Yin Sally, McRae Prue, Adsett Julie, Mudge Alison
Physiotherapy Department, Royal Brisbane and Women's Hospital, Butterfield St, Herston, Queensland, Australia.
Internal Medicine Research Unit, Royal Brisbane and Women's Hospital, Butterfield St, Herston, Queensland, Australia.
Phys Ther. 2025 Jan 8;105(1). doi: 10.1093/ptj/pzae158.
Poor interdisciplinary team communication is a known barrier to increasing inpatient mobility. Understanding why and how clinicians from different disciplines communicate about mobility would help inform communication improvements. This qualitative interview study aimed to describe and explore clinician perceptions about written mobility communication and perceived barriers and enablers to this communication.
A rapid deductive qualitative approach was used to efficiently capture information for local improvement. Clinicians (physical therapists, nurses, physicians, and occupational therapists) working on 3 internal medicine wards in a metropolitan teaching hospital in Brisbane, Australia were purposefully sampled and invited to participate in individual interviews. Questions were based on the Consolidated Framework for Implementation Research. Interviews were recorded, transcribed, and analyzed using deductive and inductive thematic methods.
From 17 interviews, key themes identified that written communication about patient mobility is important and valued by clinicians; clinicians learn documentation on the job, often from physical therapists; clinicians are not aware of organizational responsibility for mobility communication; multiple purposes for written communication contribute to multiple locations and inconsistency; and clinicians perceive that improvement would require a multidisciplinary and multilevel approach. Suggestions for improvement included the use of a common language, consistent use of existing bedside communication tools, and clearer responsibility for written communication about mobility.
Written communication about patient mobility was valued by clinicians, and a range of barriers to effective interdisciplinary communication was identified. Clear professional roles and responsibility for written mobility communication are important. Suggestions for improvement included an interdisciplinary language supported by multidisciplinary education and organizational governance.
Written communication about patient mobility is recognized as critical to safe, high-quality hospital care. Our findings suggest that successful mobility communication improvements must involve multiple disciplines and include clear organizational governance to support staff training, clear role responsibilities, and quality monitoring.
This study found that staff on a medical ward think writing about mobility is important for patient and staff safety. Having clear roles and responsibilities for writing about mobility is important and consistency may be improved through education and training.
跨学科团队沟通不畅是已知的阻碍住院患者活动能力提升的因素。了解不同学科的临床医生就患者活动能力进行沟通的原因及方式，将有助于改进沟通。这项定性访谈研究旨在描述和探讨临床医生对书面活动能力沟通的看法以及这种沟通存在的障碍和促进因素。
采用快速演绎定性方法，以有效获取信息用于局部改进。在澳大利亚布里斯班一家大都市教学医院的3个内科病房工作的临床医生（物理治疗师、护士、医生和职业治疗师）被有目的地抽样并邀请参加个人访谈。问题基于实施研究综合框架。访谈进行录音、转录，并采用演绎和归纳主题方法进行分析。
通过17次访谈，确定了关键主题，即关于患者活动能力的书面沟通对临床医生很重要且受到重视；临床医生在工作中学习记录，通常是从物理治疗师那里学习；临床医生不清楚组织在活动能力沟通方面的责任；书面沟通的多种目的导致多处记录且不一致；临床医生认为改进需要多学科、多层次方法。改进建议包括使用通用语言、始终如一地使用现有的床边沟通工具，以及明确关于活动能力书面沟通的责任。
临床医生重视关于患者活动能力的书面沟通，并确定了有效跨学科沟通的一系列障碍。明确书面活动能力沟通的专业角色和责任很重要。改进建议包括由多学科教育和组织管理支持的跨学科语言。
关于患者活动能力的书面沟通被认为对安全、高质量的医院护理至关重要。我们的研究结果表明，成功改进活动能力沟通必须涉及多个学科，并包括明确的组织管理，以支持员工培训、明确的角色责任和质量监测。
本研究发现，内科病房的工作人员认为记录患者活动能力对于患者和工作人员的安全很重要。明确记录患者活动能力的角色和责任很重要，并且可以通过教育和培训提高一致性。
