Describing the Clinical Communication Space through a Model of Common Ground: 'you don't know what you don't know'.

Common ground refers to the knowledge shared by two communicating parties to enable communication to occur. We suggest that common ground could enhance collaborative care delivery by serving as the linkage between different healthcare team members. Despite research describing the importance of common ground to facilitate communication, little is known about how common ground forms, moments where it is necessary, and barriers to achieving it. To address this shortcoming we studied collaborative care delivery in two settings and then used Grounded Theory methodology to develop a model of common ground. The model contains four main concepts: moments of common ground, barriers to common ground, fabric of common ground, and consequences of weak common ground. Our findings show that common ground is multi-dimensional with both static and dynamic aspects. The results from this paper help us to better understand collaborative care delivery and how to design information and communication technologies to support it.