9.2 Factors Influencing Interprofessional Communication
Andrea Chute, Sharon Johnston, Brandi Pawliuk (adapted by Brock Cook)
Learning Objectives
- discuss factors that influence interprofessional communication
- discuss communication strategies that influence interprofessional communication in negative ways.
Several factors can influence interprofessional communication positively or negatively and can have varying effects on healthcare professionals and client outcomes.
The factors affecting interprofessional communication can be divided into three main categories: those related to the physical environment, those related to the context, and those related to the communication styles of the people involved.
You should consider these factors and how to modify your communication patterns for effective interprofessional communication.
First, you will often be working in physical environments that are sometimes noisy and have many moving parts, including clients, families, and multiple members of interprofessional teams. In addition to the many people, there may be beeping machines and overhead announcements. You should be aware that this can cause sensory overload: healthcare environments are often unfamiliar for clients and their families, so you should consider this.
Second, interprofessional communication in healthcare environments occurs in a complex context involving a lot of information and dynamic and complex clinical situations requiring a high acuity level. Healthcare professionals often work in fast-paced and high-pressure environments, making it challenging to communicate effectively. Time constraints may prevent professionals from communicating thoroughly, leading to errors or misunderstandings. It can be very intense, with life-threatening conditions, death, uncertainty, fear, and anxiety – and can lead to work overload. This context can also influence the dynamic nature and intensity of interprofessional conversations.
The hierarchical relationships in interprofessional teams and imbalances of power or ideas about power can also affect how individuals communicate and interpret conversations. You must communicate compassionately and systematically. The healthcare organisation’s culture can impact how professionals communicate with each other. For instance, a culture of blame or punishment for mistakes can discourage open communication and transparency.
Personal biases such as stereotypes or prejudices can impact how professionals communicate. For example, a nurse may make assumptions about a physician’s competence based on race or gender. Professionals from different disciplines may have different goals and priorities, impacting communication. Communication can become fragmented or ineffective without a shared understanding of goals and priorities.
Third, each group of healthcare professionals has its own culture and communication styles, which may not align with those of other healthcare professionals. For example, nurses are often taught to be descriptive and embed narrative elements in their communication. This descriptive style capitalises on a comprehensive and storied approach. Other healthcare professionals, such as physicians and pharmacists, are taught to be more concise and efficient. As you can imagine, these two communication styles may not always align, so you should reflect on how to tailor your communication to the person or group you are speaking with while still communicating your point of view. Education and communication skills training can be crucial in improving interprofessional communication. Without sufficient training, professionals may lack the skills and knowledge necessary to communicate effectively with each other.
Some examples of ineffective inter-professional communication and strategies to manage each are presented below (*HP = health professional).
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Example |
Effects |
How to manage this type of communication |
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Disrespectful communication HP #1: “It’s 11:00 a.m. already!” [shakes head in disapproval] “Goodness gracious, you haven’t got her out of bed yet?! What’s wrong with you?”
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Demoralises and demeans another person. Although there may be a reason why the client was not helped out of bed, the healthcare professional may feel disempowered and not share the information.
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HP #2 could respond: “It is probably better for you to inquire why I have not gotten the client out of bed. Your communication is disrespectful and disregards what is going on with Mrs. Hart. Would you like to know what is going on?” Alternatively, HP #1, who was initially disrespectful, could have engaged in a discussion guided by inquiry instead of blame and said: “I noticed Mrs Hart is not out of bed yet. How can I help?” |
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Example |
Effects |
How to manage this type of communication |
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Failure to communicate concern. HP #1: “The client’s BP is 140/88” HP #2: “Okay.”
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The first healthcare professional stated a finding but did not indicate or emphasise their concern. Thus, the second healthcare professional did not recognise the need to be concerned or engage in a dialogue. Failure to communicate one’s concerns can have a negative effect on patient outcomes. |
When communicating, it is essential to explicate and emphasise when you have concerns and make sure that the individual that you are discussing it with recognises the importance of what you are saying. For example, the conversation could be modified such that the concern is acknowledged, and they engage in a discussion about the plan of care: HP #1: “The client’s BP is 140/88. This is unusual for this client; their baseline BP is 100/60. I am concerned about the high BP and think we should intervene.” HP #2: “That is quite a jump. Is the client’s pain well-controlled?” |
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Example |
Effects |
How to manage this type of communication |
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Failure to communicate the rationale for an action or decision. HP #1: “Let’s try putting the client in the prone position.” HP #2: “You want us to roll the client onto their abdomen?” HP #1: “Yes.” HP #2: “I think that will be difficult.”
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The communication is not dialogical because of the failure to communicate a rationale for an action or decision by either of these professionals. As a result, neither professional understands the perspective of the other. |
When communicating, it is essential to provide the rationale for your actions and decisions. For example, the conversation could be modified so that each person’s rationale is identified: HP #1: “Let’s try putting the client in the prone position. Some recent research has suggested that this can improve respiratory function when a client has severe respiratory distress that is not responding to other interventions.” HP #2: “I am concerned about rolling the client onto their abdomen with all the tubes and wires. Do you have a suggestion?” HP #1: “If you are open to it, I can get one more person, and we can do it as a team. What do you think?” |
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Example |
Effects |
How to manage this type of communication |
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Unclear/incomplete communication or miscommunication. HP #1: “Can you help Ms Di Lallo with her breakfast?” HP#2: “Yes” HP#1: “She’s at Table 1.” HP#2: [walks over to the client], “Hi, Ms Di Lallo. Are you ready for your breakfast?” Client: “Yes, can you please pass me my coffee?” HP#2: [passes Ms Di Lallo her coffee]. HP#3: “Oh, hold on! Ms Di Lallo, I need to thicken your coffee first.”
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This unclear communication about the client’s diet led to a near miss. Unclear, incomplete, or miscommunication can result in client care errors and have serious consequences for their health. |
When communicating, it is important to include all pertinent information to provide safe, effective care. All healthcare professionals need to clarify any communication shared. For example, the conversation could be modified by ensuring communicating all the required information: HP#1: “Can you help Ms Di Lallo with her breakfast?” HP#2: “Yes” HP#1: “Great, she’s at Table 1. Ms Di Lallo has dysphagia, so you need to make sure all her fluids are thickened and follow the dysphagia diet protocol. The thickener should be on her tray. Do you have any questions?” HP#1: “No, I’m aware of the dysphagia diet protocol and will monitor Ms Di Lallo during her meal.” |
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Example |
Effects |
How to manage this type of communication |
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Ineffective conflict resolution on a plan of care. HP#1: “Mr Pink said he does not feel ready to be discharged, and I agree.” HP#2: “I think I can determine when Mr Pink can be discharged, considering I have been working with him for six months, and you just met him last week.” HP#1: “We must talk to the whole team.”
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The communication is ineffective because the HCPs disagree about the client’s care plan. They are not focusing on the context of the interprofessional communication and/or explaining their reasoning based on the client’s needs. They focus on their opinions instead of using a client-centred perspective and evidence-informed approach.
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In the case of a disagreement, HCPs need to effectively explain their reasons in the context of client-centred care and evidence-informed approaches. It’s always important to use effective conflict resolution strategies. For example, the conversation could be modified as follows: HP#1: “Mr Pink said he is not ready to be discharged. I agree with him because he has no support system to help him with his activities of daily living at home.” HP#2: “I believe he is physically and mentally ready to go home, but you make a good point. Let’s put together a plan for home care.” HP#1: “Great.”
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Key Takeaways
- Several factors influence interprofessional communication, including the physical environment, context, and communication styles.
- Respectful interprofessional communication and interaction are essential to safe and effective work environments, including healthcare settings.
Exercises
1. Identify the factors influencing your professional communication and how you modify communication patterns to engage in effective interprofessional communication.
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Attribution Statement
Content adapted, with editorial changes, from:
Chute, A., Johnson, S., & Pawliuk, B. (2023). Professional communication skills for health studies. MacEwan Open Books. https://doi.org/10.31542/b.gm.3. Used under a CC BY-NC-SA 4.0 licence.
Lapum, J., St.-Amant, O., Hughes, M., Garmaise-Yee, J., & Lee, C. (Eds.). (2020). Professional communication in health professions [Adapted]. Toronto Metropolitan University Pressbooks. https://pressbooks.nscc.ca/healthcommunication/. Used under a CC BY-NC 4.0 licence.
