Schmelzer Sarah Dana, Berger Sina, Seelandt Julia Carolin, Erden Zeynep, Liberatore Florian
Winterthur Institute of Health Economics, ZHAW University of Applied Sciences, Winterthur, Switzerland
Winterthur Institute of Health Economics, ZHAW University of Applied Sciences, Winterthur, Switzerland.
BMJ Open Qual. 2025 Jun 1;14(2):e003242. doi: 10.1136/bmjoq-2024-003242.
Effective communication within healthcare teams is essential for efficient work coordination and patient safety. Communication in teams can take two forms: implicit and explicit, both of which play important roles in enhancing teamwork and output. However, within an unstable team constellation, maintaining effective communication can be challenging. There is limited empirical research on how temporary nursing staff impact team communication. The aim of this study is to evaluate the differences in communication patterns of permanent and temporary nursing staff.
In this observational study, we observed communication patterns among nurses during their daily afternoon huddles. During the live observations, we used INTERACT coding software for assessing communication patterns of permanent and temporary nursing staff. Whereby we distinguish between temporary and per diem nurses. We used lag sequential analysis to explore implicit and explicit communication patterns of temporary, per diem and permanent nursing staff. We hypothesised that temporary nursing staff primarily rely on explicit communication, whereas permanent nurses tend to rely more on implicit communication.
Across 50 huddles with a total of 309 participating nurses, the mean huddle duration was 8.50 min and included 3074 communication transitions. We found that for per diem nurses, implicit communication was followed by explicit communication. This pattern was not observed for permanent and temporary nurses. Furthermore, for permanent and temporary nurses, preceding implicit communication was followed by implicit communication.
Our study reveals that per diem nurses, with their lower employment levels and less consistent presence, tend to shift from implicit to explicit communication. This contrasts with temporary and permanent nurses, who maintain implicit communication patterns, likely due to more developed team mental models and greater mutual trust. These findings suggest that experience and consistency in the work environment are important factors shaping communication styles among nursing staff.
医疗团队内部的有效沟通对于高效的工作协调和患者安全至关重要。团队沟通可以采取两种形式：隐性和显性，这两种形式在增强团队合作和产出方面都发挥着重要作用。然而，在不稳定的团队组合中，维持有效的沟通可能具有挑战性。关于临时护理人员如何影响团队沟通的实证研究有限。本研究的目的是评估长期和临时护理人员沟通模式的差异。
在这项观察性研究中，我们观察了护士们日常下午碰头会期间的沟通模式。在现场观察期间，我们使用INTERACT编码软件来评估长期和临时护理人员的沟通模式。我们区分了临时护士和日薪护士。我们使用滞后序列分析来探究临时、日薪和长期护理人员的隐性和显性沟通模式。我们假设临时护理人员主要依赖显性沟通，而长期护士往往更依赖隐性沟通。
在总共50次有309名参与护士参加的碰头会中，平均碰头时长为8.50分钟，包括3074次沟通转换。我们发现，对于日薪护士来说，隐性沟通之后是显性沟通。长期和临时护士未观察到这种模式。此外，对于长期和临时护士来说，之前的隐性沟通之后接着是隐性沟通。
我们的研究表明，日薪护士由于其较低的就业水平和不太稳定的出勤情况，倾向于从隐性沟通转向显性沟通。这与长期和临时护士形成对比，他们保持隐性沟通模式，这可能是由于更完善的团队心智模式和更高的相互信任。这些发现表明，工作环境中的经验和稳定性是塑造护理人员沟通方式的重要因素。
