Interprofessional communication in organ transplantation in Gauteng Province, South Africa

Abstract

Background. Communication is essential to the transplant process, but it is challenging in South Africa (SA) because of the complexity of the country and the health system, the nature of transplantation as a technical procedure with inherent psychological considerations, and the large number of professionals involved. Transplant communication has not been explored in SA, and this study was the first to use health communication methods to generate empirical evidence relating to it.

Objective. To explore communication in transplant settings in Gauteng Province, SA.

Methods. Qualitative methods were used to collect data across six hospitals and transplant centres in Gauteng. State and private institutions were equally represented. Health professionals and transplant co-ordinators participated. Thematic analysis of data was undertaken.

Results. Facilitators of interprofessional transplant communication included appreciation of its importance to good practice and cohesive individual transplant teams. Barriers to interprofessional communication were observed when individual teams had to come together in a multi-team, interdisciplinary environment, when interchange became aggressive, and when information was not passed on to other health professionals timeously. These barriers had implications for continuity of care and ethics, which could lead to moral distress.

Conclusion. Transplantation in Gauteng is characterised by aspects of good teamwork, and the importance of effective communication is acknowledged. Transplantation also faces some challenges in terms of interprofessional communication. Recommendations for mitigating some of the gaps include integrating a health communication specialist into the transplant process, ‘knotworking’, the use of apology, and an advance warning text-message system for transplant professionals.