Barriers to effective health communication
DOI:
https://doi.org/10.33448/rsd-v10i7.16218Keywords:
Communication; Communication barriers; Patient safety; Medical errors.Abstract
Introduction: communication is essential to establish inter-professional relationships, the way it is effective can generate errors and result in harm to patients. Objective: evaluate the factors that influence human and organizational relationships, being able to impact the communication of the teamwork and implicating the occurrence of adverse events in two hospitals in the metropolitan region of Porto Alegre/RS. Methodology: It was carried out a multiple and embedded case study and data collection between July and August 2020, through semi-structured, virtual and recorded interviews, to analyze the data, Laurence Bardin's method of analysis has been adopted. Results: the results are related to the barriers for effective communication between the teamwork, the ones frequently mentioned were: management and processes, personnel, power relations and workload, the biggest difference between the units of analysis occurred in the first mentioned barrier. Conclusion: the difficulties related to management and process, and power relations, reinforced the need to implement and monitor protocols and routines, and, the construction of relationships between teams based on dialogue, weak points tomitigate adverse events associated with communication.
References
Agency for Healthcare Research and Quality. (2017). Estimando os custos adicionais de internação hospitalar e mortalidade associados às condições selecionadas do hospital. AHRQ. https://www.ahrq.gov/professionals/quality-patient-safety/pfp/haccost2017.html.]
AHRQ. Agency for Healthcare Research and Quality. (2004). Pesquisa hospitalar sobre cultura de segurança do paciente. Pesquisa Hospitalar Sobre Cultura de Segurança Do Paciente. Rockville: AHRQ. Https://Www.Ahrq.Gov/Sops/Surveys/Hospital/Index.Html.
Albsoul, R., FitzGerald, G., Finucane, J., & Borkoles, E. (2019). Factors influencing missed nursing care in public hospitals in Australia: An exploratory mixed methods study. International Journal of Health Planning and Management, 34(4), e1820–e1832. https://doi.org/10.1002/hpm.2898
Bardin, L. (2016). Análise de conteúdo (70th ed.).
Bragadóttir, H., & Kalisch, B. J. (2018). Comparison of reports of missed nursing care: Registered Nurses vs. practical nurses in hospitals. Scandinavian Journal of Caring Sciences, 32(3), 1227–1236. https://doi.org/10.1111/scs.12570
Brasil Ministério da saúde. (2013). Portaria n 529, de01 de abril de 2013, institui o Programa Nacional de segurança do paciente. Brasília(DF): Ministério Da Saúde.
Campbell, A., Sutcliffe, K., Carlstrom, M., Clements, J., Martin, G., Dixon-Woods, M., Aveling, E., Willars, J., Tarrant, C., & Pronovost, P. (2019). Improving Employee Voice about Transgressive or Disruptive Behavior: A Case Study. Academic Medicine, 94(4). https://doi.org/10.1097/ACM.0000000000002447
Codier, E., & Codier, D. D. (2005). Make Patients Safer ? American Journal of Nursing, 117(7), 58–62.
Cooper, J. (2017). Mixed Methods Analysis of a National Database. Annual Familly Medecine, 25, 455–462.
Dec. no 94.406, de 08. 06. 8. (1987). Regulamenta a Lei no 7.498, de 25 de junho de 1986, que dispõe sobre o exercício da Enfermagem, e dá outras providências. Brasilia/DF. http://www.cofen.gov.br/decreto-n-9440687_4173.html?fbclid=IwAR0F7ElRZQ1_D8FxzMg2bIiJffBc2uT8-WSHtNC05DAMtRqFL1RiDBSXLj0
Dewa, C. S., Loong, D., Bonato, S., & Trojanowski, L. (2017). The relationship between physician burnout and quality of healthcare in terms of safety and acceptability: A systematic review. BMJ Open, 7(6). https://doi.org/10.1136/bmjopen-2016-015141
Duffourc, M. N. (2018). Filling voice promotion gaps in healthcare through a comparative analysis of error reporting and learning systems and open communication and disclosure policies in the United States and Germany. American Journal of Law and Medicine, 44(4), 579–605. https://doi.org/10.1177/0098858818821137
Umberfield, E., Ghaferi, A. A., Krein, S. L., & Manojlovich, M. (2019). Using Incident Reports to Assess Communication Failures and Patient Outcomes. Joint Commission journal on quality and patient safety, 45(6), 406–413. https://doi.org/10.1016/j.jcjq.2019.02.006
Figueiredo, T. W. B., Da Silva, L. A. A., Brusamarello, T., De Oliveira, E. S., Dos Santos, T., & Pontes, L. (2018). Tipos, Causas E Estratégias De Intervenção Frente a Erros De Medicação: Uma Revisão Integrativa. Revista de Enfermagem e Atenção à Saúde, 7(2), 155–175. https://doi.org/10.18554/reas.v7i2.2494
Foronda, C., MacWilliams, B., & McArthur, E. (2016). Interprofessional communication in healthcare: An integrative review. Nurse Education in Practice, 19, 36–40. https://doi.org/10.1016/j.nepr.2016.04.005
Gillespie, B., Kang, E., Chaboyer, W., Harbeck, E., Steel, C., & Fairweather, N. (2017). Correlates of non-technical skills in surgery: A prospective study. BMJ Open, 7(1). https://doi.org/10.1136/bmjopen-2016-014480
Green, B., Oeppen, R. S., Smith, D. W., & Brennan, P. A. (2017). Challenging hierarchy in healthcare teams – ways to flatten gradients to improve teamwork and patient care. British Journal of Oral and Maxillofacial Surgery, 55(5), 449–453. https://doi.org/10.1016/j.bjoms.2017.02.010
Grow, H. M., McPhillips, H. A., & Batra, M. (2019). Understanding physician burnout. Current Problems in Pediatric and Adolescent Health Care, 49(11), 1–8. https://doi.org/10.1016/j.cppeds.2019.100656
Hammoudi, B. M., Ismaile, S., & Abu Yahya, O. (2018). Factors associated with medication administration errors and why nurses fail to report them. Scandinavian Journal of Caring Sciences, 32(3), 1038–1046. https://doi.org/10.1111/scs.12546
Heneka, N., Bhattarai, P., Shaw, T., Rowett, D., Lapkin, S., & Phillips, J. L. (2019). Clinicians’ perceptions of opioid error–contributing factors in inpatient palliative care services: A qualitative study. Palliative Medicine, 33(4), 430–444. https://doi.org/10.1177/0269216319832799
Habermas, J. (1997). Teoría de la acción comunicativa: complementos y estudios previos (Cátedra S.A (ed.); 3°).
Kahriman, İ., & Öztürk, H. (2016). Evaluating medical errors made by nurses during their diagnosis, treatment and care practices. Journal of Clinical Nursing, 25(19–20), 2884–2894. https://doi.org/10.1111/jocn.13341
Kong, L. N., Zhu, W. F., He, S., Chen, S. Z., Yang, L., Qi, L., & Peng, X. (2019). Attitudes towards patient safety culture among postgraduate nursing students in China: A cross-sectional study. Nurse Education in Practice, 38(1), 1–6. https://doi.org/10.1016/j.nepr.2019.05.014
Kowalski, S. L., & Anthony, M. (2017). CE: Nursing's Evolving Role in Patient Safety. The American journal of nursing, 117(2), 34–48. https://doi.org/10.1097/01.NAJ.0000512274.79629.3c
Lee, C. T. S., & Doran, D. M. (2017). The Role of Interpersonal Relations in Healthcare Team Communication and Patient Safety: A Proposed Model of Interpersonal Process in Teamwork. The Canadian Journal of Nursing Research = Revue Canadienne de Recherche En Sciences Infirmieres, 49(2), 75–93. https://doi.org/10.1177/0844562117699349
Levine, K. J., Carmody, M., & Silk, K. J. (2020). The influence of organizational culture, climate and commitment on speaking up about medical errors. Journal of Nursing Management, 28(1), 130–138. https://doi.org/10.1111/jonm.12906
Maia, C. S., Freitas, D. R. C. de, Gallo, L. G., & Araújo, W. N. de. (2018). Notificações de eventos adversos relacionados com a assistência à saúde que levaram a óbitos no Brasil, 2014-2016. Epidemiologia e Servicos de Saude : Revista Do Sistema Unico de Saude Do Brasil, 27(2), e2017320. https://doi.org/10.5123/S1679-49742018000200004
Manias, E., Cranswick, N., Newall, F., Rosenfeld, E., Weiner, C., Williams, A., Wong, I. C. K., Borrott, N., Lai, J., & Kinney, S. (2019). Medication error trends and effects of person-related, environment-related and communication-related factors on medication errors in a paediatric hospital. Journal of Paediatrics and Child Health, 55(3), 320–326. https://doi.org/10.1111/jpc.14193
Martin, G. P., Aveling, E. L., Campbell, A., Tarrant, C., Pronovost, P. J., Mitchell, I., Dankers, C., Bates, D., & Dixon-Woods, M. (2018). Making soft intelligence hard: A multi-site qualitative study of challenges relating to voice about safety concerns. BMJ Quality and Safety, 27(9), 710–717. https://doi.org/10.1136/bmjqs-2017-007579
Mushtaq, F., O’Driscoll, C., Smith, F. C. T., Wilkins, D., Kapur, N., & Lawton, R. (2018). Contributory factors in surgical incidents as delineated by a confidential reporting system. Annals of the Royal College of Surgeons of England, 100(5), 401–405. https://doi.org/10.1308/rcsann.2018.0025
Olde Bekkink, M., Farrell, S. E., & Takayesu, J. K. (2018). Interprofessional communication in the emergency department: residents’ perceptions and implications for medical education. International Journal of Medical Education, 9, 262–270. https://doi.org/10.5116/ijme.5bb5.c111
Pattni, N., Arzola, C., Malavade, A., Varmani, S., Krimus, L., & Friedman, Z. (2019). Challenging authority and speaking up in the operating room environment: a narrative synthesis. British Journal of Anaesthesia, 122(2), 233–244. https://doi.org/10.1016/j.bja.2018.10.056
Pelzang, R., & Hutchinson, A. M. (2018). Patient safety issues and concerns in Bhutan’s healthcare system: A qualitative exploratory descriptive study. BMJ Open, 8(7). https://doi.org/10.1136/bmjopen-2018-022788
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2021 Carolina Sityá Carús; André Guirland Vieira; Letícia Thomasi Jahnke Botton; Claudio Schubert; Maria Anobes Bonet Grespan Fagundes
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors who publish with this journal agree to the following terms:
1) Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
2) Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
3) Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work.