沟通要素相关的新出现主题进行分类。跨专业PCMH团队成员将有效沟通的要素描述为:1)共享知识,2)情境/目标意识,3)解决问题,4)相互尊重;以及具有5)透明、6)及时、7)频繁、8)一致和9)简洁特点的沟通。简洁是一个新出现的主题,对于面临结构化门诊时间表挑战的跨专业PCMH团队可能特别相关。未来的工作可以集中在理解如何教授和维持有效的简洁沟通。纳入各种策略的全面质量改进努力,包括团队沟通培训、信息和通信技术以及标准化沟通工具,可能有助于以简洁明了的方式传达相关患者信息。