Supporting patient safety: examining communication within delivery suite teams through contrasting approaches to research observation.

OBJECTIVE: to explore the nature of intra- and interprofessional communication on delivery suites, with a particular focus on patient safety.
DESIGN: longitudinal study using contrasting forms of observation: ethnographic methods alongside the highly structured Interaction Process Analysis (IPA) framework.
SETTING: four contrasting delivery suites offering different models of care and serving different populations: two in the north of England and two in London. PARTICIPANTS: the multidisciplinary delivery suite teams and visiting professionals from related areas. KEY
FINDINGS: the ethnographic observations and quantitative findings combine to highlight four principal areas relating to communication: communication underpinning collaboration; effects of workload pressures on communication practices; interprofessional communication; and the influence of architecture on communication. Contextual factors (e.g. case acuity, client throughput, model of care) underscore some inter site differences and attention is drawn to implications for safety. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: the use of complementary methods aided exploration of communication in the complex environment of the delivery suite. The findings reflect the complexity of communication patterns and the multiple influences on patterns and norms. Interprofessional tensions, workload pressures and the design of the environment can restrict communication, with implications for safety. As such, these findings have implications for policy in that safety solutions which focus efforts on standardising communication need to be located within wider strategies that also address structural and organisational networks and influences.