Relational coordination and psychological safety among interprofessional healthcare team members on an acute inpatient stroke unit: a cross-sectional study.

Abstract

Interprofessional teamwork is essential for delivering safe, high-quality stroke care, yet effective coordination across professions remains challenging. As part of a quality improvement project, we conducted a cross-sectional study to assess baseline interprofessional teamwork on an acute inpatient stroke unit, focusing on relational coordination (RC) and psychological safety. An electronic survey was completed by 53 healthcare team members (n = 137), including attending-physicians (senior physicians), trainee-physicians (fellows and residents), nurses, and other allied health professionals. Overall, RC scores were moderate (within professions: 4.10-4.60; between professions: 3.50-4.00), except for attending physicians and medical trainees, whose RC was strong (4.57). Perceptions were non-reciprocal: attending-physicians and medical trainees rated RC with nurses and other professions as strong (>4.00), while those groups rated RC with them as weak (<3.50). Psychological safety, lowest among nurses, significantly accounted for the association between profession and RC communication. These findings highlight gaps in interprofessional teamwork and underscore the importance of structured interventions. Insights from this study informed the adaptation of an interprofessional bedside rounding model to strengthen communication, enhance psychological safety, and foster collaborative stroke care.