Abstract
BackgroundPatient safety is a key target in public health, health services and medicine. Communication between all parties involved in gynecology and obstetrics (clinical staff/professionals, expectant mothers/patients and their partners, close relatives or friends providing social support) should be improved to ensure patient safety, including the avoidance of preventable adverse events (pAEs). Therefore, interventions including an app will be developed in this project through a participatory approach integrating two theoretical models. The interventions will be designed to support participants in their communication with each other and to overcome difficulties in everyday hospital life. The aim is to foster effective communication in order to reduce the frequency of pAEs. If communication is improved, clinical staff should show an increase in work satisfaction and patients should show an increase in patient satisfaction.MethodsThe study will take place in two maternity clinics in Germany. In line with previous studies of complex interventions, it is divided into three interdependent phases. Each phase provides its own methods and data. Phase 1: Needs assessment and a training for staff (n = 140) tested in a pre-experimental study with a pre/post-design. Phase 2: Assessment of communication training for patients and their social support providers (n = 423) in a randomized controlled study. Phase 3: Assessment of an app supporting the communication between staff, patients, and their social support providers (n = 423) in a case-control study. The primary outcome is improvement of communication competencies. A range of other implementation outcomes will also be assessed (i.e. pAEs, patient/treatment satisfaction, work satisfaction, safety culture, training-related outcomes).DiscussionThis is the first large intervention study on communication and patient safety in gynecology and obstetrics integrating two theoretical models that have not been applied to this setting. It is expected that the interventions, including the app, will improve communication practice which is linked to a lower probability of pAEs. The app will offer an effective and inexpensive way to promote effective communication independent of users’ motivation. Insights gained from this study can inform other patient safety interventions and health policy developments.Trial registrationClinicalTrials.gov Identifier: NCT03855735; date of registration: February 27, 2019.
Highlights
Patient safety is a key target in public health, health services and medicine
Further plans to communicate trial results to participants, healthcare professionals, the public, and other relevant groups via publication, presentations and press releases will be developed using a participatory approach, with the restriction that anonymity is ensured at all times. This project investigates interpersonal communication based on communication competences and the Health Action Process Approach (HAPA) to better understand where and how problems may occur and how to overcome these problems with interventions in everyday clinical life
The overall aim of the project is to support communication based on the communication competences model and the HAPA, and to overcome difficulties in everyday hospital life
Summary
Communication between all parties involved in gynecology and obstetrics (clinical staff/professionals, expectant mothers/patients and their partners, close relatives or friends providing social support) should be improved to ensure patient safety, including the avoidance of preventable adverse events (pAEs). Different communication errors and barriers to effective communication have been identified in parts of the clinical team Errors, such as the omission of important information, describe the kind of suboptimal communication behaviors, whereas barriers are obstructions to engaging in effective communication behaviors and include organizational and (inter-) personal factors such as rapidly changing healthcare teams, work overload, lack of mutual respect, not feeling part of the team, lack of self-confidence, and lack of training [6]. Consistent execution of successful communication requires excellent listening skills, superb administrative support, and collective commitment to move past traditional hierarchy and professional stereotyping.”
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