The expected and actual communication of health care workers during the management of intrapartum : an interpretive multiple case study : original research

Background: Daily activities within a health care organisation are mediated by information communication processes (ICP) involving multiple health care professionals at different levels of care. Effective perinatal management requires critical information to be accurately communicated. If there is a breakdown in this communication patient safety is at risk for various reasons such as: inadequate critical information, misconception of information and uninformed decisions being made. The purpose of this study was to interpret the complexities around ICP in order to contribute to the effective management of the intrapartum period. Methods: Multi method, multiple case study approach was used to understand the ICP during the management of the intrapartum period. During the study, the expected ICP, the actual ICP, the challenges involved and the desired ICP were analysed. Twenty-four in-depth interviews with skilled birth attendants (SBAs) employing observer-as-participant roles, field notes, and document review methods were utilised to gather the data. Thematic analysis was utilised to analyse the data using Atlas TI software. Results: The study revealed three subthemes which emerged from the expected ICP, whilst three others that emerged formed the theme actual ICP. The subthemes from the expected ICP included: accessibility of obstetric services, expected referral, recommended tools, expected communication and expected documentation. The theme actual ICP held three emerging subthemes: the handover processes, collaborative information seeking, information communicated and referral processes. Conclusion: This study showed that what was expected was not what was actually happening.The requirements of the policies and protocols need to be effectively implemented to improve practice building these into current biomedical guidelines. La communication attendue et effective entre les travailleurs de santé pendant la gestion des soins périnatals: une étude interprétative de cas multiples. Contexte: Les activités journalières au sein d'un établissement de santé sont influencées par le processus de communication des informations (PCI) impliquant de nombreux professionnels de la santé aux différents niveaux de soins. La prise en charge périnatale efficace exige une communication précise des informations essentielles. S'il y a un manque de communication la sécurité des patients est en danger pour plusieurs raisons: des informations essentielles inadéquates, des malentendu