Effect of Communication in on Collaborative Working

Effect of Communication in on Collaborative Working Discuss how communication within an inter-professional team could affect collaborative working Introduction This assignment will discuss how communication within an inter-professional team could affect collaborative working. It will focus on effective communication and understanding other professional roles. It will also examine collaborative working in a team and the barriers that can affect inter- professional team. According to Curtis, Tzannes and Rudge (2011) communication is the art of imparting a message, idea or information between two or more people and is a two way process of transferring information from a source (sender) to a destination (receiver) without the information becoming scrambled on its way so that the exact meaning is understood (Clemow, 2010). A failure to ensure effective communication may adversely affect clinical practice due to increased staff frustration causing undue anxiety and apprehension to patients. (Pincock, 2004) maintains that poor communication by health service staff is a significant cause of complaints brought against the National Health Services (NHS) and clearly shows the importance of achieving effective communication at all times. The Morecambe Bay Report (2015), reported poor working relationships between midwives, obstetricians and paediatricians, which caused major organisational failures and substandard care. (Cheung et al, 2010) stressed inter-professional communication failures are known to be the root cause of adverse events. The increase of effective communication will support government policies such as The Quality and Outcomes Framework (QOF, 2013) and the NHS Outcomes 2013/14, which have been produced to improve patient care through meeting the outcomes of the five key domains, which is a legal requirement of the Care Quality Commission (CQC, 2011). Collaboration between healthcare providers is necessary in any healthcare setting, since there is no single profession which can meet all patient’s needs. Consequently, good quality care depends upon professionals working collaboratively in inter-professional teams. In order to improve the quality of patient care and ensure that the goals of care are being achieved, many settings are using the collaborative care delivery model. The collaborative approach involves teams of health professionals working together to provide more coordinated and comprehensive care to clients (Kearney, 2008). According to Day (2006) collaboration in health care settings involves professionals assuming complementary roles and co-operatively working together, sharing responsibility for problem-solving and making-decisions. Collaboration between health care professionals can increase team member’s awareness of different types of knowledge and skills. Berry (2007) affirms that inter-professional education is a collaborative approach to develop students as future inter-professional team members. The IPE module has given individual students an insight into other students chosen professions and the importance of communication between them. Bronstein (2003) discovered the diverse cultures, norms and languages of each profession make the process of interdisciplinary collaboration resemble the bringing together of inhabitants from different backgrounds. The Morecambe Bay Report (2015) also emphasised the cultural differences between the inter-professional team which led to dysfunctional and serious failures of clinical care. According to Kerridge (2002) culture influences all aspects of our lives, it therefore influences our unconscious perception of others. These cultural differences brings with it many challenges to inter-professional working. MacDonald et al (2010) recognised the ability of a professional to learn about other professional roles leads to a broadening and an enrichment of the knowledge required to collaborate with other team members in providing effective healthcare. Inter-professional team work allows healthcare professionals to identify unique differences and to understand the roles and contributions of other members (Lee, 2011). As members of an inter-professional healthcare team, it is imperative that the basis of our different knowledge and skills set be acknowledged and understood. As an inter-professional we must understand what other healthcare professional do, how to access their services and understand the teams goals and needs from their perspective. For instance, in collaborative partners working to achieve quality care we must find ways for healthcare professionals to become good collaborators and competent team members (MacDonald et al, 2010). Working with different professionals however can be very challenging because each inter-professional has a particular approach to patients care for example, a doctor might decide to treat a cancer patient by using chemotherapy even though, there is a small chance of success and the treatment has significant side effects. The nurse on the other hand might feel like the level of pain from the side effect is too much that treatment should not continue. These different in views should be recognised and inter professionals must share their views, justify treatment approaches, and most importantly involve the patient. The success of collaborative working relies on sharing patient concerns as well as professional perspectives, values and beliefs (Cook, Gerrish Clerk, 2007). McWilliams et al (2010) suggest that inter-professional working is very challenging in the workplace, and it is not an easy concept for healthcare professionals to adopt. He argued that inter-professional working is not being delivered to patients, due to communication misunderstanding of information regarding collaborative working. It has been suggested that this is due to the lack of support and training from managers and that managers should involve staff in changes within practice (Dunsford, 2009). However, challenges in inter-professional collaboration such as professional hierarchy can prevent an inter-professional work system from achieving it goals in improving quality of care (Reeves et al, 2009).Traumacentrum (2009) also considered the design of the care system to be responsible for communication issues. Understanding the design of the care system can therefore be a first step towards gaining insight into the root causes of communication failures (Clemow, 2010). A common barrier to effective communication and collaboration is hierarchy between professionals (Berry, 2007). Deutschlander (2009) concur that communication failures in an inter-professional setting arise from vertical hierarchical differences, concerns with upward influence, role and power conflict, and ambiguity. Communication is likely to be distorted or withheld in situations where there are hierarchical differences between communicators (Hornby Atkins, 2000). Nursing and Midwifery Council’s Code of Professional Practice (NMC, 2015) stated that nurses must engage and communicate with a wide range of professionals to ensure that the patient receives quality care. (Gerard,2002) states that communication is an essential part of health care planning and delivery, no matter which area or discipline one happens to work in, as healthcare delivery involves working with people. Verbal communication is used to convey feelings, ideas and emotions and integral within verbal communication is the process of effective or active listening (Barret, Sellman Thomas 2005). Non-verbal communication conveys how we communicate both unconsciously and consciously which includes body language, facial expressions, posture, eye contact and touch (Leathard, 2003). Written communication can take various forms such as documents, patient care plans, prescription charts, letters and emails (Drake, 2007). In regard to verbal communication, a clear explanation of procedures should be given to the patient in terms that they can understand taking into account age, ethnicity and level of understanding. (Adler Rodman, 2009) suggests that professionals can often be poor listeners, as they are too busy to listen properly and jump ahead to reach their own conclusions and appear impatient and high handed as they already have a fixed idea of what they intend to do. The use of active listening techniques such as open posture and questions enhance a practitioner’s ability to accurately assess the information needs of a patient, by creating and encouraging an atmosphere in which the patient feels free to express their needs (Leathard, 2003). Day (2006) states that a vital method of communication between the inter-professional team is through the patient’s records. Good record keeping should be accurate and is essential for professional practice. Most patient records are handwritten and this sometimes presented barriers because some professionals used meaningless phrases, abbreviations and jargon which are difficult to comprehend. Booker (2005) acknowledges that the use of jargon is a way of making professional status known, however, Cheng et al (2011) points out that patients have a right to view their records and it should be written in a way that they can understand. Inter- professional caregivers are supposed to be communicators, especially when documenting patient information. If what is documented does not communicate, then the healthcare giver has failed in his or her profession and legal duty (Hornby Atkins, 2000). The Morecambe Bay Report (2015) stated that lack of openness and effective communication was a key contributor in the care received by patients, where a patient chart had gone missing, before it could be used as evidence in an investigation. If previous documentation is not properly documented or incomplete, other members of the team would find it difficult making good decisions based on the information available (Tummey, 2005). There are situations where nurses and other professionals work effectively together. The multidisciplinary team work well in long term care situations, because it is virtually impossible to tease apart the ever- changing social and healthcare needs of dependent individual and their family. When it comes to recommending patients to the right support system for example referral to social workers, the doctors and nurses discuss the patient’s condition before deciding their next line of action (Warren, 2007). A further barrier to effective verbal communication within an inter-professional team may be found within styles of speech. Speech that is heavily accented, containing technical and medical jargon or which is spoken too quickly may present communication barriers for the inter-professional team and patients, when caring for patients with hearing, learning, or language difficulties, when English may not be a person’s first language, effective communication is essential. (Yukl, 2010). Communication is fundamental in providing good nursing care and collaborative working with the modern healthcare environment. The NHS England Strategy (2014) The NHS five years forward view require healthcare professionals to consider their possible future, the choices faced, and how the services need to change, for a more engaged relationship with patients and communities, so that wellbeing is promoted and ill-health prevented. In order that patient centred care is provided inter-professionals will need to utilise effective communication skills and build upon existing communication skills and knowledge, by increasing awareness of the many barriers to communication that exist within the inter-professional team ( Pogue,2007). In conclusion, this assignment has discuss on how effective communication can hinder and impact on collaborative working. It also recognised how poor communication can lead to catastrophic result among inter-professional team. Effective communication can lead to positive outcomes, such as improving information flow, more effective involvement and improved safety, and improved collaborative working morale and service user’s experience (Day, 2006). Excellent communication and information given is essential to patient care. The more inter-professional team considers the significance of communication, the more their method towards team collaboration will be influenced positively and better would be the results. REFERENCES LIST Adler,B.R. Rodman, G. (2009). Understanding Human Communication. Oxford:Oxford University Press. Barrett. G. Sellman. D. Thomas. J. (2005). Interprofessional working in health and social care: Professional perspectives. Basingstoke: Palgrave Macmillan. Berry, D. (2007). Health Communication. Theory and Practice. Maidenhead: Open University Press. Bronstein, L. R. (2003). A Model for Interdisciplinary Collaboration. Social Work, 48(3), 297-306. Brooker, C. Nicol, M. (2005). Nursing adults: The practice of caring. London: Elsevier. Care Quality Commission. (2011). Promoting patient safety. Retrieved 18/3/2015from, http://www.cqc.org.uk/public/reports-surveys-and-reviews/reports/mental health- act-annual-report-2010/11/promoting-patient Cheung, D.S., Kelly, J.J., Beach, C., Berkeley, R.P., Betterment, R.A., Broida, R.I., Dalsey, W.C., et al. (2010). Improving handoffs in the emergency department. Annals of Emergency Medicine, 55(1) 171–180. Clemow, R. (2010) Nursing and Collaborative Practice, 2nd edition. Exeter: Learning Matters LTD. Cook. G. Gerrish K. Clarke. C. (2001). Decision making in teams: issues arising from two UK evaluations. Journal of Interprofessional Care. Vol. 15(4), 141-51. Curtis, K., Tzannes, A., Rudge, T. (2011). How to talk to doctors –A guide for effective communication. International Nursing Review, 58(6), 13–20. Day, J. (2006) Interprofessional Working. Cheltenham: Nelson Thornes. Deutschlander, S. (2009). Role understanding and effective communication as core competencies for collaborative practice. Journal of Interprofessional Care, 23(3), 41–51. Dunsford, J. (2009). Structured communication: Improving patient safety with SBAR. Nursing for Women’s Health, 13(4), 384–390 England, NHS, (2014) Five Year Forward View. Community Practitioner. Ethics for Nurses and Midwives. London: NMC. Gerard, K. (2002). Interprofessional working: opportunities and challenges. Nursing Standard. Vol. 17 (6). 33-35. Headrick, L., A., Wilcock, P. M. Batalden, P. B. (1998). Interprofessional Working and Continued medical Education. British Medical Journal, 316(7133), 771-774. Hornby, S. and Atkins, J. (2000) Collaborative Care: Inter-professional, Interagency and Interpersonal, 2nd edition. Oxford: Blackwell Science. Kearney, A. (2008). Facilitating interprofessional education and practice. The Canadian Nurse, 104(3), 22-6. Retrieved March 21, 2015, from ProQuest Health and Medical Complete. Kerridge, J. (2012). Leading change 1: identifying the issue. Nursing Times, 4(108), 12-15 Leathard. A. (2003). Interprofessional collaboration: From policy to practice in health and social care. Hove: Brunner-Routledge. Lee, V. S. (2012). What is inquiryà ¢Ã¢â€š ¬Ã‚ guided learning? New directions for teaching andlearning, 2012(129), 5-14. MacDonald, M., Bally, J., Ferguson, L., Murray, B., Fowler-Kerry, S., Anonson, J. (2010). Knowledge of the professional role of others: a key interprofessional competency. Nurse Education in Practice, 10(4), 238-242. Mc Williams, R., Holt, J., Coates, C., Cotterill, D., Eastburn, S., Laxton, J., Mistry, H., Young, C. (2010). Identifying common competences in health and social care: An example of multi-institutional and inter-professional working. Nurse Education Today, 30(3), 264-270. Nursing and Midwifery Council. (2015) The Code: Standards OF Conduct, performance and Pincock, S. (2004). Poor Communication Lies at the heart of NHS complaints. [Electronic version], British Medical Journal 328 (430), 10. Pogue, P. (2007). The nurse practitioner role: Into the future. Canadian Journal of Nursing Leadership, 20(2), 34–38. The Care Quality Commission (CQC). (2015) University Hospital of Morecambe Bay NHS, Foundation Trust. London. Traumacentrum Limburg. (2009). Failure mode and effects analysis CVA, Myocardia infarct, Heuptrauma, Obstetric, Psychiatric. Maastricht: Traumacentrum Limburg Tummey, R. (Ed.) (2005) Planning Care in Mental Health Nursing. Hampshire: Palgrave Macmillan. Warren, J. (2007) Service User and Carer Participation in Social Work. Exeter: Learning Matters LTD. Yukl, G. (2010). Leadership in organizations (7th Ed.). New Jersey: Prentice Hall.