Outcomes for critically ill patients improve when clinicians work together and communicate effectively as a team (1–3). Communication between clinicians is particularly important in the care of children with cancer, who are at higher risk of deterioration and subsequent mortality (2, 3). High-quality interdisciplinary communication has been linked to earlier recognition of adverse events and decreased mortality (4). Communication failures, however, often impact clinicians understanding of patient care plans (4), resulting in worse patient outcomes by delaying treatment and causing injury (5). Thus, enhancing interprofessional communication is important to improve patient outcomes and quality of care delivery (4, 6).

Barriers to teamwork and communication between clinicians include feeling disempowered to speak up, issues with hierarchy, and negative interpersonal communication (7). Few studies have addressed the quality of team communication, especially in resource-diverse settings. The CritCom tool, developed to fill this gap, is a new reliable and valid bilingual survey to assess the quality of interdisciplinary communication around patient deterioration for pediatric oncology patients (8). CritCom is an anonymous electronic provider survey that evaluates communication between clinicians across six domains: actionable, clarity, tone, collaboration and teamwork, leadership, and empowerment. CritCom was initially piloted at 42 hospitals in 22 countries among clinicians who care for children with cancer at risk of deterioration (9). For centers with three or more participants, a center-specific report was created to summarize responses and communicate results. This study explains the development of the report, which includes the initial drafting, review using focus groups, and revision of the report. This study also evaluated the clarity and usability of the CritCom center reports.

Recently, emphasis has been placed on creating dissemination efforts that are adaptable to local contexts, engaging stakeholders and encouraging continuing collaboration between researchers and participants (10). The use of reports can aid in quicker knowledge translation, closing the significant gap between research and practice (11). Further, reports must be developed in a clear manner, tailored to the stakeholder with clear and actionable messages (12). If research findings are not disseminated, then the research efforts themselves are largely considered a waste of effort and resources (13).

Timely report development, publication, and dissemination are important to quickly inform survey participants and hospital administration of the strengths and weaknesses of communication at their center, which can ultimately be used to implement policy focused on interprofessional communication in critical care settings, improving patient outcomes.

Focus groups consisted of 11 English-speaking participants from five countries and 12 Spanish-speaking participants from four countries; these were 57% physicians and 43% nurses with a primary work area in the ward (65%) and intensive care unit (ICU) (35%). Identified themes included experiences with communication in their setting, report interpretation, and recommendations for improvement ( Table 1 ).

Participants noted multiple examples of poor communication in their clinical settings: “Maybe with nurse and physicians is better, but don’t think the multidisciplinary team we don’t have the same language for everyone.” They also reported instances of good communication: “how we communicate with other people not only because it is a doctor, a nurse, or staff member. We have to go all on the side of good communication for us to have the results … well positive to be able to assist the patient.” Poor and good communication were noted to impact patient care: “Well, I consider that if we take a long time to report on the patient’s status, we also lengthen the patient’s treatment time.”

Overall, participants found the CritCom report to be clear, specific, and helpful to the strengths and weaknesses of communication between clinicians at their center. “It’s very well designed and the information is adequate, concrete and at the same time extensive within two to three pages with a lot of graphics.” Participants described the report scores and graphs easy to interpret. “We just have to improve in the few points that we failed and not drop points in those where we did well.” Participants also recognized the utility of the report to develop strategies to enhance communication within and between units: “What we must work on and where we can continue to apply the knowledge that we already have but only reinforce them and have greater empowerment which is where we scored the lowest.”

Additionally, participants offered several recommendations to improve the report, such as providing more information about participant demographics. Many also noted a need to include actionable steps: “It would also be good to add a box with recommendations from their experience that they elaborated this survey to improve that communication in at least the areas where the scores were the lowest.”

This study describes the evaluation of the CritCom report to promote understanding of study findings by centers participating in the CritCom assessment. Our findings demonstrate that participants found the report to be clear, usable, and useful to visualize and understand their results.

The time lag between research and implementing findings into practice is too long (10, 18). Further, the percentage of research results that are implemented into practice is low, at approximately 14% (13, 18). Dissemination of information is necessary to adopt research findings into clinical practice (13).

Adapting research findings through the creation of reports is helpful to minimize this time lag by quickly transferring information from the researchers back to the clinical setting. Clear, easy to read, and descriptive reports describing communication can help hospital administration and unit leaders pinpoint areas of strength and weakness that can be targeted for intervention. Feedback from this report illustrates that participants could use the report to take actionable steps to improve communication at their hospital.

Studies have found that simply publishing research findings is often ineffective in actually changing practice, and thus the gap remains between research and practice (11). Targeted dissemination efforts, such as the CritCom report, are useful methods of translating information back into the hands of clinicians.

This work represents an example of how research findings can be made available to participants to promote local quality improvement and actionable change. Clinicians, researchers, and administrators can utilize the CritCom report to interpret CritCom results and improve interdisciplinary communication and, subsequently, patient outcomes. For example, the report can inform center-specific trainings or other strategies to improve the areas of communication that scored low. Providing clear and contextually appropriate reports of research findings allows participants to use study results to advocate to their hospital administration for local change.

This study has several limitations. Only nurses and physicians were invited to participate; members of the interprofessional team (respiratory therapists, etc.) were not included, as these roles did not exist at all centers. Additionally, this study was limited to English- and Spanish-speaking participants. This limits the generalizability of our findings regarding CritCom report usability to other professions and languages; future work should include these groups.

In summary, participant feedback illustrates that the CritCom report successfully provided clear and relevant findings regarding communication quality at each center. Using dissemination methods such as a summary report is useful to provide participants timely and actionable research data to inform strategies to improve team communication in their setting.

The raw data supporting the conclusions of this article will be made available by the authors, without undue reservation.

Ethical review and approval were waived for this study due to determination of non-human subjects research as defined by the Common Rule at 45 CFR 46.102(I) and the Office for Human Research Protections (OHRP). It is under an exempt IRB from St. Jude Children’s Research Hospital. The written informed consent was waived by IRB from St. Jude Children’s Research Hospital.

LC: Writing – review & editing, Writing – original draft, Formal analysis, Data curation. JR: Writing – review & editing, Methodology, Funding acquisition, Data curation, Conceptualization. PW: Writing – review & editing, Formal analysis, Data curation. MP: Writing – review & editing, Project administration, Formal analysis, Data curation. KP: Writing – review & editing, Project administration, Conceptualization. DL: Writing – review & editing, Funding acquisition, Conceptualization. DG: Writing – review & editing, Methodology, Conceptualization. SM: Writing – review & editing, Supervision, Methodology, Funding acquisition, Conceptualization. AA: Writing – review & editing, Resources, Methodology, Investigation, Funding acquisition, Conceptualization.