EXAMINING THE EFFICACY OF COMMUNICATION STRATEGIES IN INTERDISCIPLINARY HEALTHCARE TEAMS IN NIGERIA

CHAPTER ONE

INTRODUCTION

1.1 Background of the study

By their inherent nature, humans operate in an interconnected manner. Due to the rapid expansion of information on the Internet and the increasing complexity of work structures, it is necessary for varied groups to work together in order to address difficulties and overcome obstacles. The healthcare sector necessitates the utilisation of cooperation as a fundamental instrument. Healthcare in Nigeria is characterised by high costs, fragmentation, unreliability, a reactive approach, and limited effectiveness in enhancing population health or reducing the widespread and alarming gaps in health status and life expectancy (Bassey, Olumide & Agu, 2022). The healthcare business is characterised by fragmentation, with different professionals, including doctors, nurses, and psychiatrists, needing to collaborate in teams, maintain regular communication, and exchange resources and tools (Manser, 2019). Teamwork and collaboration are essential and crucial for the future healthcare professionals because the idea of health encompasses an intricate and comprehensive system where biological, psychological, physical, socioeconomic, cultural, and environmental factors work together as interconnected and interacting determinants of each other (Weiss, Tilin, & Morgan, 2018). The health paradigm has transitioned from focussing on acute care interventions and reducing mortality rates to a model that prioritises the overall health goals of patients. The present delivery of healthcare places great emphasis on the provision and availability of high-quality care.

Berwick, Nolan, and Whittington introduced the "Triple Aim" concept to enhance the quality of care in healthcare, so contributing to the healthcare vocabulary (Ma, 2020). The Triple Aim is a methodology aimed at enhancing the quality of care for individuals, promoting the overall health of populations, and decreasing the average expenditures of care for populations (Bodenheimer & Sinsky, 2022). These aims are interdependent and necessitate a methodical incorporation of joint practice and education. In 2014, the Triple Aim framework was extended to the Quadruple Aim, which now encompasses the goal of enhancing the experience of delivering healthcare (Sikka, Morath, & Leape, 2019). The Triple Aim prioritised the needs and desires of patients and communities, but it overlooked the healthcare personnel. In order to effectively accomplish the objectives of the Quadruple Aim, it is essential for healthcare providers to actively participate in their daily healthcare encounters. Contrary to happiness, the concept here is that all healthcare professionals have a sense of achievement and significance in their contributions to the patient and as a team - a feeling of importance (Sikka et al., 2019). Physicians and clinic personnel who are not satisfied pose a danger to the patient-centeredness of treatment and the Quadruple Aim (Bodenheimer & Sinsky, 2018). In order to achieve each objective of the Quadruple Aim, it is necessary to transition the healthcare culture from a fragmented system, where practitioners work individually, to a collaborative care model (Khalili, Hall, & DeLuca, 2019). Studies indicate that interprofessional teams exhibit a lower rate of errors compared to individuals, leading to enhanced patient care and heightened safety (Baker, Day, & Salas, 2020).

Due to the varied range of professions and varying degrees of experience within an interprofessional healthcare team, it is crucial for members to possess excellent communication skills in order to effectively collaborate with each other and with their patients. In order to foster a dynamic team, it is essential to provide both formal and informal avenues for individuals to learn about and engage with professionals from different fields. This will help to cultivate a greater understanding and appreciation for the responsibilities of others, challenge stereotypes, and ultimately improve the overall functioning of the team (Sargeant, Loney, & Murphy, 2018). In order to equip future healthcare professionals with the necessary skills to work effectively in a team-based care model, simulation is employed as an educational approach. This allows students to gain experience, practise, and enhance their interprofessional skills, including communication, collaboration, and teamwork (Baker, Pulling, McGraw, Dagnone, Hopkins-Rossell, & Medves, 2018).

 Effective communication is crucial when delivering information to a patient, family member, healthcare provider, or clinic staff. Communication is crucial as it ensures the provision of secure and high-quality care for all individuals involved. According to a study conducted by John Hopkins in 2016, around 250,000 individuals in the United States perish annually due to medical errors, ranking it as the third most common cause of death following heart disease and cancer (Makary & Daniel, 2018). Moreover, The Joint Commission (2017), an autonomous, non-profit entity tasked with accrediting hospitals across the country, approximated that 80% of severe medical errors are caused by miscommunication among healthcare providers during transitions of care. Hence, the nascent healthcare paradigm of interprofessional teams has the potential to mitigate the substantial annual mortality rate by means of effective communication. In 2011, the Institute of Medicine (IOM) Committee made a significant recommendation in its influential report, Crossing the Quality Chasm: A New Healthcare System for the 21st Century. The recommendation emphasised the importance of healthcare professionals collaborating in interprofessional teams to effectively communicate and address the complex and challenging needs of patients (Mitchell et al., 2022). Subsequently, the IOM has released and implemented definitive principles and values for healthcare that is centred around teamwork (Mitchell et. al, 2022). Universities offering health professional programs acknowledge the importance of equipping their students with the necessary skills to thrive in real-world healthcare settings. As a result, these programs are incorporating interprofessional education (IPE) into their curriculum to enhance students' ability to collaborate and communicate effectively as a cohesive healthcare team.

Effective communication plays a crucial role in shaping the collaboration and overall effectiveness of interprofessional teams. Inadequate team communication raises the likelihood of safety hazards for patients (Leonard, Graham, & Boacum, 2017; Walker, 2018). Therefore, comprehending and implementing effective communication is crucial for successful collaboration. While both undergraduate and graduate students receive instruction in communication skills, they are frequently not provided with the theoretical basis or practical application of these abilities in a healthcare environment (Woodward, 2022; Yedidia et al., 2017). Utilising a methodical simulation, a thoroughly investigated pedagogical approach necessitates students' direct participation in learning and honing their communication abilities inside an authentic healthcare environment. In addition, standardised patients, who undergo meticulous training to accurately represent real patients, offer useful feedback regarding the specific abilities observed throughout the simulated encounter (Barry et al., 2022).

Interdisciplinary healthcare teams are crucial for delivering complete care, especially in intricate cases that necessitate the expertise of numerous specialists (Bodenheimer & Sinsky, 2018). The healthcare system in Nigeria encompasses a wide range of professional positions, such as doctors, nurses, chemists, physiotherapists, and social workers, among others. Efficient communication among these experts is essential for guaranteeing the best possible results for patients. Nevertheless, communication within these teams might be impeded by obstacles such as cultural diversity, hierarchical systems, and differing levels of education (Bankole & Ojo, 2023). The healthcare system in Nigeria has various obstacles, such as scarce resources, a high ratio of patients to healthcare providers, and the burden of both infectious and non-communicable diseases (Bankole & Ojo, 2023). These problems amplify the necessity for proficient and successful communication tactics. Inadequate communication can result in misinterpretations, inaccuracies in healthcare provision, diminished patient contentment, and potentially harmful health consequences. Studies on communication techniques in interdisciplinary teams have emphasised the significance of precise, uniform, and organised communication methods. These strategies encompass regular team meetings, the implementation of standardised communication tools such as SBAR (Situation, Background, Assessment, Recommendation), and the incorporation of technology to enhance information exchange (Van et al., 2022). Nevertheless, the effectiveness of these interventions in the Nigerian healthcare context has not been thoroughly investigated. Therefore, the necessity for this investigation arises.

1.2 Statement of the Problem

The increasing complexity of healthcare needs, coupled with the diverse expertise required to address them, has made interdisciplinary healthcare teams an essential component of the healthcare system. These teams, which bring together professionals from various disciplines such as medicine, nursing, pharmacy, and social work, are designed to provide comprehensive and coordinated patient care. However, the effectiveness of these teams is heavily dependent on the quality of communication strategies employed among team members.

In Nigeria, the delivery of effective healthcare is often dependent on the collaboration of interdisciplinary teams, which include doctors, nurses, pharmacists, physiotherapists, and other healthcare professionals (Obi et al., 2022). However, there are growing concerns regarding the efficacy of communication strategies within these teams. Ineffective communication can lead to misunderstandings, errors in patient care, and ultimately, negative patient outcomes ((Bankole & Ojo, 2023)). Despite the critical role that communication plays in the success of interdisciplinary healthcare teams, there is limited research on the specific communication strategies used in Nigeria and their effectiveness. This study seeks to examine the efficacy of these communication strategies, identify potential barriers to effective communication, and suggest improvements that could enhance teamwork and patient care outcomes in the Nigerian healthcare context. 

Objectives of the study

The primary objective of this study is to critically examine the efficacy of communication strategies in interdisciplinary healthcare teams in Nigeria. Specific objectives of this study are to:

To assess the existing communication strategies employed by interdisciplinary healthcare teams in Nigeria

To assess the Impact of Communication on Team Dynamics among interdisciplinary healthcare teams in Nigeria

To examine the effect of Communication on Patient Outcomes

To analyze the primary barriers to effective communication within interdisciplinary healthcare teams in Nigeria.

To propose recommendations for improving communication strategies within interdisciplinary healthcare teams in Nigeria

1.4 Research Questions

The following research questions which are in line with the objectives of this study will be answered in this study:

What are the communication strategies employed by interdisciplinary healthcare teams in Nigeria?

What is the Impact of Communication on Team Dynamics among interdisciplinary healthcare teams in Nigeria?

What is the effect of Communication on Patient Outcomes?

What are the barriers to effective communication within interdisciplinary healthcare teams in Nigeria?

What are the recommendations for improving communication strategies within interdisciplinary healthcare teams in Nigeria?

1.5 Research Hypotheses

To determine the effectiveness of this study, the following research null hypotheses will be formulated to guide the study and it will be tested at 0.05% levels of significance.:

Ho: Communication has no significant impact on Team Dynamics among interdisciplinary healthcare teams in Nigeria.

Ha: Communication has significant impact on Team Dynamics among interdisciplinary healthcare teams in Nigeria.

1.6 Significance of the study

The objective of this research is to offer evidence-based suggestions to increase communication techniques and boost the overall performance of interdisciplinary healthcare teams in the Nigerian environment. The study will establish a fundamental reference point for healthcare professionals, public health programs, policymakers, students, and academics.

Enhancing comprehension and enhancing communication tactics within interdisciplinary healthcare teams might result in enhanced collaboration among team members. Implementing this strategy can optimise team performance, minimise miscommunications, and cultivate a more unified working atmosphere, ultimately enhancing the standard of patient care. Enhancing communication techniques can empower healthcare personnel by equipping them with superior tools and practices for efficient collaboration. These outcomes may result in heightened job contentment, decreased exhaustion, and a work atmosphere that is more conducive to providing assistance and encouragement.

Moreover, proficient communication is essential for providing exceptional patient care. The study can enhance patient outcomes by detecting and resolving communication obstacles, leading to greater treatment adherence, less mistakes, and increased patient satisfaction.

Moreover, the results can provide valuable insights for healthcare policies and practices concerning team communication in Nigeria. This can facilitate the establishment of training programs, communication protocols, and organisational methods that optimise the functioning of interdisciplinary teams.

Moreover, the study will offer valuable understanding of the particular communication obstacles encountered by healthcare teams in Nigeria, taking into account local cultural, organisational, and resource-related variables. Having a comprehensive awareness of the context is crucial in order to create solutions that are not only practical but also culturally sensitive.

Furthermore, by investigating the effectiveness of communication tactics in interdisciplinary teams, this study will enhance the current knowledge base and establish a basis for future research. It can identify specific areas that require additional examination, especially in various locations or healthcare facilities in Nigeria. Although the primary emphasis is on Nigeria, the discoveries can provide significant insights for other low- and middle-income nations that face comparable healthcare systems and difficulties. This can enhance worldwide dialogues on enhancing interdisciplinary team communication and healthcare delivery.

1.7 Scope of the study

Broadly, this study focus is to critically examine the efficacy of communication strategies in interdisciplinary healthcare teams in Nigeria. Specifically, this study seeks to assess the existing communication strategies employed by interdisciplinary healthcare teams in Nigeria, assess the Impact of Communication on Team Dynamics among interdisciplinary healthcare teams in Nigeria and examine the effect of Communication on Patient Outcomes. 

Further, this study will focus on analyzing the barriers to effective communication within interdisciplinary healthcare teams in Nigeria and it also seeks to propose recommendations for improving communication strategies within interdisciplinary healthcare teams in Nigeria.

 The study is carried out in Nigeria. 

1.8 Limitations of the study

During the examination, the researchers observed numerous minor limitations, which are typical in any human attempt. The primary constraint was the paucity of comprehensive literature on the subject, stemming from the dearth of data on assessing the effectiveness of communication techniques in interdisciplinary healthcare teams in Nigeria. Consequently, a substantial investment of time and effort was required to ascertain the suitable materials, books, or information and collect data. 

Moreover, this study is limited by its limited sample size and restricted geographic coverage, concentrating exclusively on Nigeria. Hence, the ability to generalise the results of this study to a wider scope is limited, emphasising the necessity for more research. 

Furthermore, the researcher's shortcomings were predominantly attributed to financial restraints, as they are a student who lacks the necessary financial resources to support themselves. The excessively high transportation fees at the study site presented a difficulty in fulfilling the financial responsibilities associated with transportation costs.

In addition, the researcher encountered a time limitation as a result of the necessity to do this research while concurrently meeting the responsibilities of attending lectures and engaging in other educational endeavors.

1.9 Definition of terms

Communication: Communication is a process that involves sending and receiving messages through the verbal and non-verbal methods. Communication is a two-way means of communicating information in the form of thoughts, opinions, and ideas between two or more individuals with the purpose of building an understanding.

Interdisciplinary teamwork: Interdisciplinary teamwork (also known as Inter-Professional collaboration) in healthcare refers to the collaborative approach where professionals from different disciplines work together to deliver comprehensive patient care.

Patient outcome: Patient outcomes are the results from care and treatments patients have received whilst in hospital, other clinical or care settings. They focus on meeting the physical, social, and emotional needs of patients from their own perspective to highlight what is important to them.