Effective Interprofessional Communication for Patient Safety in Low-Resource Settings: A Concept Analysis

Abstract

Background: Implementing effective interprofessional communication (IPC) in low-resource settings is challenging, primarily due to limited awareness and understanding of the concept. This analysis examined the concept of effective IPC for patient safety in low-resource settings. Its key attributes, antecedents, consequences, and empirical referents were identified. Methods: The Walker and Avant framework was used to analyze effective IPC. A literature review was conducted using PubMed, CINAHL, Embase, and Google Scholar, covering research from 2014 to 13 May 2025. Results: Effective IPC embodies clarity, accuracy, consistency, trust, collaboration, and timely information exchange. Strong leadership commitment, transparent communication, ongoing training, and a systematic incident reporting method contribute to better patient safety (PS) and improved healthcare outcomes. Conclusions: Effective interprofessional communication (IPC) is crucial for enhancing patient safety (PS). The concept and its attributes are unclear and underutilized in low-income countries like Malawi due to inadequate training, lack of standardized tools, weak leadership support, and limited psychological safety. Effective IPC should be integrated into preservice training, standardize PS education, and foster collaboration in clinical settings.

1. Introduction

Effective interprofessional communication (IPC) improves patient safety, decision-making, and professional relationships [1,2,3]. Ebert et al. defined interprofessional communication (IPC) as the ability of different healthcare professionals to communicate in a collaborative, responsible, and responsive manner that is essential for well-functioning healthcare [4]. Recognizing its importance, the Joint Commission International (JCI), an independent body whose mission is to identify, measure, and share best practices in quality and patient safety (PS) around the world, emphasizes effective IPC as a crucial element of PS in its International Patient Safety Goals (IPGS) [5,6]. Despite this emphasis, poor communication among health professionals remains one of the leading causes of preventable medical errors globally.

More than 70% of hospital adverse events (AEs) can be attributed to communication failures, particularly during handovers, transitions of care, and emergencies [7]. These errors often occur due to unclear, inaccurate, untimely, or incomplete communication or information sharing during transfer of care and emergencies [7].

Throughout this paper, we use the term low-resource settings (LRS), which refers to healthcare systems in low-income countries (LICs). In LRS, such as in Malawi, the lack of awareness of effective IPC is compounded by insufficient infrastructure and resources, a shortage of trained healthcare professionals, and weak governance [8]. Weak health systems are a significant factor contributing to the ineffectiveness of IPC. Most infrastructure and resource issues arise mainly due to factors like a lack of availability for purchase or being unaffordable within national budgets [9]. Other challenges include poor funding allocation or corruption, as well as inadequate communication and resource distribution within the health system [10]. Additionally, many healthcare professionals lack formal training in structured communication approaches [11,12,13]. Research indicates that only 8% of medical schools provide formal training on patient handovers during didactic sessions [14]. The situation is similar in low-resource settings, such as Malawi, where communication training is inadequate and inconsistent.

Despite the inclusion of communication training in healthcare curricula, gaps persist in its application to patient safety. For instance, standardized communication techniques, such as Situation–Background–Assessment–Response (SBAR) or Pediatric Early Warning Score (PEWS), are not adequately taught and understood in clinical practice [15]. This is attributed to a lack of awareness of its priority and hierarchical barriers [16]. Findings of a scoping review conducted in South Africa on interaction patterns among health professionals in resource-limited settings revealed that doctors feel superior. As such, nurses are not interested in ward rounds [17]. These factors lead to poor care quality, increased patient harm, and higher mortality rates [6,8,12,18].

Furthermore, a high workload affects effective IPC in LRS. In Malawi, the health worker-to-patient densities are, respectively, 0.019 physicians and 0.283 nursing and midwifery personnel per 1000 population. This is below the WHO-recommended ratio of 1 to 6 for general wards and 2.5 physicians per 1000 population [19]. Medical errors often arise due to burnout [20], decreased concentration [21,22], and hasty handover communication [17,23]. Addressing these issues is crucial to avoid miscommunications that can lead to incorrect diagnoses and medication errors [1,2,24].

Teamwork is another crucial factor in achieving effective IPC. When communication is ineffective, teamwork is reduced or absent [25,26,27,28]. Lack of teamwork between healthcare professionals can result in treatment delays, limit mutual understanding, and information sharing [3]. Given these challenges, it is clear that the concept of effective IPC is not well-understood, leading to its underutilization. Therefore, there is a need to analyze the concept of effective IPC for PS in LRS.

This study analyzes the concept of IPC for patient safety in clinical settings using Walker and Avant’s [29] concept analysis framework. Specifically, the analysis defines effective IPC, clarifies its key attributes, identifies antecedents that influence effective IPC, determines the consequences of effective IPC in clinical practice, and explores empirical referents that provide measurable indicators of effective IPC. By conducting this concept analysis, we aim to contribute to a better understanding of its role in patient safety, particularly in low-resource settings such as Malawi.

The findings of this study will provide a clear understanding of effective IPC, offering practical insights for healthcare professionals, educators, and policymakers to enhance its implementation and reduce patient harm in clinical environments.

2. Materials and Methods

2.1. Design

The Walker and Avant’s [29] eight-step framework was used to analyze the concept of effective IPC because it is a well-established method for clarifying complex and ambiguous healthcare concepts. It systematically identifies defining attributes, antecedents, and consequences, supporting our aim to conceptualize ‘effective interprofessional communication’ in low-resource settings. This framework builds on Wilson’s techniques [30]. Each of the eight steps, concept selection, purpose determination, usage identification, attribute definition, model case construction, related/borderline/contrary cases, antecedent/consequence identification, and empirical referent specification, has been briefly described for clarity. A deductive content analysis approach was used to identify and synthesize defining attributes of effective IPC by comparing items one by one. Similar data were grouped through repeated terms and keyword clustering until saturation was reached. The meanings of concepts were validated using the Oxford, Cambridge, and Collins English Dictionaries [31,32,33]. Subsequently, model, related, borderline, and contrary cases were constructed. Finally, antecedents and consequences were identified, and empirical referents were defined.

2.2. Literature Search

The search began by defining the questions and aims of IPC. A comprehensive literature search was conducted in PubMed, Scopus, CINAHL, and Embase, using combinations of keywords such as ‘interprofessional communication,’ ‘patient safety,’ ‘standardized communication,’ ‘low-resource settings,’ and ‘medical errors.’ Boolean operators (AND, OR, NOT) were used to refine the search. We selected 2014 as the start date because key WHO patient safety policies were released that year, influencing IPC research globally. The search was concluded in May 2025; thus, only studies published up to this point were included (not the entire year). The evidence base for the concept analysis was strengthened by searching and reviewing grey literature, such as standards, guidelines, academic papers, government reports, factsheets, and research reports. This information was gathered using Google/Google Scholar from organization websites or relevant site search functions. The selection process adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, as shown in Figure 1.

2.3. Inclusion and Exclusion Criteria

The initial search resulted in 337 articles (see Figure 1). Following the initial search, duplicate records (n = 7) were removed. Studies were excluded for the following reasons: not addressing interprofessional communication (n = 156), not focused on clinical settings (n = 78), not in English (n = 7), lack of full text (n = 64), and publication outside the inclusion timeframe (n = 1). As a result, 24 articles that met the inclusion criteria were retained and are included in the concept analysis. Additionally, we introduced a basic quality appraisal step, assessing included studies for clarity of objectives, methodological rigor, and relevance to IPC.

3. Results

3.1. Defining the Concept of Effective Interprofessional Communication and Related Definitions

Effective interprofessional communication comprises three words. The Oxford English Dictionary [31] describes ‘effective’ as success in producing a desired or intended result. ‘Interprofessional’ implies trained workers with expertise in different fields, in this case, within healthcare settings. Mueller [35] defined ‘interprofessional’ as interactions between various professions that comprise healthcare professionals from diverse disciplines, including nurses, doctors, pharmacists, laboratory technologists, radiology technologists, physiotherapists, and dietitians. The word ‘communication’ originates from the Latin word ‘communis,’ which means ‘sharing.’ Communication involves more than just speaking, conversing, or rambling aimlessly. The Oxford English Dictionary [31] defines communication as the imparting, conveying, or exchanging of ideas, knowledge, and information.

3.2. Illustration of Defining Attributes, Antecedents, and Consequences

To synthesize the findings from the literature and clearly illustrate how the defining attributes, antecedents, and consequences of effective IPC interrelate between developed and low-resource settings, a summary of selected key studies is provided in

Table 1. Attributes, Antecedents, and Consequences.

No.	Authors & Year	Country	Study Title	Attributes	Antecedents	Consequences
1.	Alhur et al. (2024) [1]	Saudi Arabia	Enhancing Patient Safety Through Effective Interprofessional Communication: A Focus on Medication Error Prevention	The accuracy of information exchanged is vital.	Standardized communication protocols and interprofessional meetings have improved healthcare discussions. Targeted training programs focus on skill development, while technology boosts communication effectiveness.	Structured communication platforms can significantly reduce medication errors in hospitals. Workload and time constraints often compromise care quality.
2.	Atinga et al. (2024) [36]	Ghana	“It’s the patient that suffers from poor communication”: Analyzing communication gaps and associated consequences in handover events from nurses’ experiences	Incomplete documentation and substandard record-keeping practices were found to delay care	Work ethics, lack of exposure to training on clinical communication skills, absence of formal handover procedures, and environmental hygiene affect communication during clinical shift changes.	Unwanted and unproductive distractions can dramatically increase the risk of medical errors (diagnostic and treatment errors), complications, and extended hospitalizations.
3.	Aveling et al. (2015) [9]	Two East African countries (At the request of study participants, the countries are not named)	Why is patient safety so hard in low-income countries? A qualitative study of healthcare workers’ views in two African hospitals	Although staff felt there was cooperation within professions, weak communication and coordination between professions, teams was frequently described.	Inadequate training and limited opportunities, a Shortage of material resources, cause poor patient care	Lack of materials (including low staffing levels and perceived deficits in the competences of staff) and equipment affected patient safety due to High turnover of staff, associated with staff dissatisfaction,
4.	Bender et al. (2022) [37]	United States of America	Improving interprofessional communication: Conceptualizing, operationalizing, and testing a healthcare improvisation communication workshop	The healthcare improvisation communication workshop, focusing on presence, acceptance, and trust, offers a framework for effective interprofessional communication and collaboration.	The study found that training helps in achieving learning gains and behavior change in interdisciplinary communication and collaboration	When staff receive training, it ensures the delivery of high-quality, patient-centered care.
5.	Blakeney et al. (2024) [18]	United States of America	A scoping review of new implementations of interprofessional bedside rounding models to improve teamwork, care, and outcomes in hospitals	Consistency, Information sharing and collaboration are attributes of effective bedside rounds	Positive teamwork among health professionals can improve patient outcomes	Several articles linked better communication between interprofessional teams and patients or families during rounds to improved patient outcomes.
6.	Brito et al. (2022) [38]	Brazil	Effective communication strategies among health professionals in Neonatology: An integrative review	Communication failures include excessive or reduced information, limited questions, inconsistent or erroneous information, lack of standardization, illegible records, and interruptions.	Care team integration, information verification, computerized systems, systematic handoffs, multidisciplinary rounds, sector transitions, and regular team meetings lead to effective communication	Adoption of the SBAR tool is associated with an improvement in communication among the professionals and in the quality and safety of patient care in Neonatology
7.	Campbell et al. (2018) [39]	United Kingdom	A scoping review of evidence relating to communication failures that lead to patient harm	Timeliness, legibility, content, layout, and ambiguity in hospital letters were believed to increase the risk of prescribing errors in communication between primary and secondary care.	Shared patient care planning and decision-making helped to ensure collective ownership of the patient, bringing members of each team together. In some cases, intensivists assumed ownership and responsibility without further consultation.	The majority of studies in this category were judged to have resulted in severe patient harm, with one study linking communication failures to death
8.	Dietl et al. (2023) [3]	Germany	Interdisciplinary and interprofessional communication intervention: How psychological safety fosters communication and increases patient safety	The study highlighted teamwork as an important aspect of achieving patient safety	Interpersonal and interprofessional training is the foundation of interprofessional communication and collaboration in the context of patient safety	Perceived patient safety risks decreased post-training
9.	Etherington et al. (2019) [40]	Canada	Interprofessional communication in the operating room: a narrative review to advance research and practice	Open communication and teamwork are attributes of interprofessional communication in the operating room.	Structured and standardized communication increases accuracy and understanding between team members. Institutional culture and information sharing by team members are vital for establishing a common understanding of the situation, treatment plan, and individual roles.	A flat hierarchy in institutional culture promotes open communication among team members, improving patient safety. Preoperative briefings with checklists enhance teamwork, identify hazards, and reduce surgical complications.
10.	Huener et al. (2023) [41]	Germany	Reducing preventable adverse events in obstetrics by improving interprofessional communication skills—Results of an intervention study	Problems in administering treatment in time and failure to provide complete information hinder IPC (Timeliness and completeness)	Integration of communication tools into interprofessional training alongside medical emergency training in obstetrics.	Communication training improves patient safety and increases patient satisfaction
11.	Jepkosgei et al. (2022) [42]	Kenya	Understanding intra- and interprofessional team and teamwork processes by exploring facility-based neonatal care in Kenyan hospitals	Openness of communication and a supportive co-existence environment foster effective and timely communication.	Local leadership practices, such as training, coaching, and a positive culture, are essential for enhancing cognitive and behavioral skills, fostering positive team relationships, and effective teamwork.	Professional hierarchies lead to delays in patient care and consequently the persistence of professionals’ silos. Findings suggest that local leadership practices promote shared decision making, coordination of tasks, and building trust.
12.	Manias et al. (2021) [43]	Australia	Interprofessional and Intraprofessional Communication about Older People’s Medications across Transitions of Care	Discharge summaries and accountability transfers to community doctors lacked clarity, and pharmacists were often not updated on changing plans, despite their key role in managing medications during transitions. (lack of clarity, unreliable and incomplete information sharing)	clear processes for disseminating discharge summaries to community doctors, accountability to close the loop with medication management and greater levels of interactions between different health professional disciplines across settings	Medication safety was compromised during care transitions due to unclear discharge information processes and accountability transfer to community doctors.
13.	Mistri et al. (2023) [44]	India	Enhancing patient safety culture in hospitals	Clear, open, and concise communication is necessary to ensure accurate transfer of information between HCPs	Positive organizational culture (Strong and supportive leadership, staff training, and teamwork	Patient safety culture improves health outcomes, encourages incident reporting, builds trust and confidence, and reduces costs.
14.	Mueller et al. (2019) [35]	USA	Principles of Pediatric Patient Safety: Reducing Harm Due to Medical Care (policy statement)		Training of new clinicians and integrating patient safety into ongoing medical education helps the future workforce incorporate all tenets of pediatric patient safety as part of everyday work life.
15.	Mueller et al. (2021) [45]	South Africa	Preparing graduates for interprofessional practice		undergraduate training is an integral part of patient care and clinical education
16.	Nyoni et al. (2021) [17]	South Africa	Towards Continuing Interprofessional Education: Interaction patterns of health professionals in a resource-limited setting	Working collaboratively	A shared interaction and documentation process that is driven by a common language.	Collaboration of health professionals within the workplace has been linked to improved patient care, patient outcomes, and improved healthcare worker satisfaction
17.	Olino et al. (2019) [46]	Brazil	Effective communication for patient safety: transfer note and Modified Early Warning Score	Using the protocol enhances timely admission to the ICU	Development of a structured vital sign protocol, staff training on utilization of the tool	Increased adherence to MEWS is linked to improved patient safety and reduced neonatal mortality in hospitals
18.	Pittalis et al. (2021) [23]	Malawi	Using Network and Complexity Theories to Understand the Functionality of Referral Systems for Surgical Patients in Resource-Limited Settings: The Case of Malawi	Collaboration between and a shared objective of care are important in determining the referral network’s overall performance	System functionality impacts the quality, efficiency, and safety of patient referral-related care. (Availability of protocols and standards to guide referrals
19.	Pornrattanakavee et al. (2022) [47]	Thailand	Impact of interprofessional collaborative practice in palliative care on outcomes for advanced cancer inpatients in a resource-limited setting	Working collaboratively	Co-working and communication between specialist palliative care nurses and medical oncologists are considered key factors for effective interprofessional collaboration in resource-limited settings.	Improved quality of life and significantly reduced readmission rate at 7 days after hospital discharge.
20.	Raymond & Harrison (2014) [25]	South Africa	The structured communication tool SBAR (Situation, Background, Assessment, and Recommendation) improves communication in neonatology	The use of SBAR enhanced the timeliness and promptness of patient care and senior review. Clarity of instruction resulted from using SBAR	Healthcare worker training in interprofessional communication is important for patient safety	Implementing SBAR enhances communication among professionals and positively impacts perceptions of patient care quality and safety.
21.	Rickard et al. (2022) [48]	Gambia	Clinical handover communication at maternity shift changes and women’s safety in Banjul, the Gambia: a mixed-methods study	Many participants complained that “incomplete notes” coupled with “illegible handwriting” could lead to information lapses regarding patient care.	Absence of standardized guidelines, training, poor organizational culture, and individual factors (challenges with transportation) affect multidisciplinary handover communication	Communication failures had resulted in the omission or duplication of treatments, potentially causing patient harm.
22.	Stewart and Snowden (2021) [49]	Georgia	Promoting Communication and Safety Through Clear and Concise Discharge Orders	Recent improvements in assessment support the idea that clear and concise directives enhance communication.		This project indicates that admission nurse satisfaction and reaction to the tool were affected positively by the addition of the DO to the discharge process.
23.	Tiwary et al. (2021) [6]	Nepal	Poor communication by health care professionals may lead to life-threatening complications: examples from two case reports	Clear communication is essential for the proper treatment of patients, especially in countries with high rates of illiteracy	Effective communication training for healthcare professionals, including pharmacists, is essential.	Poor communication can lead to life-threatening complications in patients.
24.	Toumi et al. (2024) [50]	Tunisia	The SBAR tool for communication and patient safety in gynecology and obstetrics: a Tunisian pilot study	Positive evaluations concerning clarity, relevance of communication, and time spent on the call underscore the potential effectiveness of structured clinical communication.	Education and training of students and health professionals are vital to ensure good quality standardized communication.	Health workers’ awareness of WHO-recommended structured communication tools like SBAR improved communication, staff satisfaction, and patient safety in the Tunisian healthcare setting.

. Articles were selected based on their relevance to the concept. Studies conducted in developed countries such as Australia, the United Kingdom (UK), the United States of America (USA), Canada, and Germany were chosen as benchmarks for effective interprofessional communication. On the other hand, studies from low-resource settings, such as Africa, were also included. The objective was to conduct a critical analysis of the factors influencing both the similarities and discrepancies in concept awareness and utilization.

Table 1 synthesizes evidence from both conceptual and empirical literature, illustrating the presence of particular effective IPC attributes. A thorough analysis of the literature review conducted helped to identify attributes from recurring characteristics, features, or properties that defined the concept. Additionally, antecedents and consequences have been identified. Walker and Avant’s model of concept analysis was employed, ultimately leading to the definition of the concept.

3.3. Defining Attributes of the Concept

Defining attributes are the core characteristics that distinguish a concept from similar ones [31]. Through an extensive review of the literature, eight defining attributes of effective interprofessional communication were identified. These include (1) clarity, (2) completeness, (3) accuracy, (4) timeliness, (5) consistency, (6) openness, (7) collaboration, and (8) information sharing. Each attribute plays a critical role in ensuring safe and effective IPC.

3.3.1. Clarity

Refers to the ability to communicate messages in a way that is easily understood, thereby reducing ambiguity and misinterpretation [31]. In healthcare, clear communication has been associated with accurate transfer of information [45], instructions [25], test results, and treatment plans [39,50]. A study by Stewart and Snowden reveals that clear discharge information improves communication and safety [49]. Research by Toumi et al. [50] and Raymond and Harrison [25] further indicates that clarity of communication is enhanced through the use of structured communication tools, facilitating more effective information exchange. On the other hand, a study by Manias et al. [43] found that unclear discharge summaries and accountability transfer to community doctors compromised medication safety in older people.

Legibility of records can affect communication among HCPs and patient safety. For instance, a study by Rickard et al. [48] on clinical handover communication at maternity shift changes and women’s safety identified handwriting as one of the information lapses between HCPs. Similarly, Brito et al. [38] in their study on effective communication strategies among health professionals in Neonatology identify illegible records as one of the communication failures among HCPs.

3.3.2. Completeness

Ensures that a message includes all the necessary details required for accurate understanding and decision-making. Rickard et al. [48] and Stewart and Snowden [49] report that omitting key information about a patient during handover can lead to an AE and healthcare professional dissatisfaction. Furthermore, a study by Atinga et al. [36] reveal that incomplete documentation and substandard record-keeping practices are linked to delayed care. This information can be omitted through verbal or written orders [51]. The absence of a structured framework to communicate information, such as handovers, leads to information gaps [12,25,50,52]. For instance, a study by Rickard et al. reveals that absence of standardized communication can result in omission or duplication of treatment, resulting in potential patient harm [48].

3.3.3. Accuracy

Refers to the correctness and precision of communicated information [32]. Inaccurate communication is a leading cause of preventable medical errors [1,39,44]. For instance, a study by Alhur et al. [1] on enhancing patient safety through effective interprofessional communication suggests utilizing structured communication protocols to enhance accurate transfer of information. Similarly, Mistri et al. [44] reports that accurate transfer of information through clear and open communication improves patient outcomes. Alhur [1] reports that inaccurate and erroneous documentation of drugs like insulin can result in hypoglycemia and an emergency admission attributed to poor handwriting or misinterpretation. Findings further reveal that utilizing technology boosts the accuracy of communication. Evidence reveals that implementing electronic prescription systems has been shown to reduce medication errors by up to 50% [53].

3.3.4. Timeliness

Refers to delivering information at the right moment to facilitate immediate and appropriate action [31]. A study by Campbell et al. [39] on evidence relating to communication failures that lead to patient harm states that timeliness, among other factors, is believed to increase prescription errors in communication between primary and secondary care. Similarly, a study by Raymond and Harris [25] suggests using structured communication tools, such as SBAR, to enhance the timeliness and promptness of patient care. This can be achieved by only communicating critical and relevant information. Furthermore, an intervention study by Huener et al. on reducing preventable adverse events in obstetrics suggests that effective IPC is hindered by failure to administer treatment in time [41]. For instance, delayed communication of critical laboratory results, such as sepsis markers, can lead to delayed antibiotic administration and increased patient mortality rates [25].

Similarly, research findings by Olino et al. indicate that using standardized protocols such as MEWS enhances timely admission to the ICU, thereby reducing neonatal mortality [46]. Implementing automated alerts for abnormal laboratory results facilitates a timely clinical response, thereby enhancing patient survival rates.

3.3.5. Consistency

Refers to conveying the same message across different communication channels to ensure a uniform understanding [31]. For instance, a scoping review of new implementations of interprofessional bedside rounding models by Blakeny et al. [18] identified consistency as one of the attributes of better communication. When conflicting preoperative instructions are given regarding the patient’s status, complications such as bleeding during surgery can occur [18]. Employing standardized documentation templates and protocols guarantees consistent messaging across care teams [18].

3.3.6. Openness

Occurs when healthcare professionals feel safe admitting mistakes, reporting concerns, and relying on one another’s expertise [40,42,54]. A study by Etherington [40] revealed that a flat hierarchy in institutional culture promotes open communication among team members, improving patient safety. A study by Mistri et al. [44] supports these findings which reports that openness in communication among team members encourages incident reporting [55], builds trust, and confidence. Similarly, a study by Jepkosgei et al. [42] on neonatal care in Kenyan hospitals found that open communication and a supportive environment promote effective and timely teamwork. When communication is open in an organization, junior workers freely question their seniors’ decisions if they suspect an error [40,42,56]. Promoting psychological safety in teams encourages healthcare workers to speak up without fear of retribution and improves patient outcomes [57]

3.3.7. Collaboration

Refers to healthcare professionals working together across disciplines to achieve shared goals [53]. Collaboration within the workplace has been linked to improved patient care, patient outcomes, and improved healthcare professional satisfaction [17,23]. Challenges in language among HCPs can hinder collaboration. Research on interprofessional education reveals that a common language drives collaboration [17]. Additionally, findings of a study by Pornrattanakavee et al. [47] further indicate that collaboration between specialist palliative nurses and medical oncologists reduced readmission rates in low-resource settings. Similarly, lack of collaboration among HCPs can lead to unnoticed drug interactions or other AEs in patients on multiple medications. On the other hand, multidisciplinary rounds and case discussions enhance effective IPC and improve clinical outcomes [17,48].

3.3.8. Information Sharing

A study by Olino et al. [46] emphasizes sharing allergy history during patient care. Failure to do so can lead to serious complications, such as anaphylactic shock. It further indicates that interoperable electronic health records ensure a seamless exchange of information across care settings [47].

3.4. Construction of Model, Borderline, Relative, and Contrary Cases

As part of Walker and Avant’s concept analysis approach, constructing model, borderline, related, and contrary cases helps illustrate the defining attributes of effective interprofessional communication [29]. These cases clarify the boundaries of the concept, making it easier to distinguish effective interprofessional communication from other forms of communication in clinical settings. Additionally, they are designed to show how the concept will be applied in clinical practice. All cases are based on the author’s clinical experience in Malawi. While many conceptual elements originate from Western studies, they were critically examined and adapted for applicability in African low-resource healthcare settings. We now discuss this limitation explicitly in Section 3 and emphasize the importance of future validation and local adaptation of these concepts.

3.4.1. Model Case

A model case is a real-life example that demonstrates all defining attributes of the concept under analysis [29]. In this scenario, Dr. P, a senior obstetrician, conducted an emergency cesarean section for a patient referred from a community hospital because of obstructed labor. The wound became infected, prompting Dr. P to order a wound culture and a sensitivity test. The laboratory technician promptly performed the test and communicated the results via phone and electronic health record system to Dr. P. The results indicated resistance to first-line antibiotics but susceptibility to a specific alternative drug. Upon receiving timely and accurate results, Dr. P contacted the pharmacist, who informed him that the required antibiotic was out of stock in the hospital pharmacy. The pharmacist escalated the issue to the Drug and Therapeutics Committee, which coordinated procurement from an external supplier within 24 h. Meanwhile, the dietitian provided nutritional support, and the physiotherapist collaborated to ensure early ambulation for patient recovery. After four weeks of multidisciplinary care, the patient made a full recovery and was discharged safely.

Analysis

This case illustrates all eight defining attributes of effective interprofessional communication: clarity, completeness, accuracy, timeliness, consistency, openness, collaboration, and information sharing. Furthermore, it indicates that effective IPC can be achieved despite the numerous challenges faced in low-resource settings. The healthcare team worked together, communicated clearly and promptly, shared essential patient data, and acted promptly to ensure positive patient outcomes.

3.4.2. Borderline Case

A borderline case is closely related to the concept but lacks some key attributes, making it distinguishable from the model case [29]. In this scenario, Miss H, a 15-year-old girl with valvular heart disease, attended a routine cardiology clinic visit where she was scheduled to receive prophylactic benzathine penicillin to prevent recurrence of rheumatic fever. Nurse M administered the injections following the standard protocol. However, shortly thereafter, the patient collapsed and went into cardiac arrest. The nurse immediately called for help, and a multidisciplinary team worked together to resuscitate the patient. Unfortunately, resuscitation was unsuccessful, and the patient died after 30 min. Following the event, the nurse manager requested an incident report, but Nurse M provided only a brief and unclear description out of fear of repercussions. This incident was not formally investigated, and no safety debriefing was conducted for staff learning.

Analysis

Although this case demonstrates some attributes of interprofessional communication, such as timeliness, collaboration, and openness during resuscitation, it lacks clarity, completeness, and consistency in post-event communication. Failure to provide a comprehensive incident report and a lack of psychological safety hindered efforts to improve patient safety and learn from the event [44]. In the model case, information was fully documented and appropriately shared and escalated. In contrast, the borderline case suffered from incomplete documentation and a lack of follow-up communication, creating a gap in patient safety. Challenges such as a lack of awareness about patient safety, lack of materials (including low staffing levels and perceived deficits in competencies, common in low-resource settings, may have contributed [9,23,44].

3.4.3. Contrary Case

A contrary case does not exhibit any defining attributes of the concept [29]. This case serves as an example of ineffective IPC and its consequences on patient safety. In this scenario, Nurse G worked in the emergency ward when Mrs. O, a 60-year-old patient, experienced respiratory distress due to an asthma attack. Nurse G mistakenly administered the wrong medication, confusing Salbutamol with a similar-looking vial containing a beta blocker. Within minutes, Mrs. O’s condition worsened, leading to severe bradycardia and cardiac arrest. Nurse T, who was nearby, noticed the error but did not report it, fearing repercussions. The team failed to communicate the incident to the attending physician, who later ordered another dose of the same incorrect medication, further worsening the patient’s condition. Mrs. O eventually died, and the incident was not documented or disclosed to hospital management.

Analysis

This case demonstrated ineffective IPC, as it lacked clarity, accuracy, openness, collaboration, and accountability. Failure to communicate medication errors resulted in a preventable death. Additionally, the absence of incident reporting prevents future learning and quality improvements. Failure to establish psychological safety actively deters staff from reporting errors, significantly heightening the risk of harm to patients. Without information sharing, errors remain undetected, leading to repeated mistakes. A dysfunctional healthcare system (absence of policies, structures, communication tools, and lack of training) affects the quality, efficiency, and safety of patient referrals in low-resource settings [23].

3.4.4. A Related Case

A related case has some similarities to interprofessional communication, but does not fully align with the concept [29]. In this scenario, a surgeon must obtain informed consent from a patient scheduled for elective knee replacement surgery. The surgeon took the time to explain the procedure, its benefits, risks, and expected outcomes. The patient was allowed to ask questions, and the doctor addressed all concerns clearly and thoroughly. After understanding the risks and benefits, the patient signed a consent form.

Analysis

Although this case involves effective communication, it is not an example of effective IPC. Effective IPC involves multiple healthcare professionals working together, whereas this case focuses solely on provider–patient communication. Informed consent is a legal and ethical communication process and not an interprofessional safety intervention. Implementation of structured communication platforms has been shown to markedly decrease the incidence of medical errors and reduce both time and workload, even in developed countries [48]. This framework highlights the need for applying effective communication in low-resource clinical settings to improve patient safety and operational efficiency.

3.5. Antecedents of Effective Interprofessional Communication

Antecedents refer to events or conditions that must be in place before the concept can occur [29]. Effective IPC does not occur in isolation; it requires a set of enabling factors that create conditions for safe, structured, and collaborative communication in healthcare settings. The following were identified as antecedents of effective IPC

3.5.1. A Strong Leadership Commitment

The role of leadership in strengthening interprofessional communication is well supported in the literature. Leadership commitment fosters a culture of safety in which open communication is encouraged [44]. Without the active involvement of hospital administrators and clinical leaders, healthcare teams struggle to implement standardized communication frameworks and reporting systems [42]. A culture of safety must be championed by healthcare leaders and administrators, who set expectations for open and transparent communication. In high-performing hospitals, leaders encourage daily safety huddles, ensuring that safety concerns are openly discussed without fear of punishment [58]. Communication protocols may not be standardized without leadership buy-in, which can lead to fragmented and unsafe patient care [46].

3.5.2. Positive Teamwork Among Health Professionals

Healthcare teams must actively engage in collaborative decision-making, communication training, and incident reporting [17,42]. Limited participation in safety initiatives fosters communication silos, leading to independent departmental operations. In low-resource settings, such as Malawi, staff shortages and increased workload further impede effective teamwork [59].

3.5.3. Mutual Trust

Mutual trust is necessary for effective IPC. For instance, studies by Arteaga et al. [27] and Dietl et al. [3] indicate that a psychologically safe environment enables healthcare professionals to express concerns, mistakes, or safety risks without fear of retaliation. Evidence suggests that organizations with “just culture” policies encourage healthcare workers to report near misses, leading to improved communication [2,3]. In settings where fear of blame dominates, critical safety concerns remain unreported, leading to repeated errors and adverse patient outcomes.

3.5.4. Education and Training

Regular training and education on effective IPC is important for patient safety. Over 40% of reviewed literature emphasizes that when healthcare professionals are familiar with IPC principles, the rate of medical errors decreases [3,6,9,21,36,38,45,49,51]. Mueller and Couper [45] further suggest graduate contextual clinical training. The aim is to gain an understanding of realities on the ground. Without training, staff members may not be familiar with standard communication frameworks. increasing the risk of miscommunication and medical errors. Although most countries in low-resource settings lack these interdisciplinary trainings, it is possible to enhance IPC by incorporating structured communication tools into the curriculum [37,41,45].

3.6. The Consequences of Effective Interprofessional Communication

Consequences are the outcomes or effects resulting from the presence of a concept [29]. Identifying these components clarifies the factors that influence effective IPC and their impact on patient safety. Enhanced patient safety and a reduction in medical errors were some of the consequences of effective IPC [1,3,25,39,40,44,48]. Others included positive patient outcomes [18], increased confidence in clinical decision-making [41,42], improved coordination, trust, and teamwork [17,23,42,44,60], and staff and client satisfaction [17,41,49,50]. Conversely, the absence of standardized communication protocols, inadequate training, governance issues, distractions, and staffing shortages has led to increased readmission rates, prolonged hospital stays, patient harm, higher mortality, and greater staff turnover due to dissatisfaction [9,36,39,48]. Unfortunately, these consequences were more prevalent in low-resource settings.

3.7. Operational Definition of Effective Interprofessional Communication

In this article, effective interprofessional communication (IPC) is defined as ‘Consistent sharing of verbal (in person or via phone) or written information by healthcare professionals about patient transfers, discharges, critical results, and handovers that is clear, complete, timely and accurate using available resources to enhance patient safety, improve working relationships, confidence in decision-making, and patient and staff satisfaction’.

4. Discussion

This article aimed to explore the concept of effective interprofessional communication in low-resource settings. The key attributes identified for effective interprofessional communication (IPC) included clarity, accuracy, completeness, timeliness, consistency, openness, collaboration, and information sharing. While some literature addressed definitions of interprofessional communication, the majority of the discussion centered on students within academic institutions [36,42,52]. Furthermore, various studies have focused on the efficacy of intraprofessional communication. The results indicated notable similarities and differences in the conceptualization of interprofessional communication across diverse resource settings.

Research on effective interprofessional communication is limited. Nevertheless, some of the analyzed studies managed to define the concept using fewer terms. For instance, Mueller et al. [35] define “interprofessional” as interactions among healthcare professionals such as nurses, doctors, and pharmacists. Olino et al. [46] define “effective communication” as the complete and accurate exchange of information between health professionals, requiring confirmation from the sender. Additionally, Manias et al. [43] define “interprofessional communication” as the sharing of information and perspectives among healthcare professionals from various disciplines, which is crucial for patient safety and minimizing medication errors. Our study defines effective interprofessional communication as ‘Consistent sharing of verbal (in person or via phone) or written information by healthcare professionals about patient transfers, discharges, critical results, and handovers that is clear, complete, timely, and accurate using available resources to enhance patient safety, improve working relationships, confidence in decision-making, and patient and staff satisfaction’.

For a clear understanding of the concept, the analysis further highlighted the linkage between effective IPC and patient safety in low-resource settings. More than 70% of adverse events in healthcare stem from communication failures, especially during critical patient handovers. Our findings indicate that communication failures include missing, excess, unreliable, and inconsistent information. These findings reinforce the conclusions of Pittalis et al. [23], who also observed that inconsistent and incomplete communication during emergencies and patient transfers frequently leads to AE in LRS. The Joint Commission’s report highlights that missing critical patient information during handovers can lead to medical errors like treatment delays, incorrect medication administration, and inappropriate care [3,40].

Furthermore, our findings demonstrated that a lack of materials (including low staffing levels and perceived deficits in staff competencies) and equipment are linked to ineffective IPC for patient safety in LRS. A shortage of staff can harm effective IPC. This analysis revealed that insufficient staffing levels during specific shifts have been linked to an increased risk of errors and reduced quality of care [9,17,23]. In low-resource clinical settings like Malawi, high workloads and a lack of supervisory oversight during night and weekend shifts are equally common. Attending to large patient numbers in addition to combining clinical and non-clinical responsibilities, such as feeding and maintaining personal hygiene of patients, causes distress among healthcare professionals [50]. This scenario can result in inadequate information processing capabilities.

In low-resource settings, missing data is common during communication among professionals. This analysis indicated that the communication gap stems from a lack of awareness, the absence of standardized written guidelines, weak governance structures, and distractions in low-resource settings. Literature further highlighted disturbances, such as phone calls or those from family members. This is common in Malawi, where social media such as WhatsApp is used to communicate patient transfers, critical information, and referrals [23]. Challenges arise because, apart from Anti-Retroviral therapy services, electronic medical records have not been implemented in all areas of the facilities. This can compromise patient safety.

A connection exists between communication failures and environmental factors, particularly unpleasant odors in low-resource settings [50]. Distractions caused by an unhygienic and uncomfortable environment during afternoons and night shifts negatively impact the quality of communication among staff [50]. Discomfort and difficulty engaging in handover sessions can arise from unpleasant smells. These findings underscore the significant role that supervisors play in reinforcing adherence to safety practices during communication processes [45]. Their consistent involvement, clear communication, and commitment to safety practices are vital for fostering a positive safety culture and improving outcomes [20].

While staff skills, infrastructure, and resources are crucial, the challenge lies in effectively implementing an IPC concept in LRS. The analyzed data from high-resource settings revealed that implementing standardized communication strategies commenced years ago [3,37,49]. Additionally, advancements in using technology like electronic medical records have enhanced timely intervention [1]. The results of this analysis agree with other research that implementing effective IPC can succeed even with limited resources [23]. Learning how to use them efficiently is what matters. Evidence-based measures—such as integrating IPC into training, implanting SBAR protocols [61], applying safety barriers, and providing TeamSTEPPS training can reduce communication risks and prevent adverse events [10,33,35,36,37,38]. Integrating effective IPC practices into preservice education and ongoing training is crucial, as current methods do not sufficiently address these principles

A flat hierarchy in institutional culture can promote open communication among team members and improve patient safety [40]. Aligned with previous evidence [35,41], our findings indicate that fear of speaking up and underreporting of communication errors are major barriers to effective IPC in LRS. Developing a framework that promotes psychological safety and clear reporting mechanisms is essential to overcoming these barriers.

Evidence further revealed that with teamwork, healthcare professionals understand and respect each other’s roles, operate in a collaborative work culture, and can easily resolve interprofessional conflicts. Teams can actively listen and validate each other’s perspectives while working toward common goals. This collaboration prevents misunderstandings and ensures coordinated care for patients. This analysis revealed that strong interprofessional communication leads to higher job satisfaction and lower burnout. Hospitals with poor IPC experience higher turnover rates due to conflict, stress, and ineffective collaboration [18]. Further investigation is needed to evaluate the applicability of this concept in low-resource settings to achieve similar outcomes to those in developed countries.

4.1. Empirical Referents

Empirical referents are measurable indicators that determine the presence or absence of a concept in a real-world context [27]. Measuring the occurrence of the concept requires a comprehensive review and analysis of the existing literature. This analysis revealed that effective interprofessional communication practices are measured by elements such as clarity [1,6,25,45], completeness [36,48,49], accuracy [1,40,45,62], timeliness [27,40,62], consistency [18], openness [40,42,45], collaboration [23,47,48,53,57,61], and information sharing [23,47]. These components can be assessed across various settings. Ultimately, the presence of these indicators should lead to improved patient safety, a reduction in medical errors [1,3,25,40,41,45,49], enhanced decision-making among professionals [40,41], improved coordination and teamwork [3,17,23,44,45] and greater overall satisfaction [17,42,50,51].

4.2. Limitations

The Walker and Avant method provides a systematic approach to concept analysis; however, it relies on a subjective interpretation of defining attributes, antecedents, and consequences. Variability in the literature selection and researcher bias may have influenced the analysis. Additionally, this study relied on secondary literature and did not directly measure IPC effectiveness in clinical practice. Empirical studies, such as observational research and qualitative interviews, are needed to evaluate real-world effective IPC practices and identify gaps between theory and practice.

5. Conclusions

This concept analysis defines effective interprofessional communication (IPC) as the consistent sharing of clear, complete, timely, and accurate verbal or written information among healthcare professionals regarding patient transfers, discharges, critical results, and handovers. Effective IPC is essential for patient safety, clinical decision-making, and fostering collaboration. On the other hand, ineffective IPC can lead to preventable adverse events and decreased satisfaction for both patients and healthcare workers. In low-resource settings, the lack of effective IPC is often due to inadequate communication protocols, limited training, and a poor organizational culture. Future research should focus on adapting IPC practices for resource-limited environments, incorporating structured communication tools, and enhancing teamwork within training curricula.