On ward management and health communication

The proposed research into the dynamics of on-ward management and communication within a clinical setting aims to develop in-depth insights to the real time practices of staff across a multidisciplinary team.
Effective interdisciplinary communication is widely acknowledged as a driving force in the optimisation of efficient care and workflow (O'Leary et al., 2010; Donahue et al., 2011; Varjoshani et al., 2015), yet communication difficulties continue to be a significant barrier in its delivery with lapses in interprofessional communication having been identified as a leading cause of sentinel events associated with morbidity and mortality in healthcare settings (WHO, 2007; The Joint Commission, 2017).

Objectives:

To examine dynamics of multidisciplinary teamwork in clinical practice, through the completion of in depth field observation.
To explore potential existing barriers and facilitators to effective interprofessional communication within clinical practice, such as intra-professional subcultures, or 'silos'.
To apply findings
to the reframing of training and support programmes to better facilitate effective communication and team dynamics in clinical practice.

Method:

This qualitative observational study will be undertaken with an ethnographic approach, particularly focussing on interactional sociolinguistics and linguistic ethnography; the exploration of dynamics in a community of diverse professional and social roles will enable evaluation of linguistics as both a barrier and facilitator to interprofessional communication ( Creese, 2008; Rampton, 2017).

Data Collection
Fieldwork will take place through on ward observations, interviews, and focus groups. Data will be audio recorded where possible, and transcribed in detail for further analysis.

Sample
The ethnography will include a large sample from a clinical ward setting within Aneurin Bevan Health Board. It is anticipated that in order to gain a holistic insight, a range of professionals and other individuals will be studied, dependent on consent and ethical constraints.

Data Analysis
Data will be encoded through critical discourse analysis with the objective of identifying key areas, including barriers and facilitators, related to multidisciplinary communication in the existing heirarchical structure of healthcare teams.

Implications
Having gained in depth insights to the dynamics of a ward-based multidisciplinary team, an investigation into the dynamics of effective health communication will aim to inform the future development of strategies in training and supporting healthcare professionals to engage in effective interprofessional communication.