Interprofessional communication in the hospital setting : a systematic review of the qualitative literature

Communication plays a key role in the provision of safe patient care, and miscommunication in healthcare can lead to avoidable patient harm or mortality. Interprofessional communication (IPCom) can be challenging due to differences in training, education and roles between healthcare professions. The aim of this systematic review was to synthesize the qualitative evidence regarding healthcare providers’ perceptions of interprofessional communication in the hospital setting. Four databases (PubMed, CINAHL, Web of Science, and Embase) were searched for studies that met the inclusion criteria. Eighteen studies were identified as suitable for inclusion in the review and were examined using thematic synthesis. Thematic synthesis led to the development of five descriptive themes: 1) <i>‘Hierarchy”</i>, 2) “<i>Interprofessional Ethos,”</i> 3) <i>“Healthcare Environment,”</i> 4) “<i>Personal Factors”</i> and 5) “<i>Methods of Communication,”</i> and two overarching analytical themes: “<i>Barriers to Communication</i>” and <i>“Facilitators to Communication</i>.” Personal factors, such as strong interprofessional relationships, were found to be important facilitators to IPCom, while organizational factors, such as challenging and hierarchical working environments, were found to pose barriers to IPCom.

沟通是保障患者安全护理的核心环节，医疗保健领域的沟通失误可引发本可避免的患者伤害乃至死亡。跨专业沟通（Interprofessional Communication，IPCom）因医疗各专业在培训、教育及角色定位上存在差异，往往颇具挑战性。本系统综述旨在整合有关医疗从业者对医院环境下跨专业沟通的认知的质性研究证据。研究团队检索了PubMed、CINAHL、Web of Science及Embase四个数据库，筛选符合纳入标准的相关研究，最终纳入18项符合要求的研究，并采用主题合成法开展分析。通过主题合成，最终提炼出5个描述性主题：1）层级结构（Hierarchy）、2）跨专业职业精神（Interprofessional Ethos）、3）医疗环境（Healthcare Environment）、4）个人因素（Personal Factors）以及5）沟通方式（Methods of Communication），同时得到2个核心分析主题：沟通障碍（Barriers to Communication）与沟通促进因素（Facilitators to Communication）。研究发现，良好的跨专业人际关系等个人因素是IPCom的重要促进因素，而兼具挑战性与层级化的工作环境等组织因素则会对IPCom构成阻碍。