Assessment of nurses’ communication with department and hospital management in implementation of integrated clinical pathways in Slovenia

Abstract

Abstract Introduction. An important factor in the implementation of innovations such as integrative clinical care pathways (ICPs) is supportive communication from department and hospital management. ICPs have been introduced into the clinical environment as a tool to improve the quality, safety and efficiency of health services. Aim. The study aimed to assess communication of nurses working in three ICPs and department heads and hospital managers in a typical Slovenian hospital and to identify the main reasons for this communication using a mixed methods approach. Material and methods. The cross-sectional study used a mixed descriptive quantitative method with a survey and a qualitative method with a focus group interviews of nurses working in ICPs for chronic kidney disease, stroke and total hip arthroplasty in a typical Slovenian hospital. Result and conclusion. The results showed that communication plays an important role in the implementation of ICPs and that nurses communicate worse with hospital managers than with department heads, regardless of age, gender, education and ICPs. The main reasons for poor communication in the implementation of ICPs are communication-related (weak exchange of information, lack of appropriate communication channels, one-sided and authoritative communication on the part of hospital managers) and organisational (lack of staff, disorganisation of nursing staff).