Using an electronic tool to improve teamwork and interprofessional communication to meet the needs of complex hospitalized patients: A mixed methods study

• Published in: International journal of medical informatics (Shannon, Ireland) Vol. 127; pp. 35 - 42
• Main Authors: Tang, Terence, Heidebrecht, Christine, Coburn, Andrea, Mansfield, Elizabeth, Roberto, Ellen, Lucez, Emanuel, Lim, Morgan E., Reid, Robert, Quan, Sherman D.
• Format: Journal Article
• Language: English
• Published: Ireland Elsevier B.V 01.07.2019
• Subjects: Communication; Hospital medicine; Medical informatics; Mixed methods; Teamwork; Teamwork; Hospital medicine; Mixed methods; Communication; Medical informatics
• ISSN: 1386-5056; 1872-8243
• DOI: 10.1016/j.ijmedinf.2019.04.010

•Teamwork and communication are important in addressing the comprehensive care needs of complex hospitalized patients.•Impact of introducing electronic tools to improve teamwork and communication is mixed.•Addressing technology and non-technology factors are important to increase chance of success. Teamwork and interprofessional communication are important in addressing the comprehensive care needs of complex hospitalized patients. The objective of this study is to evaluate the impact of an electronic interprofessional communication and collaboration platform on teamwork, communication, and adverse events in the hospital setting. In this mixed methods study, we used a quasi-experimental design in the quantitative component and deployed the electronic tool in a staged fashion to 2 hospital wards 3 months apart. We measured teamwork, communication, and adverse events with Relational Coordination survey, video recordings of team rounds, and retrospective chart review. We conducted qualitative semi-structured interviews with clinicians to understand the perceived impacts of the electronic tool and other contextual factors. Teamwork sustainably improved (overall Relational Coordination score improved from 3.68 at baseline to 3.84 at three and six months after intervention, p = 0.03) on ward 1. A small change in face-to-face communication pattern during team rounds was observed (making plans increased from 22% to 24%, p = 0.004) at 3 months on ward 1 but was not sustained at 6 months. Teamwork and communication did not change after the intervention on ward 2. There was no meaningful change to adverse event rates on either ward. Clinicians reported generally positive views about the electronic tool’s impact but described non-technology factors on each ward that affected teamwork and communication. The impact of using an electronic tool to improve teamwork and communication in the hospital setting appears mixed, but can be positive in some settings. Improving teamwork and communication likely require both appropriate technology and addressing non-technology factors.