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Open Access 01-12-2014 | Research article

Situational awareness, relational coordination and integrated care delivery to hospitalized elderly in The Netherlands: a comparison between hospitals

Authors: Jacqueline M Hartgerink, Jane M Cramm, Annemarie JBM de Vos, Ton JEM Bakker, Ewout W Steyerberg, Johan P Mackenbach, Anna P Nieboer

Published in: BMC Geriatrics | Issue 1/2014

Abstract

Background

It is known that interprofessional collaboration is crucial for integrated care delivery, yet we are still unclear about the underlying mechanisms explaining effectiveness of integrated care delivery to older patients. In addition, we lack research comparing integrated care delivery between hospitals. Therefore, this study aims to (i) provide insight into the underlying components ‘relational coordination’ and ‘situational awareness’ of integrated care delivery and the role of team and organizational context in integrated care delivery; and (ii) compare situational awareness, relational coordination, and integrated care delivery of different hospitals in the Netherlands.

Methods

This cross-sectional study took place in 2012 among professionals from three different hospitals involved in the delivery of care to older patients. A total of 215 professionals filled in the questionnaire (42% response rate).Descriptive statistics and paired-sample t-tests were used to investigate the level of situational awareness, relational coordination, and integrated care delivery in the three different hospitals. Correlation and multilevel analyses were used to investigate the relationship between background characteristics, team context, organizational context, situational awareness, relational coordination and integrated care delivery.

Results

No differences in background characteristics, team context, organizational context, situational awareness, relational coordination and integrated care delivery were found among the three hospitals. Correlational analysis revealed that situational awareness (r = 0.30; p < 0.01), relational coordination (r = 0.17; p < 0.05), team climate (r = 0.29; p < 0.01), formal internal communication (r = 0.46; p < 0.01), and informal internal communication (r = 0.36; p < 0.01) were positively associated with integrated care delivery. Stepwise multilevel analyses showed that formal internal communication (p < 0.001) and situational awareness (p < 0.01) were associated with integrated care delivery. Team climate was not significantly associated with integrated care delivery when situational awareness and relational coordination were included in the equation. Thus situational awareness acted as mediator between team climate and integrated care delivery among professionals delivering care to older hospitalized patients.

Conclusions

The results of this study show the importance of formal internal communication and situational awareness for quality of care delivery to hospitalized older patients.

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The pre-publication history for this paper can be accessed here:http://www.biomedcentral.com/1471-2318/14/3/prepub

Title: Situational awareness, relational coordination and integrated care delivery to hospitalized elderly in The Netherlands: a comparison between hospitals
Authors: Jacqueline M Hartgerink
Jane M Cramm
Annemarie JBM de Vos
Ton JEM Bakker
Ewout W Steyerberg
Johan P Mackenbach
Anna P Nieboer
Publication date: 01-12-2014
Publisher: BioMed Central
Published in: BMC Geriatrics / Issue 1/2014
Electronic ISSN: 1471-2318
DOI: https://doi.org/10.1186/1471-2318-14-3

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