Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.
Act2learn HEALTH, Aalborg University College Northern Denmark, Aalborg, Denmark.
BMC Health Serv Res. 2019 Jul 29;19(1):528. doi: 10.1186/s12913-019-4362-0.
In surgical teams, health professionals are highly interdependent and work under time pressure. It is of particular importance that teamwork is well-functioning in order to achieve quality treatment and patient safety. Relational coordination, defined as "communicating and relating for the purpose of task integration," has been found to contribute to quality treatment and patient safety. Relational coordination has also been found to contribute to psychological safety and the ability to learn from mistakes. Although extensive research has been carried out regarding relational coordination in many contexts including surgery, no study has explored how relational coordination works at the micro level. The purpose of this study was to explore communication and relationship dynamics in interdisciplinary surgical teams at the micro level in contexts of variable complexity using the theory of relational coordination.
An ethnographic study was conducted involving participant observations of 39 surgical teams and 15 semi-structured interviews during a 10-month period in 2014 in 2 orthopedic operating units in a university hospital in Denmark. A deductively directed content analysis was carried out based on the theory of relational coordination.
Four different types of collaboration in interdisciplinary surgical teams in contexts of variable complexity were identified representing different communication and relationship patterns: 1) proactive and intuitive communication, 2) silent and ordinary communication, 3) inattentive and ambiguous communication, 4) contradictory and highly dynamic communication. The findings suggest a connection between communication and relationship dynamics in surgical teams and the level of complexity of the surgical procedures performed.
The findings complement previous research on interdisciplinary teamwork in surgical teams and contribute to the theory of relational coordination. The findings offer a new typology of teams that goes beyond weak or strong relational coordination to capture four distinct patterns of relational coordination. In particular, the study highlights the central role of mutual respect and presents proposals for improving relational coordination in surgical teams.
在外科团队中，卫生专业人员高度相互依存，并在时间压力下工作。为了实现高质量的治疗和患者安全，团队协作的良好运作尤为重要。关系协调，定义为“为了任务整合而进行沟通和关联”，已被发现有助于高质量的治疗和患者安全。关系协调也被发现有助于心理安全和从错误中学习的能力。尽管已经在包括手术在内的许多背景下对关系协调进行了广泛的研究，但尚无研究探讨关系协调如何在微观层面发挥作用。本研究的目的是使用关系协调理论在不同复杂性的背景下，从微观层面探索跨学科外科团队中的沟通和关系动态。
进行了一项民族志研究，涉及在丹麦一所大学医院的 2 个骨科手术室进行的 39 个外科团队和 15 次半结构访谈的参与者观察，为期 10 个月。在 2014 年进行了基于关系协调理论的演绎定向内容分析。
在不同复杂性的跨学科外科团队中确定了四种不同类型的协作，代表了不同的沟通和关系模式：1）积极和直观的沟通，2）沉默和普通的沟通，3）疏忽和模糊的沟通，4）矛盾和高度动态的沟通。研究结果表明，外科团队中的沟通和关系动态与手术程序的复杂性水平之间存在联系。
研究结果补充了关于外科团队中跨学科团队合作的先前研究，并为关系协调理论做出了贡献。研究结果提供了一种新的团队分类法，超越了弱或强的关系协调，以捕捉四种不同的关系协调模式。特别是，该研究强调了相互尊重的核心作用，并提出了改善外科团队关系协调的建议。
