Situational awareness, relational coordination and integrated care delivery to hospitalized elderly in The Netherlands: a comparison between hospitals

BMC Geriatrics

Research Article

Ton JEM Bakker¹  Ewout W Steyerberg²  Johan P Mackenbach²  Annemarie JBM de Vos³  Jacqueline M Hartgerink³  Jane M Cramm³  Anna P Nieboer³ 

[1] Argos Zorggroep, P.O. Box 4023, GA 3102, Schiedam, The Netherlands;Department of Public Health, Erasmus Medical Center Rotterdam, P.O. Box 2040, CA 3000, Rotterdam, The Netherlands;Department of Social Medical Sciences, Institute of Health Policy and Management, Erasmus University Rotterdam, P.O. Box 1738, DR 3000, Rotterdam, The Netherlands;

关键词: Internal Communication;    Organizational Context;    Situational Awareness;    Hospital Unit;    Relational Coordination;   

DOI  :  10.1186/1471-2318-14-3

 received in 2013-07-19, accepted in 2014-01-06,  发布年份 2014

来源: Springer

【 摘 要 】

BackgroundIt is known that interprofessional collaboration is crucial for integrated care delivery, yet we are still unclear about the underlying mechanisms explaining effectiveness of integrated care delivery to older patients. In addition, we lack research comparing integrated care delivery between hospitals. Therefore, this study aims to (i) provide insight into the underlying components ‘relational coordination’ and ‘situational awareness’ of integrated care delivery and the role of team and organizational context in integrated care delivery; and (ii) compare situational awareness, relational coordination, and integrated care delivery of different hospitals in the Netherlands.MethodsThis cross-sectional study took place in 2012 among professionals from three different hospitals involved in the delivery of care to older patients. A total of 215 professionals filled in the questionnaire (42% response rate).Descriptive statistics and paired-sample t-tests were used to investigate the level of situational awareness, relational coordination, and integrated care delivery in the three different hospitals. Correlation and multilevel analyses were used to investigate the relationship between background characteristics, team context, organizational context, situational awareness, relational coordination and integrated care delivery.ResultsNo differences in background characteristics, team context, organizational context, situational awareness, relational coordination and integrated care delivery were found among the three hospitals. Correlational analysis revealed that situational awareness (r = 0.30; p < 0.01), relational coordination (r = 0.17; p < 0.05), team climate (r = 0.29; p < 0.01), formal internal communication (r = 0.46; p < 0.01), and informal internal communication (r = 0.36; p < 0.01) were positively associated with integrated care delivery. Stepwise multilevel analyses showed that formal internal communication (p < 0.001) and situational awareness (p < 0.01) were associated with integrated care delivery. Team climate was not significantly associated with integrated care delivery when situational awareness and relational coordination were included in the equation. Thus situational awareness acted as mediator between team climate and integrated care delivery among professionals delivering care to older hospitalized patients.ConclusionsThe results of this study show the importance of formal internal communication and situational awareness for quality of care delivery to hospitalized older patients.

【 授权许可】

CC BY   
© Hartgerink et al.; licensee BioMed Central Ltd. 2014