Health Service Quality and its Relationship to Team Collaboration and Communication during the COVID-19 Pandemic

Mateja Šimec; Sabina Krsnik; Karmen Erjavec

doi:10.3889/oamjms.2023.11454

Authors

Mateja Šimec Faculty of Health Sciences, University of Novo Mesto, Novo mesto, Slovenia https://orcid.org/0000-0002-3233-6188
Sabina Krsnik Faculty of Health Sciences, University of Novo Mesto, Novo mesto, Slovenia https://orcid.org/0000-0002-9897-7623
Karmen Erjavec Faculty of Health Sciences, University of Novo Mesto, Novo mesto, Slovenia https://orcid.org/0000-0003-4971-0292

DOI:

https://doi.org/10.3889/oamjms.2023.11454

Keywords:

Health service, Quality in healthcare, Clinical setting, Integrated clinical pathway, Interprofessional team

Abstract

BACKGROUND: In the search for innovative methods to improve the quality and efficiency of health services, integrated clinical pathways (ICPs) have been introduced.

AIM: As there is a gap in research on ICP efficiency, the aim of the study was to investigate the role and impact of collaboration and communication among three interprofessional ICP teams on the self-assessment of efficiency of ICPs.

METHODS: A cross-sectional study was conducted using a descriptive quantitative with a survey (N = 152) and qualitative methods with a focus group (N = 27) and in-depth interviews (N = 22) in a typical general hospital in Slovenia.

RESULTS: The results showed that health care professionals found patient health care and the work of health care professionals’ better quality with ICP than without ICP. The ICPs team members assessed communication, cooperation and effectiveness in the ICP team as relatively good but identified the lack of staff as the main reason for their limitations. The impact of ICP team collaboration and communication on ICP safety exists but it does not explain a sufficient proportion of the variance and the corelation is medium strong. The result also revealed that the Covid-19 pandemic did not primarily affect ICP team members' fear of possible infection, as studies have shown in the first wave of the Covid-19 pandemic, but rather staff shortages leading to increased fear of errors and possible complaints and lawsuits from patients and relatives.

CONCLUSION: Measures are needed for the additional employment of team members and the retention of current staff through financial compensation and the promotion of supportive workplace characteristics.

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Author Biography

Sabina Krsnik, Faculty of Health Sciences, University of Novo Mesto, Novo mesto, Slovenia

Faculty of Health Sciences

References

McKee M, Healy J. The role of the hospital in a changing environment. Bull World Health Organ. 2000;78(6):803-10. PMid:10916917

Scott M, Cook S. Framework for the implementation of integrated care pathways: Part 3. J Integr Care. 2005;9(2):86-91. https://doi.org/10.1177/147322970500900209 DOI: https://doi.org/10.1177/147322970500900209

Hogan C, Barry M, Burke M, Joyce P. Healthcare professionals’ experiences of the implementation of integrated care pathways. Int J Health Care Qual Assur. 2011;24(5):334-47. https://doi.org/10.1108/09526861111139179 PMid:21916088 DOI: https://doi.org/10.1108/09526861111139179

Busetto L, Luijkx K, Calciolari S, Ortiz LG, Vrijhoef HJ. Barriers and facilitators to workforce changes in integrated care. Int J Integr Care. 2018;18(2):17-27. https://doi.org/10.5334/ijic.3587 PMid:30127701 DOI: https://doi.org/10.5334/ijic.3587

Sleeman KE, Koffman J, Bristowe K, Rumble C, Burman R, Leonard S, et al. It doesn’t do the care for you: A qualitative study of health care professionals’ perceptions of the benefits and harms of integrated care pathways for end of life care. BMJ Open. 2015;5(9):e008242. https://doi.org10.1136/bmjopen-2015-008242 PMid:26369795 DOI: https://doi.org/10.1136/bmjopen-2015-008242

Seys D, Panella M, VanZelm R, Sermeus W, Aeyels D, Bruyneel L, et al. Care pathways are complex interventions in complex systems: New European pathway association framework. Int J Care Coord. 2019;22(1):5-9. https://doi.org/10.1177/2053434519839195 DOI: https://doi.org/10.1177/2053434519839195

Schrijvers G, van Hoorn A, Huiskes N. The care pathway: Concepts and theories: An introduction. Int J Integr Care. 2012;18(12):e192. https://doi.org/10.5334/ijic.812 PMid:23593066 DOI: https://doi.org/10.5334/ijic.812

Mater W, Ibrahim R. Delivering quality healthcare services using clinical pathways. Int J Comput Appl. 2014;95(1):5-8. https://doi.org/10.5120/16556-1441 DOI: https://doi.org/10.5120/16556-1441

Mould G, Bowers J, Ghattas M. The evolution of the pathway and its role in improving patient care. Qual Saf Health Care. 2010;19(5):e14. https://doi.org/10.1136/qshc.2009.032961 PMid:20430932 DOI: https://doi.org/10.1136/qshc.2009.032961

World Health Organization. Conceptual Framework for the International Classification for Patient Safety. Geneva: World Health Organization; 2009.

Alli BO. Fundamental Principles of Occupational Health and Safety. 2nd ed. Geneva: International Labour Organization; 2008. Available from: https://www.ilo.org/wcmsp5/groups/public/@dgreports/@dcomm/@publ/documents/publication/wcms_093550.pdf [Last accessed on 2022 Nov 12].

Al Lawati MH, Dennis S, Short SD, Abdulhadi NN. Patient safety and safety culture in primary health care: A systematic review. BMC Fam Pract. 2018;19(1):104. https://doi.org/10.1186/s12875-018-0793-7 PMid:29960590 DOI: https://doi.org/10.1186/s12875-018-0793-7

Šimec M, Krsnik S, Erjavec K. Assessment of nurses’ communication with department and hospital management in implementation of integrated clinical pathways in Slovenia. Nurs Cent. 2022;21(3):138-42. https://doi.org/10.2478/pielxxiw-2022-0022

Grover A, Niecko-Najjum LM. Primary care teams: Are we there yet? Implications for workforce planning. Acad Med. 2013;88(12):1827-9. https://doi.org/10.1097/ACM.0000000000000028 PMid:24128628 DOI: https://doi.org/10.1097/ACM.0000000000000028

Chichirez CM, Purcărea VL. Interpersonal communication in healthcare. J Med Life. 2018;11(2):119-22. PMid:30140317

Kreps GL. Communication and effective interprofessional health care teams. Int Arch Nurs Health Care. 2016;2(3):51. https://doi.org/10.23937/2469-5823/1510051 DOI: https://doi.org/10.23937/2469-5823/1510051

Šimec M, Krsnik S, Erjavec K. Integrated clinical pathways: Communication and participation in a multidisciplinary team. Open Access Maced J Med Sci. 2021;9(B):1549-55. https://doi.org/10.3889/oamjms.2021.7205 DOI: https://doi.org/10.3889/oamjms.2021.7205

Cramm JM, Nieboer AP. Professionals’ views on interprofessional stroke team functioning. Int J Integr Care. 2011;11:e081. https://doi.org/10.5334/ijic.657 PMid:23390409 DOI: https://doi.org/10.5334/ijic.657

Aquino MR, Mullis R, Moore C, Kreit E, Lim L, McKevitt C, et al. “It’s difficult, there’s no formula”: Qualitative study of stroke related communication between primary and secondary healthcare professionals. Int J Integr Care. 2020;20(4):11. https://doi.org/10.5334/ijic.5465 PMid:33250676 DOI: https://doi.org/10.5334/ijic.5465

Feigin VL, Roth GA, Naghavi M, Parmar P, Krishnamurthi R, Chugh S, et al. Global burden of stroke and risk factors in 188 countries, during 1990-2013: A systematic analysis for the Global Burden of Disease Study 2013. Lancet Neurol. 2016;15(9):913-24. https://doi.org/10.1016/S1474-4422(16)30073-4 PMid:27291521 DOI: https://doi.org/10.1016/S1474-4422(16)30073-4

Rubin S, Orieux A, Clouzeau B, Rigothier C, Combe C, Gruson D, et al. The incidence of chronic kidney disease three years after non-severe acute kidney injury in critically ill patients: A single-center cohort study. J Clin Med. 2019;8(12):2215-25. https://doi.org/10.3390/jcm8122215 PMid:31847384 DOI: https://doi.org/10.3390/jcm8122215

Lankhorst NE, Damen J, Oei EH, Verhaar JA, Kloppenburg M, Bierma-Zeinstra SM, et al. Incidence, prevalence, natural course and prognosis of patellofemoral osteoarthritis: The cohort hip and cohort knee study. Osteoarthritis Cartilage. 2017;25(5):647-53. https://doi.org/10.1016/j.joca.2016.12.006 PMid:27940216 DOI: https://doi.org/10.1016/j.joca.2016.12.006

Schwarz CM, Hoffmann M, Schwarz P, Kamolz LP, Brunner G, Sendlhofer G. A systematic literature review and narrative synthesis on the risks of medical discharge letters for patients’ safety. BMC Health Serv Res. 2019;19(1):158. https://doi.org/10.1186/s12913-019-3989-1 PMid:30866908 DOI: https://doi.org/10.1186/s12913-019-3989-1

Tullar JM, Brewer S, Amick BC 3rd, Irvin E, Mahood Q, Pompeii LA, et al. Occupational safety and health interventions to reduce musculoskeletal symptoms in the health care sector. J Occup Rehabil. 2010;20(2):199-219. https://doi.org/10.1007/s10926-010-9231-y PMid:20221676 DOI: https://doi.org/10.1007/s10926-010-9231-y

Michaels D, Wagner GR. Occupational safety and health administration (OSHA) and worker safety during the COVID-19 pandemic. JAMA. 2020;324(14):1389-90. https://doi.org/10.1001/jama.2020.16343 PMid:32936212 DOI: https://doi.org/10.1001/jama.2020.16343

Diemath HE. Patient complaints and liability cases in Austria. Neurosurg Q. 2007;17(2):132-3. https://doi.org/10.1097/WNQ.0b013e318032e20c DOI: https://doi.org/10.1097/WNQ.0b013e318032e20c

Karačić J, Viđak M, Marušić A. Reporting violations of European charter of patients’ rights: Analysis of patient complaints in Croatia. BMC Med Ethics. 2021;22(1):148. https://doi.org/10.1186/s12910-021-00714-3 PMid:34749721 DOI: https://doi.org/10.1186/s12910-021-00714-3

Kenda AM, Leskovar R, Pirnat R, Uršič D, Pukšič M. Empirical evidence on violations of patient rights in the Republic of Slovenia. J Local Self Gov. 2016;14(3):575-89. https://doi.org/10.4335/14.3.575-589(2016) DOI: https://doi.org/10.4335/14.3.575-589(2016)

European Commission. State of Health in the EU: Slovenia: European Commission; 2020. https://doi.org/10.1787/25227041 DOI: https://doi.org/10.1787/25227041

Busetti F, Baffoni G, Tussardi IT, Raniero D, Turrina S, De Leo D. Policies and practice in the disclosure of medical error: Insights from leading countries to address the issue in Italy. Med Sci Law. 2021;61(1 Suppl):88-91. https://doi.org/10.1177/0025802420979441 PMid:33591872 DOI: https://doi.org/10.1177/0025802420979441