Evaluating an intervention to improve communication between healthcare professionals within secondary care


  • Kristina Åström Academic Department of Pharmacy, Barts and the London NHS Trust, Royal London Hospital, London E1 1BB, UK
  • Catherine Duggan Academic Department of Pharmacy, Barts and the London NHS Trust, Royal London Hospital, London E1 1BB, UK
  • Ian Bates Department of Practice and Policy, School of Pharmacy, University of London, 29–39 Brunswick Square, London WC1N 1AX, UK


Communication between HCPs, risk management, communication, joint communication note


Aims and objectives: The purpose of this study was to evaluate a method to improve communication between healthcare professionals (HCPs) in secondary care.
Setting: The study was undertaken at a London Teaching Hospital on a General Emergency Medical ward containing 23 beds and all stages of the study involved representatives from medicine, nursing, pharmacy and physiotherapy.
Methods: Following an evaluation of the types of communication problems that occurred on a general medical ward, HCPs developed a joint communication note (JCN). A specific place to communicate, request comments and decisions and to follow up on monitoring. This was attached to the end-of-bed-notes folder for each patient for maximum access and convenience. The content of the messages were described coded and assessed. A second focus group was convened to assess the effects of the JCN and explore HCPs’ perceptions of the intervention. The findings were collated to provide recommendations to improve communication within General and Emergency Medicine and across the Trust.
Results: A total of 29 HCPs participated in the study (8 doctors, 12 nurses, 4 pharmacists and 5 therapists). During the four weeks of implementation 44 JCNs were collected which comprised a total of 123 messages, a range of 1–10 messages and a median of two per JCN. Different professions used the JCN in different ways: pharmacists and nurses used it the most, whilst doctors relied on the exiting medical notes and therapists used it least. Despite decreased use by the end of the study, it was agreed that the JCN provided a means for HCPs to communicate with each other.
Conclusions: Whilst the JCN did not solve all problems with communication, it is a useful first step in influencing the communication culture within the Trust and the findings will be used to inform the development of electronic communication within the Trust. The differences between the professions highlighted the need to account for professional and behavioural differences when implementing any future developments in communication.


Berko, R. M., & Wolvin, A. D. (1989). Communication. Boston, MA: Houghton Mifflin.

Davis, C. (2000). Getting health care professionals to work together: There’s more to collaboration than simply working side by side. BMJ, 320, 1021–1022.



Research Article