Abstract
Introduction: High-quality communication and relationships among healthcare professionals are associated with better work environments and quality of care.1-2 Workflow differences across hospital units can impede communication and relationships among healthcare professionals.3 Researchers have used relational coordination (RC), a process of communication supported by shared goals, shared knowledge, and mutual respect, to understand healthcare professionals' communication and relationships with each other in civilian hospitals.4-6 However, RC has not been explored in military hospitals. The aim of our study was to determine if RC among military and civilian nurses and physicians differs between hospital units in an Army hospital.
Methods: We conducted a secondary analysis from a cross-sectional, exploratory study using a convenience sample of military and civilian licensed practical nurses (LPNs), registered nurses (RNs), physician residents, and physicians (n = 289). Data was collected from January 2020 to March 2020 and participants completed a 47-item survey regarding their experiences of RC on various hospital units. We used t-tests and one-way ANOVAs to explore bivariate relationships between RC and other study variables, and multiple regression to explore whether RC varied by unit type.
Results: The overall response rate was 43% (678 participants were invited to complete the survey, and 289 completed the survey). The highest response rate was for LPNs, while the lowest was for physician residents (93%, 26%, respectively). Seventy percent of participants were civilian (n = 203), 75% registered nurses (n = 217), and 78% female (n = 216). The mean age of respondents was 40 years old (SD = 11.65) and the mean experience level was 11.9 years (SD = 9.49). RC was not associated with unit type. Total RC and between role RC were associated with professional role. Physicians reported higher RC (β = .45, P = .01), and LPNs reported lower RC (β = -.06, P = .01). Education and experience were associated with RC. Participants with less experience reported higher RC (β = - .01, P = .00), and participants with graduate degrees reported lower RC (β = -.62, P = .00).
Conclusion: To strategically transform healthcare, interprofessional clinical teams need to form cohesive relationships and seamlessly collaborate to effectively coordinate their work. Given our results, we suggest interventions to strengthen RC and communication, including joint interdisciplinary meetings, huddles, and structured communication tools.
Relevance to Clinical Practice: The results of this study are crucial to understanding how healthcare professionals, and specifically, nurses communicate, form relationships, and share interdependent tasks on healthcare teams. Armed with this knowledge, researchers can develop interventions to reduce the negative aspects of the social structure of interprofessional teams that constrict communication, degrade relationships, and promote poor outcomes, including authority gradients, hierarchies, and uneven levels of status and influence among team members. Nurse leaders and investigators can use the results of this study to improve RC, interprofessional relationships, communication, and mutual respect.
Notes
References
1. Gasparino RC, Ferreira TD, Oliveira HC, Alves DF, Balsanelli AP. Leadership, adequate staffing and material resources, and collegial nurse-physician relationships promote better patients, professionals and institutions outcomes. J Adv Nurs. 2021;77(6):2739-2747.
2. Ulrich B, Barden C, Cassidy L, Varn-Davis N. Critical care nurse work environments 2018: findings and implications. Critical Care Nurse, 2019;39(2):67–84. https://doi.org/10.4037/ccn2019605"
3. Manojlovich M, Harrod M, Hofer TP, Lafferty M, McBratnie M, Krein SL. Using qualitative methods to explore communication practices in the context of patient care rounds on general care units. J Gen Intern Med. 2020;35(3):839-845. doi: 10.1007/s11606-019-\n05580-9.
4. Gittell JH. Relationships between service providers and their impact on customers.\Journal of Service Research. 2002;4(4):299-311.
5. Gittell JH, Logan C, Cronenwett J, Foster TC, Freeman R, Godfrey M, Vidal DC.\Impact of relational coordination on staff and patient outcomes in outpatient surgical clinics. Health Care Manage Rev. 2020;45(1):12-20. doi: 10.1097/HMR.0000000000000192
6. Havens DS, Gittell JH, Vasey J. Impact of relational coordination on nurse job satisfaction, work engagement and burnout: achieving the quadruple aim. J Nurs Admin. 2018;\n48(3):132-140.
Sigma Membership
Rho Lambda
Type
Presentation
Format Type
Text-based Document
Study Design/Type
Other
Research Approach
Other
Keywords:
Relational Coordination, Interprofessional Communication, Interdisciplinary
Recommended Citation
House, Sherita L.; Ali, Hebatallah N.; and Stucky, Christopher, "Relational Coordination: Exploring Teamwork Across Hospital Units Among Healthcare Professionals in an Army Hospital" (2025). Creating Healthy Work Environments (CHWE). 5.
https://www.sigmarepository.org/chwe/2023/presentations_2023/5
Conference Name
Creating Healthy Work Environments
Conference Host
Sigma Theta Tau International
Conference Location
Austin, Texas, USA and Virtual
Conference Year
2023
Rights Holder
All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record.
Review Type
Abstract Review Only: Reviewed by Event Host
Acquisition
Proxy-submission
Date of Issue
2025-10-14
Relational Coordination: Exploring Teamwork Across Hospital Units Among Healthcare Professionals in an Army Hospital
Austin, Texas, USA and Virtual
Introduction: High-quality communication and relationships among healthcare professionals are associated with better work environments and quality of care.1-2 Workflow differences across hospital units can impede communication and relationships among healthcare professionals.3 Researchers have used relational coordination (RC), a process of communication supported by shared goals, shared knowledge, and mutual respect, to understand healthcare professionals' communication and relationships with each other in civilian hospitals.4-6 However, RC has not been explored in military hospitals. The aim of our study was to determine if RC among military and civilian nurses and physicians differs between hospital units in an Army hospital.
Methods: We conducted a secondary analysis from a cross-sectional, exploratory study using a convenience sample of military and civilian licensed practical nurses (LPNs), registered nurses (RNs), physician residents, and physicians (n = 289). Data was collected from January 2020 to March 2020 and participants completed a 47-item survey regarding their experiences of RC on various hospital units. We used t-tests and one-way ANOVAs to explore bivariate relationships between RC and other study variables, and multiple regression to explore whether RC varied by unit type.
Results: The overall response rate was 43% (678 participants were invited to complete the survey, and 289 completed the survey). The highest response rate was for LPNs, while the lowest was for physician residents (93%, 26%, respectively). Seventy percent of participants were civilian (n = 203), 75% registered nurses (n = 217), and 78% female (n = 216). The mean age of respondents was 40 years old (SD = 11.65) and the mean experience level was 11.9 years (SD = 9.49). RC was not associated with unit type. Total RC and between role RC were associated with professional role. Physicians reported higher RC (β = .45, P = .01), and LPNs reported lower RC (β = -.06, P = .01). Education and experience were associated with RC. Participants with less experience reported higher RC (β = - .01, P = .00), and participants with graduate degrees reported lower RC (β = -.62, P = .00).
Conclusion: To strategically transform healthcare, interprofessional clinical teams need to form cohesive relationships and seamlessly collaborate to effectively coordinate their work. Given our results, we suggest interventions to strengthen RC and communication, including joint interdisciplinary meetings, huddles, and structured communication tools.
Relevance to Clinical Practice: The results of this study are crucial to understanding how healthcare professionals, and specifically, nurses communicate, form relationships, and share interdependent tasks on healthcare teams. Armed with this knowledge, researchers can develop interventions to reduce the negative aspects of the social structure of interprofessional teams that constrict communication, degrade relationships, and promote poor outcomes, including authority gradients, hierarchies, and uneven levels of status and influence among team members. Nurse leaders and investigators can use the results of this study to improve RC, interprofessional relationships, communication, and mutual respect.
Description
Summary: In this presentation, we will explore relational coordination, a framework about the coordination of work between and among professionals in a workgroup across hospital units. During this presentation we will provide participants with evidence-based recommendations to improve interprofessional collaboration across hospital units.
Target Audience: Clinical and Leaders
Themes: Interprofessional/Interdisciplinary
Subject Group: Adult
Demographic Group: Healthcare Workers