Key result
Rural Transitions Nurse Program linked to high relational coordination that increases with time and enrollment.
Why the study?
Ensuring safe transitions of care requires effective team relationships and communication, prompting evaluation of relational coordination practices within a nationwide transitions of care intervention for Veterans.
Observational (n=44)
Yes
Effect estimate: rs = 0.66 (correlation with months participating)
Scale-up time and patient volume are positively correlated with the development of high-quality relationships and communication within healthcare teams managing care transitions.
May inform rural care transition scaling; hypothesis-generating for duration and volume effects on team coordination.
BACKGROUND: Ensuring safe transitions of care around hospital discharge requires effective relationships and communication between health care teams. Relational coordination (RC) is a process of communicating and relating for the purpose of task integration that predicts desirable outcomes for patients and providers. RC can be measured using a validated survey. PURPOSE: The aim of the study was to demonstrate the application of RC practices within the rural Transitions Nurse Program (TNP), a nationwide transitions of care intervention for Veterans, and assess relationships and mechanisms for developing RC in teams. METHODOLOGY/APPROACH: TNP implemented practices expected to support RC. These included creation of a transition nurse role, preimplementation site visits, process mapping to understand workflow, creation of standardized communication templates and protocols, and inclusion of teamwork and shared accountability in job descriptions and annual reviews. We used the RC Survey to measure RC for TNP health care teams. Associations between the months each site participated in TNP, number of Veterans enrolled, and adherence to the TNP intervention were assessed as possible mechanisms for developing high RC using Spearman (rs) correlations. RESULTS: The RC Survey was completed by 44 providers from 11 Veterans Health Administration medical centers. RC scores were high across sites (mean = 4.19; 1-5 Likert scale) and were positively correlated with months participating in TNP (rs = .66) and number of enrollees (rs = .63), but not with adherence to the TNP intervention (rs = .12). PRACTICE IMPLICATIONS: The impact of practices to support RC can be assessed using the RC Survey. Our findings suggest scale-up time is a likely mechanism to the development of high-quality relationships and communication within teams.
No takes yet. Share an insight, caveat, or question.
Gilmartin et al. (2020) conducted an observational in Transitions of care (n=44). rural Transitions Nurse Program (TNP) was evaluated on Relational coordination (RC) score (rs = 0.66 (correlation with months participating)). The rural Transitions Nurse Program yielded high relational coordination scores (mean 4.19), which positively correlated with months of participation (rs=0.66) and number of enrollees (rs=0.63).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: