Interview and Interdisciplinary Issue Identification

Interdisciplinary teamwork is the key to ensuring high-quality, coordinated care in healthcare organizations. Collaboration between healthcare professions contributes to improved patient safety and increased productivity and continuity of care in healthcare facilities (Vaseghi et al., 2022). This assessment will be directed at identifying communication issues that are apparent in an actual interview with a working nurse and locating an organizational issue that could be solved using an interprofessional approach.

Interview Summary

The interview was carried out with a registered nurse who works in a busy unit in medical-surgical unit. The nurse indicated that a major issue that has been hard to conquer in everyday practice is the lack of effective communication between the various health care providers when discharging patients. The medication reconciliation process is not timely, and at times, the pharmacist is not informed, so the pharmacist does not have enough time to verify that the prescription matches what the patient has. Nurses are, therefore, unable to give full education to patients and family, and crucial orders can be hastened or missed.

Another observation made by the nurse was that team members do not necessarily have clear goals in the process of discharging. Occasionally, there are situations where the nurse, the pharmacist, or the physician assumes that something was done by someone else, and that too results in confusion and delays. The nurse believed that communication enhancement and an organized interdisciplinary approach would help solve these issues. Nonetheless, the nurse indicated readiness to collaborate in case effective tools and processes were implemented.

• Strategies Employed in the Interview

The type of interview used was semi-structured. Semi-structured interviews allow for exploration of the answers from a series of predetermined open questions that will inform researchers about the situation, perception, and barriers to the open questions (Schmiedhofer et al., 2021). With regard to sampling, it was decided to purposely choose a practicing nurse and a ward pharmacist to ensure that the perspectives of two key areas of discharge planning and medication reconciliation were captured. Ethical considerations were to ensure informed consent and to ensure confidentiality. The data gathering concentrated on occurrences of recent discharges and role definitions. The use of semi-structured interviewing and thematic analysis is proven in the most recent literature to be a pragmatic and efficient approach for questions of healthcare quality improvement.

Issue Identification

The primary issue that can be determined from the interview is the lack of consistent and timely communication amongst disciplines at discharge. This breakdown leaves a patient with no full medication reconciliation and without patient education and follow-up that is thorough and consistent. These gaps put patients at risk of medication errors, readmission, and impact the quality and safety of care. The nurse emphasized that these challenges are not because of the unwillingness of the staff to communicate with one another, but because of the lack of a common system that can help to ensure timely interdisciplinary communication.

The huddle, accompanied by structured discharge, and the use of standardised communication tools may be considered a good interdisciplinary approach to address this. The research suggests that collaborative interdisciplinary meetings improve communication, role clarity, and a reduction in errors (Pimentel et al., 2021). Applying a standardized checklist and short daily huddles is congruent with the Team Strategies and Tools to Enhance Performance and Patient Safety (STEPPS) framework, that proven to be effective in the area of enhancing interdisciplinary communication and interdisciplinary collaboration in the clinical context (Shi et al., 2024). This would help the nurses, the pharmacists, and the physicians to work together towards achieving safer and more effective discharge procedures, as well as provide continuity of care.

Change Management Theories

The initiative can be framed using two complementary change theories. There are two complementary change theories that can be used to frame the initiative. The Kotter approach, which has eight steps, offers a practical change management pathway to building urgency and establishing guiding coalitions to embed new processes into the organization’s culture (Prosci, 2024). The three-stage model of Lewin- unfreeze, change, refreeze- is a simple approach to preparing individuals for the change of routine, the introduction of new working processes, and the establishment of them in the working routine (Stanz et al., 2021). The steps Kotter would take would be: sequence, create a sense of urgency with baseline data, create a guiding coalition, create and communicate short-term wins from the pilot, and institutionalize the new process. The model that would assist in supporting the staff during the behavioral transitions would be Lewin’s model. Both peer-reviewed sources, Prosci (2024) and Stanz et al. (2021), provide credible, evidence-based support to validate Kotter and Lewin’s model as effective for promoting sustainable behavioral and cultural change in clinical settings.

Leadership Strategies That Could Lead to an Interdisciplinary Solution

The first leadership style is the recommended: transformational leadership. Most recent systematic nursing reviews have associated transformational leadership with a better nursing working environment, increased staff engagement, and patient outcomes (American Nurses Association, 2023). Transformational leaders evoke a common vision and empower employees to embrace new operations. A transformational leader might wish to make the change as per the proposed discharge improvement, use transformational behaviors in practice, and continually seek feedback. Transformational leadership is a complementary model that motivates and empowers employees to accept change, as per Lewin’s model. By combining Lewin’s structured change process with transformational leadership principles, the improvements in communication will be achieved and then sustained as both are implemented and effective, which will further improve teamwork and patient outcomes. The source from the American Nurses Association (2023) is credible as it demonstrates the role of transformational leadership in nursing practice.

Collaboration Approaches

The interprofessional competencies and teamwork training equip the team with a good basis for interdisciplinary work. Role definition, common goals, planned interaction, and communication methods are some of the collaboration facilitators identified in systematic reviews of collaboration (Awaisi et al., 2024). TeamSTEPPS is an evidence-based program designed to improve team member communication, leadership and monitoring of the situation, and mutual support. The results of recent analyses indicate that TeamSTEPPS adaptations can enhance the outcomes of team performance and patient safety when they are coupled with local process modifications and leadership support (Shi et al., 2024). Interdisciplinary discharge huddles are another potential technique. Brief and planned huddles at a known time every day enable each discipline to identify the roles of impending discharges (Chance et al., 2024). This will boost teamwork and patient safety while maintaining the ability to communicate across the disciplines. Moreover, Shi et al (2024) also provide strong evidence supporting the effectiveness of the TeamSTEPPS framework in enhancing healthcare team performance and patient safety.

Conclusion

During the interview, it was discovered that there was no communication and role allocation in the discharge of patients. Using an evidence-based interdisciplinary approach with the support of TeamSTEPPS tools and standardised checklists can improve teamwork, roles, and reduce errors. This improved cross-disciplinary collaboration improves safer, better, and patient-centred care.